BACKGROUND: The clinical presentation of European patients with mild-to-moderate COVID-19 infection is still unknown. OBJECTIVE: To study the clinical presentation of COVID-19 in Europe. METHODS: Patients with positive diagnosis of COVID-19 were recruited from 18 European hospitals. Epidemiological and clinical data were obtained through a standardized questionnaire. Bayesian analysis was used for analysing the relationship between outcomes. RESULTS: A total of 1,420 patients completed the study (962 females, 30.7% of healthcare workers). The mean age of patients was 39.17 ± 12.09 years. The most common symptoms were headache (70.3%), loss of smell (70.2%), nasal obstruction (67.8%), cough (63.2%), asthenia (63.3%), myalgia (62.5%), rhinorrhea (60.1%), gustatory dysfunction (54.2%) and sore throat (52.9%). Fever was reported by 45.4%. The mean duration of COVID-19 symptoms of mild-to-moderate cured patients was 11.5 ± 5.7 days. The prevalence of symptoms significantly varied according to age and sex. Young patients more frequently had ear, nose and throat complaints, whereas elderly individuals often presented fever, fatigue and loss of appetite. Loss of smell, headache, nasal obstruction and fatigue were more prevalent in female patients. The loss of smell was a key symptom of mild-to-moderate COVID-19 patients and was not associated with nasal obstruction and rhinorrhea. Loss of smell persisted at least 7 days after the disease in 37.5% of cured patients. CONCLUSION: The clinical presentation of mild-to-moderate COVID-19 substantially varies according to the age and the sex characteristics of patients. Olfactory dysfunction seems to be an important underestimated symptom of mild-to-moderate COVID-19 that needs to be recognized as such by the WHO.

BayesiaLab Changé France

British Rhinological Society London UK

Confederation of European Otorhinolaryngology Head and Neck Surgery Vienna Austria

Department of Head and Neck Surgery Foch Hospital School of Medicine UFR Simone Veil Université Versailles Saint Quentin en Yvelines Paris France

Department of Human Anatomy and Experimental Oncology Faculty of Medicine UMONS Research Institute for Health Sciences and Technology University of Mons Mons Belgium

Department of Internal Medicine Infectiology CHU Saint Pierre Brussels Belgium

Department of Internal Medicine Infectiology EpiCURA Hospital Baudour Belgium

Department of Medicine Neurology CHU de Charleroi Charleroi Belgium

Department of Mental and Physical Health and Preventive Medicine University of L Vanvitelli Naples Italy

Department of Microbiology Laboratoire Hospitalier Universitaire de Bruxelles Universitair Laboratorium Brussel Mons Belgium

Department of Otolaryngology Head and Neck Surgery 1st Faculty of Medicine University Hospital Motol Prague Czech Republic

Department of Otolaryngology Head and Neck Surgery EpiCURA Hospital Hornu Belgium

Department of Otolaryngology Head and Neck Surgery Morgagni Pierantoni Hospital Forli Italy

Department of Otorhinolaryngology and Head and Neck Surgery CHU de Bruxelles CHU Saint Pierre School of Medicine Université Libre de Bruxelles Brussels Belgium

Department of Otorhinolaryngology Head and Neck Surgery APHM Aix Marseille University La Conception University Hospital Marseille France

Department of Otorhinolaryngology Head and Neck Surgery Hospital Universitario Donostia San Sebastian Spain

Department of Statistics Language Sciences University of Mons Mons Belgium

Division of Otolaryngology Head and Neck Surgery Centre Hospitalier de l'Université de Montréal Montreal QC Canada

From COVID 19 Task Force of the Young Otolaryngologists of the International Federations of Oto rhino laryngological Societies Paris France

Guy's and St Thomas NHS Foundation Trust London UK

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