Prevalence and Clinical Spectrum of Ear, Nose, and Throat Manifestations in Laboratory-Confirmed COVID-19 Cases

Abstract

Background: The COVID-19 pandemic has been associated with diverse clinical manifestations, with increasing recognition of ear, nose, and throat (ENT) symptoms as prominent features of the disease. While anosmia and ageusia have been widely reported, comprehensive data on the full spectrum of ENT manifestations in hospitalized patients, particularly in South Asian populations, remains limited. Objective: To determine the frequency and clinical characteristics of ear, nose, and throat manifestations in patients with confirmed COVID-19 infection. Methodology: This hospital-based cross-sectional study was conducted at Bolan Medical College & hospital, Quetta, from March 2021 to March 2022 and enrolled 240 patients with RT-PCR-confirmed SARS-CoV-2 infection. All participants underwent structured clinical interviews to document ENT and systemic symptoms, followed by comprehensive ENT examinations. Olfactory function was assessed using smell identification kits, gustatory function was evaluated with basic taste tests, and hearing was examined using otoscopy and tuning fork tests (512 Hz). Results: ENT manifestations were identified in 68.3% (164/240) of patients. The most common symptoms included ageusia (63.3%), anosmia (60.4%), sore throat (51.7%), and hearing loss (42.5%). Chemosensory disturbances such as anosmia and ageusia typically presented early in the disease course (median onset: 3 days) and often preceded systemic symptoms. Objective testing confirmed 89.7% of self-reported anosmia cases and 76.5% of hearing loss complaints. Conclusion: This study found that 68.3% of COVID-19 patients experienced ENT symptoms, most commonly ageusia (63.3%), anosmia (60.4%), and sore throat (51.7%). Early-onset chemosensory disturbances often preceded systemic symptoms, making them valuable diagnostic markers. Hearing loss showed delayed onset but greater persistence, requiring clinical attention.