Sinonasal pathophysiology and COVID-19 (multiple reviews)

Added September 15, 2020

What is this? Some patients with COVID-19 will develop upper respiratory tract symptoms, including disruption to their sense of smell or taste. There are several relevant systematic reviews and more details of these, including citations and links to the full reviews, below this summary of their findings.

What was found: Gengler et al. (2020) found that the sinonasal tract may be an important site for infection, and sinonasal viral shedding may be an important transmission mechanism. They also noted that loss of smell without nasal obstruction may be a highly specific indicator of COVID‐19.

Lehrich et al. (2020) found that approximately half of COVID-19 patients will have some disruption to their sense of smell or taste, but that sinonasal symptoms are less likely to appear in COVID-19 patients than those infected with other coronaviruses.

Krajewska et al. (2020) found that the most common ear, nose and throat (ENT) symptoms with COVID-19 infection were cough, sore throat, dyspnoea, rhinorrhoea, nasal congestion and dizziness. They also reported that ENT specialists were at increased risk of contracting COVID-19.

What are the reviews:

Citation: Gengler I, Wang JC, Speth MM, et al. Sinonasal pathophysiology of SARS‐CoV‐2 and COVID‐19: A systematic review of the current evidence. Laryngoscope Investigative Otolaryngology. 2020;5(3):354-9.

In this rapid review, the authors searched for studies that evaluated nasal and sinonasal pathophysiology in COVID-19 patients. They restricted their search to articles published in English or Chinese and did their most recent search on 30 March 2020. They included 19 studies, and identified an additional two studies, which are awaiting assessment.

Citation: Krajewska J, Krajewski W, Zub K, et al. COVID-19 in otolaryngologist practice: a review of current knowledge. European Archives of Oto-Rhino-Laryngology. 2020 Jul;277(7):1885-97.

In this rapid review, the authors searched for articles reporting clinical characteristics of COVID-19 in relation to ENT symptoms. They did not restrict their searches by date, type or language of publication and did the search before 18 April 2020. They included 50 studies, mostly conducted in China.

Citation: Lehrich BM, Goshtasbi K, Raad RA, et al. Aggregate Prevalence of Chemosensory and Sinonasal Dysfunction in SARS-CoV-2 and Related Coronaviruses. Otolaryngology–Head and Neck Surgery. 2020 May 19;163(1):156-61.

In this rapid review, the authors searched for studies assessing sinonasal symptoms and effects on taste and smell of COVID-19 and other coronaviruses. They searched up to 24 April 2020. They included 49 studies (total: 10,415 patients; with 28 of these studies (9263 patients) being specific to COVID-19.


Disclaimer: This summary has been written by staff and volunteers of Evidence Aid in order to make the content of the original document accessible to decision makers who are searching for the available evidence on the coronavirus (COVID-19) but may not have the time, initially, to read the original report in full. This summary is not intended as a substitute for the medical advice of physicians, other health workers, professional associations, guideline developers, or national governments and international agencies. If readers of this summary think that the evidence that is presented within it is relevant to their decision-making they should refer to the content and details of the original article, and the advice and guidelines offered by other sources of expertise, before making decisions. Evidence Aid cannot be held responsible for any decisions made about the coronavirus (COVID-19) on the basis of this summary alone.