- Losing sense of smell may be a hidden symptom of coronavirus, doctors warn
- Doctors say loss of sense of smell might be Covid-19 symptom
- When you lose your sense of smell and taste, should you suspect coronavirus?
- What are anosmia and ageusia?
- Why could the coronavirus cause anosmia?
- What is the evidence for anosmia (loss of smell) as a clinical feature of COVID-19? – CEBM
- Doctors warn an inability to smell could be a symptom of Covid-19
- If you’ve lost your sense of smell or taste, you could be a ‘hidden carrier’ of the coronavirus
- Young people may not present common coronavirus symptoms
- Smell and Taste Disorders
- What causes smell and taste disorders?
- How are smell and taste disorders diagnosed?
- How are smell and taste disorders treated?
- What are the complications of smell and taste disorders?
- Key points about smell and taste disorders
- Next steps
Losing sense of smell may be a hidden symptom of coronavirus, doctors warn
While every case is different, the telltale symptoms of the novel coronavirus have been widely agreed upon — a high fever, persistent cough or shortness of breath. In the most severe instances, those afflicted have reported confusion or difficulty breathing, and sometimes, anxiety is the most prevailing symptom of all.
But a team of British ear, nose and throat doctors on Friday raised the possibility of a new indicator of the coronavirus, one they say has been observed globally, even in patients who are otherwise asymptomatic: anosmia, a condition that causes the loss of sense of smell. In a statement, they warned that adults experiencing recent anosmia could be unknown carriers of covid-19, and urged them to consider self-isolation.
“All of this evidence is accumulating very rapidly, but there’s nothing yet robustly in print,” Claire Hopkins, president of the British Rhinological Society, said in an interview. “Since then, I’ve had colleagues from around the world saying: ‘That’s exactly what we’re seeing.’ They’ve been trying [to raise awareness], but it hasn’t been picked up.”
Experts at the World Health Organization say they have not yet confirmed the loss of smell or taste as a symptom of the coronavirus but haven’t ruled it out.
Hopkins, who published the statement along with Nirmal Kumar, the president of ENT UK, a body that represents ear, nose and throat specialists in Britain, said she was driven by recent discussions on rhinological discussion boards related to the coronavirus pandemic. There, she observed ENTs reporting a surge of reported anosmia across their patients, and even among themselves.
In their statement, Hopkins and Kumar cited reports from South Korea, China, Iran and Italy, where, they wrote, “significant numbers of patients with proven covid-19 infection have developed anosmia/hyposmia,” the latter of which signals a reduced ability to detect smells.
In Germany, they wrote, more than two-thirds of confirmed coronavirus cases included anosmia. And in South Korea, a country that has seen ample covid-19 testing, “30 percent of patients testing positive have had anosmia as their major presenting symptom in otherwise mild cases.
“This week, I saw nine patients that lost their sense of smell, which is unheard of in my practice,” Hopkins said. “They were almost all under 40, and they were all told not to self-isolate.”
Anosmia and hyposmia are historically linked to early symptoms of upper-respiratory infections — including previous strains of coronavirus — because the virus damages olfactory bulbs that are involved in the sense of smell.
But Hopkins raised concern at the number of covid-19 patients who were otherwise asymptomatic.
She pointed to guidance in the United States and Britain, which generally instructs people to self-isolate if they are experiencing more-obvious coronavirus symptoms.
Hopkins said she hopes that flagging another potential symptom will resonate with those who haven’t taken social distancing and self-isolation seriously enough — the ones who fail to realize they may unknowingly carry the virus.
“The lack of awareness allows these people to carry on,” she added. “This potentially gives us an opportunity to capture some of those people who are silent spreaders of disease. The patients I’m seeing haven’t had a cough or fever at all.”
What it's to be infected with coronavirus
Citing the ENT UK statement, the American Academy of Otolaryngology on Sunday wrote that in the absence of allergies, sinusitis or rhinitis, the loss of smell or taste should “warrant serious consideration for self-isolation and testing.”
“Anosmia, in particular, has been seen in patients ultimately testing positive for the coronavirus with no other symptoms,” the academy wrote. “We propose that these symptoms be added to the list of screening tools for possible covid-19 infection.”
Reports of anosmia appearing as a possible symptom of coronavirus have reverberated online in recent days. In response to a news article on the topic, Daniel Goldman — the former lead investigative counsel for the House Intelligence Committee Democrats who said last week that he and his wife had tested positive for covid-19 — wrote on that “this has been the case with both my wife and me.”
Rudy Gobert, the Utah Jazz center whose positive novel coronavirus test prompted the National Basketball Association to shut down entirely, said Sunday that he, too, had lost his sense of smell.
Just to give you guys an update, loss of smell and taste is definitely one of the symptoms, haven’t been able to smell anything for the last 4 days. Anyone experiencing the same thing?
— Rudy Gobert (@rudygobert27) March 22, 2020
Thomas Hummel, an ear, nose and throat expert at the University of Dresden in Germany, said Monday that he wasn’t surprised by the reported linkages between covid-19 and anosmia.
While he understands the need for urgent measures to “flatten the curve,” he warned that many people are functionally anosmic — including about 5 percent of all Germans — and reiterated that it will take more data to prove a true correlation.
He said the warning, without further research, could cause panic even among those who have long suffered from anosmia, further straining outpatient clinics. (For those experiencing short-term anosmia, both Hummel and Hopkins agree that the sense of smell typically returns as the body recovers).
“On one end, it would be nice to have a good study. On the other hand, it’s about not spreading the virus,” he said. “Many people out there have anosmia. They don’t have a good sense of smell. And if you alert all these people that if you have anosmia you need to stay home, there would be many false positives. That’s the other side of the coin.”
WHO experts expressed a similar sentiment, announcing Monday that they have not yet confirmed the loss of smell or taste as a symptom of the coronavirus.
“We don’t have the answer to that yet, although there’s quite a bit of interest in this online,” Maria Van Kerkhove, head of the WHO’s emerging diseases and zoonosis unit, said at a daily news briefing Monday.
Van Kerkhove said a number of countries were collecting data on the symptoms of early infections, and that the WHO is working to learn if they have identified the loss of smell or taste as a symptom.
“We have a good handle on what the major ones are: Those are fevers. This is dry cough, and this is shortage of breath,” said Van Kerkhove, adding that aches and pains and headaches were also found. Some patients, though “very few” overall, had reported gastrointestinal problems, runny noses or sneezing.
But still, Hopkins said the tendency to focus on the major symptoms could further perpetuate the spread of the virus.
“While there is a chance the apparent increase in incidence could merely reflect the attention covid-19 has attracted in the media, and that such cases may be caused by typical rhinovirus and coronavirus strains, it could potentially be used as a screening tool to help identify otherwise asymptomatic patients, who could then be better instructed on self-isolation,” Hopkins and Kumar wrote.
Adam Taylor and Cindy Boren contributed to this report.
“,”author”:”Michael Brice-SaddlerÂ closeMichael Brice-SaddlerGeneral assignment reporterEmailEmailBioBioFollowFollow”,”date_published”:”2020-03-23T00:00:00.000Z”,”lead_image_url”:”https://www.washingtonpost.com/resizer/64DjvM84M5weW8EUv8mkoDonB98=/1440×0/smart/arc-anglerfish-washpost-prod-washpost.s3.amazonaws.com/public/4HBF4QNVEFCJBMRGSGDYRSSYMY”,”dek”:null,”next_page_url”:null,”url”:”https://www.washingtonpost.com/health/2020/03/23/coronavirus-sense-of-smell/”,”domain”:”www.washingtonpost.com”,”excerpt”:”A group of British ENT doctors has pointed out a new possible indicator of the coronavirus: lost sense of smell, even in patients who are otherwise asymptomatic.”,”word_count”:1147,”direction”:”ltr”,”total_pages”:1,”rendered_pages”:1}
Doctors say loss of sense of smell might be Covid-19 symptom
(CNN)Doctors in the United States on Sunday called for the loss of sense of smell and taste to be added to the “list of screening tools” for Covid-19.
The American Academy of Otolaryngology-Head and Neck Surgery said symptoms of anosmia, or lack of sense of smell, and dysgeusia, or lack of taste, should be used to identify possible Covid-19 infections.
“Anosmia, in particular, has been seen in patients ultimately testing positive for the coronavirus with no other symptoms,” reads to a statement on the academy's website.
Those symptoms “warrant serious consideration for self-isolation and testing of these individuals,” continues the statement.
The academy made its announcement after ENT UK, a professional organization representing ear, nose and throat surgeons in the United Kingdom, said in a separate statement on its website on Saturday that anosmia could be another symptom of infection with the novel coronavirus.
It has long been known in medical literature that a sudden loss of smell, or anosmia, may be associated with certain respiratory infections.
“Previously described coronaviruses are thought to account for 10-15% cases. It is therefore perhaps no surprise that the novel COVID-19 virus would also cause anosmia in infected patients,” the ENT UK statement said.
“There is already good evidence from South Korea, China and Italy that significant numbers of patients with proven COVID-19 infection have developed anosmia,” the statement said.
“In Germany it is reported that more than 2 in 3 confirmed cases have anosmia. In South Korea, where testing has been more widespread, 30% of patients testing positive have had anosmia as their major presenting symptom in otherwise mild cases.”
Smell and taste disorders are typically treated by an otolaryngologist. An assessment of a smell disorder typically would include a physical examination of the ears, nose and throat; a review of your health history and a smell test, among other analyses.
Overall, “I think we're getting a little bit more insight into the types of symptoms that patients might have,” CNN Chief Medical Correspondent Dr. Sanjay Gupta said on New Day on Monday morning.
“In a study China where they looked at some of the earliest patients, some 200 patients, they found that digestive or stomach GI symptoms were actually there in about half the patients,” Gupta said.
“Initially this was thought to be almost solely respiratory,” he said, adding that “fever and cough and shortness of breath” still appear to be the prevailing symptoms of Covid-19.
“,”author”:”Jacqueline Howard and Jack Guy, CNN”,”date_published”:”2020-03-23T13:40:52.000Z”,”lead_image_url”:”https://cdn.cnn.com/cnnnext/dam/assets/200323082100-01-coronavirus-drive-thru-testing-0320-super-tease.jpg”,”dek”:null,”next_page_url”:null,”url”:”https://www.cnn.com/2020/03/23/health/coronavirus-symptoms-smell-intl/index.html”,”domain”:”www.cnn.com”,”excerpt”:”Doctors in the United States on Sunday called for the loss of sense of smell and taste to be added to the “list of screening tools” for Covid-19.”,”word_count”:396,”direction”:”ltr”,”total_pages”:1,”rendered_pages”:1}
When you lose your sense of smell and taste, should you suspect coronavirus?
Doctors from around the world are reporting cases of patients with COVID-19, the illness caused by the coronavirus, who have lost their sense of smell, known as anosmia, or taste, known as ageusia. The director of the University of Florida’s Center for Smell and Taste and the co-director of the UF Health Smell Disorders Program answer questions about this emerging trend.
Loss of smell occurs with the common cold and other viral infections of the nose and throat. Anecdotal reports suggest the loss of smell may be one of the first symptoms of COVID-19.
Doctors around the world are reporting that up to 70% of patients who test positive for the coronavirus disease COVID-19 — even those without fever, cough or other typical symptoms of the disease — are experiencing anosmia, a loss of smell, or ageusia, a loss of taste.
A new study just published found that 20 of 59 patients (ages 50-74) interviewed in Italy reported a smell or taste loss.
More research is needed to understand this link, but it may provide a low-cost, practical indicator of which people should self-isolate or get further testing, depending on the symptom severity and testing availability.
What are anosmia and ageusia?
The body’s chemical senses include smell, used to detect volatile odors, and taste, which recognizes food compounds sugars, salts and acids.
A number of chemosensory disorders result in the diminishment, distortion or complete loss of smell or taste functions.
For example, anosmia is the complete loss or absence of smell, while hyposmia is a reduced ability to smell. Similarly, ageusia is an absence of taste.
Approximately 13% of people over 40 years old have a significant impairment of their sense of smell. These numbers are lower for younger people, but significantly higher for the elderly.
By contrast, taste loss is much less prevalent, and often results from physical damage to the taste nerves.
Even so, both smell and taste disorders are quite common and can have major negative impacts on the health and quality of life of the millions affected.
According to news reports, many of the COVID-19 patients reporting a chemosensory loss describe a loss of taste. However, it is more ly that smell loss accounts for this symptom.
When we eat or drink, the brain combines our perceptions of taste from the mouth with what is known as retronasal olfaction – that is, the perception of smell that comes from odors leaving the mouth and entering the nose through the connecting passage in the throat – into what is specifically called flavor.
Patients who have experienced anosmia or severe hyposmia may describe a loss of taste but are still able to detect sugar, salt or acid on the tongue. What they have lost is the contribution of smell to their perception of flavor.
We would predict that in most cases, the taste loss reported by COVID-19 patients is ly due to a reduced or absent ability to smell.
Why could the coronavirus cause anosmia?
Loss of smell can result from many diverse causes such as head trauma, nasal polyps, chronic allergies, toxin exposure and neurodegenerative disease.
One of the most common causes of anosmia and hyposmia are viruses that produce upper respiratory infections, often referred to as the “common cold.”
Viruses could impact smell function in any of several ways. They could attack various cells in the nasal tissue, inducing local inflammation and disrupting odor detection. The virus could directly disable or damage the sensory cells in the nose that detect odors.
Another possibility is that viruses could follow the olfactory nerve’s pathway through the skull and into the brain, where they could do additional damage.
Whether this coronavirus wreaks havoc on our sense of smell by killing olfactory sensory neurons, by disrupting their function or by otherwise impacting nasal olfactory tissues remains unknown, but will certainly be an important area of investigation.
The doctor and patient anecdotes reported recently describe a high incidence of anosmia in COVID-19 patients, including many without other symptoms. Thus, smell testing could be a useful tool to identify people who may be infected with COVID-19.
Indeed, some otolaryngologists, doctors who treat diseases of the ear, nose and throat, in the United Kingdom and United States have recommended that individuals who experience a sudden loss of smell or taste should self-isolate for 14 days, and that smell testing should be integrated into COVID-19 screening protocols.
But do the facts bear this out? For example, one small study of 59 people found that 60% of patients with upper respiratory infections not related to COVID-19 had a significant reduction in their ability to smell. This might suggest that the prevalence of smell loss associated with COVID-19 is no higher than that typically experienced with the common cold.
Unfortunately, smell testing is rarely done as part of a normal doctor’s visit, so the data to resolve this is lacking. Furthermore, self-reporting of smell function can be inaccurate. It is thus critical to conduct controlled scientific studies to assess whether smell disorders such as anosmia are an indicator of a COVID-19 infection.
It will take time to conduct those studies. In the meantime, what should you do if you experience sudden smell loss? The advice from ENT UK, a professional group that represents ear, nose and throat surgeons, and the British Rhinological Society seems prudent.
Self-isolate, and contact your physician for recommendations of next steps. Smell testing as part of a typical COVID-19 screen, as recommended by the American Academy of Otolaryngologists, also makes sense, even if the test is not diagnostic for COVID-19 in and of itself.
Simple scratch-and-sniff smell tests could be sent to patients to take in their home and report via secure communications, minimizing coronavirus exposure of overburdened health care providers.
Along with body temperature readings and a patient history, smell testing could allow physicians to make better choices about who to prioritize for self-isolation or more specific COVID-19 testing.
Also read:Pregnancy care is changing with coronavirus — 9 questions answered
Steven D. Munger is the director of the Center for Smell and Taste, co-director of the UF Health Smell Disorders Program, and a professor of pharmacology and therapeutics, University of Florida in Gainesville. Jeb M.
Justice is an associate professor, chief of the Division of Rhinology and Skull Base Surgery and co-director of the UF Health Smell Disorders Program at the University of Florida.
This was first published on The Conversation — “Is the loss of your sense of smell and taste an early sign of COVID-19?”
What is the evidence for anosmia (loss of smell) as a clinical feature of COVID-19? – CEBM
James O’Donovan, Sarah Tanveer, Nicholas Jones, Claire Hopkins, Brent A. Senior, Sarah K. Wise, Jon Brassey, Trisha Greenhalgh
On behalf of the Oxford COVID-19 Evidence Service Team Centre for Evidence-Based Medicine, Nuffield Department of Primary Care Health Sciences University of Oxford Department of Education
University of Oxford
Correspondence to email@example.com
The current evidence base to suggest changes in olfactory sensation is a feature of COVID-19 is limited and inconclusive.
More evidence is required to establish whether there is a link between changes in olfaction and COVID-19; we therefore encourage clinicians to incorporate questions around loss of olfactory sensation into their clinical practice when assessing patients with suspected COVID-19.
There are two types of change in olfactory sensation – anosmia and hyposmia:
What is anosmia?
Anosmia is a total loss of the sensation of smell.
What is hyposmia?
Hyposmia is the partial loss of the sensation of smell.
Why do this review now?
Dozens of recent media reports have suggested new-onset anosmia in the absence of nasal obstruction or underlying respiratory disease may be a clinical feature of COVID-19.1-3
What was the objective of the review?
To understand the existing evidence surrounding olfactory symptoms (anosmia and hyposmia) as a clinical feature of COVID-19.
What data sources did we use?
We conducted a rapid systematic scoping review of the literature and searched 5 major databases (Medline; Embase; via Ovid; CINAHL via Ebsco; Web of Science and Scopus; via ProQuest).
We also searched the grey literature (member websites of The International Federation of Otorhinolaryngology (ORL) Societies (IFOS),https://www.medrxiv.org/ (a pre-print server for unpublished manuscripts in the field of health-sciences); and websites of relevant professional bodies (e.g. Society of Sensory Professionals, Fifth Sense UK) and combined this with expert consultation.
What were criteria for inclusion?
Studies or evidence published between the 31st of December 2019 and the 23rd of March 2020 was eligible for inclusion. No restrictions were placed on language. Studies were eligible for final inclusion if they described clinical features of COVID-19– specifically those related to olfactory symptomatology.
How did we grade evidence?
Included evidence was graded using the Oxford Centre for Evidence-based Medicine (CEBM) Levels of Evidence guideline.
What is the evidence behind the suggestion that changes in olfaction could be a feature of COVID-19?
We identified four relevant pieces of evidence suggesting that olfactory symptoms could be a potential clinical feature of COVID-19. These included:
- A non-peer reviewed study by Mao et al., from China where 11 of 214 (5.1%) patients with confirmed SARS-CoV-2 complained of hyposmia; however this finding was not deemed significant (p=0.338).4
- Three expert statements from the American, British and French associations of otorhinolaryngology.5-7
It is important to note that the statements from the professional bodies are largely anecdotal non-peer reviewed emerging clinical observations. The ENT UK statement (which has so far received the most traction in the popular media) stated that they had “good evidence” from multiple countries that patients with confirmed COVID-19 had also developed olfactory symptoms.
After clarifying this information with an ENT UK representative we now know that this was largely anecdotal messages shared amongst clinicians on a private online forum for otolaryngologists. Due to privacy regulations we were unable to gain access to the group to analyse the message exchanges.
The press release also stated that “in South Korea, where testing has been more widespread, 30% of patients testing positive have had anosmia as their major presenting symptom in otherwise mild cases”.6 This evidence refers to a media report by a Korean news outlet.
A journalist interviewed doctors at hospitals in Daegu.
One doctor was quoted as saying: “If you put together the doctors who conducted ward rounds or spoke to patients on the phone, approximately 30% of the confirmed (COVID-19 positive) patients reported a loss of smell as a symptom”.8
What is the strength of the evidence to suggest olfactory symptoms are a potential clinical feature of COVID-19?
Overall the evidence was graded as ‘inconclusive’ (Grade D) using the CEBM guideline.
Through the systematic-review process we also identified 56 peer-reviewed studies which described clinical features in confirmed cases of COVID-19. None of these studies mention olfactory symptoms as a clinical feature of COVID-19.
EMERGING EVIDENCE IN COVID-19
- The current state of evidence around changes in olfactory sensation being a clinical feature is highly preliminary and largely based around non peer-reviewed emerging anecdotal clinical information.
- Changes in olfaction, secondary to COVID-19, have not been mentioned as a symptom in any of the existing 56 peer-reviewed studies where symptoms of patients with confirmed cases of disease have been reported.
- This could be for several reasons: (i) symptoms around olfaction may not have been elicited and recorded (ii) unless patients are consciously monitoring for olfactory loss, many of them may not become aware of this manifestation or seek medical attention for days to weeks (iii) olfactory loss might be a symptom in milder cases of disease, rather than critically ill patients who required hospitalisation (which has formed that vast majority of patients included in the peer-reviewed literature to date).
- The preliminary current evidence base for olfactory symptoms as a potential feature of COVID-19 is limited to expert statements and one non-peer reviewed paper and inconclusive at this time. However, emerging anecdotal clinical reports suggest that this feature should be investigated further. Any new onset anosmia, in the absence of nasal obstruction or respiratory symptoms, should be recorded by clinicians who suspect a patient may be positive for COVID-19.
Disclaimer: the article has not been peer-reviewed; it should not replace individual clinical judgement and the sources cited should be checked.
The views expressed in this commentary represent the views of the authors and not necessarily those of the host institution, the NHS, the NIHR, or the Department of Health and Social Care.
The views are not a substitute for professional medical advice.
James O’Donovan is a DPhil candidate and medical doctor at the Department of Education, University of Oxford. : @james_odonovan
Sarah Tanveer is a PhD candidate at The University of Maryland.
Nicholas Jones is a Wellcome Trust Doctoral Research Fellow at University of Oxford.
Claire Hopkins is Professor of Rhinology, Kings College London, UK.
Senior is Professor of Otolaryngology/Neurosurgery at UNC School of Medicine, USA.
Sarah K. Wise is Professor Rhinology/Sinus Surgery at Emory Medicine, USA.
Jon Brassey is the Director of Trip Database Ltd, Lead for Knowledge Mobilisation at Public Health Wales (NHS) and an Associate Editor at the BMJ Evidence-Based Medicine
Trisha Greenhalgh is Professor of Primary Care at the University of Oxford. : @trishgreenhalgh
The following combination of search terms were used to search the literature:
- “SARS‐CoV‐2” OR “2019‐nCoV” OR “Coronavirus” OR “COVID-19”
- “Anosmia” OR “Hyposmia” OR “loss of smell” OR “symptom*” OR “clinical feature*” OR “Smell” OR “olfact*”
Doctors warn an inability to smell could be a symptom of Covid-19
Health care workers are calling attention to a potential new symptom of a novel coronavirus infection: the loss of one’s sense of smell.
Clinicians in the U.S. and elsewhere around the world have reported, anecdotally, that some patients infected with the virus experience anosmia, or an inability to smell.
The American Academy of Otolaryngology recently called for anosmia to be added to a list of screening tools for Covid-19, the disease caused by the virus.
On Monday, World Health Organization officials announced they were further probing a possible link between anosmia and coronavirus — though they noted the evidence of a potential connection remains preliminary.
“A loss of smell or a loss of taste is something that we’re looking into,” Maria Van Kerkhove, the head of WHO’s emerging diseases and zoonoses unit, said on a briefing call with reporters on Monday. “We are reaching out to a number of countries and looking at the cases that have already been reported to see if this is a common feature. We don’t have the answer to that yet.”
There are a number of unanswered questions about the new potential symptom, which at this point, is thought to be temporary.
Experts aren’t sure how common it is, or at what point in the progression of the disease a patient loses the ability to smell.
They also want to be sure the new symptom isn’t merely a sign of allergies, a cold, or the seasonal flu, all of which can lead a person to develop anosmia or ageusia, the reduced sense of taste that can sometimes accompany an inability to smell.
“It’s certainly popping up as a symptom, but how universal it is, we don’t know,” said Eric Holbrook, director of rhinology at Massachusetts Eye and Ear, a Boston hospital. Holbrook said he started hearing about the possible tie between anosmia and coronavirus in case reports from clinicians in Europe about a week ago.
Those reports are among a growing amount of anecdotal evidence that suggests experts might want to consider anosmia as a potential sign of infection.
In report published on March 16 in the South Korean newspaper Chosun, clinicians estimated that roughly 30% of patients who tested positive for coronavirus had temporarily lost their sense of smell.
In Germany, clinicians at the University Hospital in Bonn surveyed 100 patients with coronavirus and found that up to two-thirds “described a loss of smell and taste lasting several days,” Hendrik Streeck, head of the hospital’s virology institute, told the German news site Frankfurter Allgemeine.
The known symptoms of Covid-19 have evolved as cases have climbed globally. The Centers for Disease Control and Prevention lists fever, cough, and shortness of breath as the core coronavirus symptoms.
Difficulty breathing, persistent chest pain or pressure, confusion, and bluish lips or face are listed as emergency symptoms for which people should seek immediate care.
The WHO says other symptoms can include tiredness, fatigue, and in some patients, “aches and pains, nasal congestion, runny nose, sore throat, or diarrhea.”
The WHO and CDC haven’t added anosmia to their coronavirus symptom lists, which health care workers use to screen patients who might have been infected with coronavirus. But some health care workers are encouraging their peers to consider the symptom when caring for patients they suspect might have be infected.
“I wouldn’t use it alone [to screen patients], but I think if it’s added to some of the other symptoms, it adds to the possibility,” said Holbrook. “If someone says yes, it would definitely make me more suspicious that they need further work-up.”
Using the new symptom as a screening tool is a delicate task, experts noted. Emphasizing it too early, or too heavily, could mean clinicians might miss patients who haven’t lost their sense of smell, but who are infected and have other symptoms.
Ignoring a lost sense of smell, however, could mean doctors don’t detect infection in cases where patients have only mild symptoms or are asymptomatic.
In those cases, using anosmia as a screening tool could help clinicians catch cases that would otherwise fly under the radar and give those infected individuals more guidance on self-isolation.
But to do that, clinicians need more data on the role anosmia might play in Covid-19.
“One of the things I think a lot of physicians and patients are struggling with is trying to determine whether these mild symptoms are related to, say, allergies or a mild cold,” Holbrook said. He added that it’s also difficult to distinguish between a loss of the sense of smell and a loss of the sense of taste, which patients can sometimes mix up.
“But anything that gives us a heads-up into who needs to be isolated or tested, that might be a good screening tool,” Holbrook said.
To get a better handle on the new symptom and its ties to coronavirus, Holbrook said he and his colleagues will be looking at people with anosmia and confirmed Covid-19, as well as those experiencing anosmia who have tested negative. That will allow them to compare both groups and understand whether anosmia is truly a core coronavirus symptom.
“That’s important data — data that we need. Many of us are trying to start doing those studies,” Holbrook said.
Helen Branswell contributed reporting.
An earlier version of this article mischaracterized South Korean research about anosmia. It was a non peer-reviewed report which suggested that roughly 30% of South Koreans with Covid-19 lose their sense of smell, not a Nature study.
If you’ve lost your sense of smell or taste, you could be a ‘hidden carrier’ of the coronavirus
- A sudden loss of smell – known as anosmia or hyposmia – could be a symptom of the coronavirus, even if patients experience no other symptoms, according to leading rhinologists in the UK.
- Evidence from South Korea, China, and Italy suggests that many patients with COVID-19 may have experienced a loss of smell without any other symptoms.
- The British Association of Otorhinolaryngology calls on the authorities to advise anyone with a loss of smell or taste to self-isolate.
- Young people could be more ly to carry the disease without presenting the more commonly recognised symptoms of fever and coughing, they believe.
Anyone experiencing a sudden loss of smell could be a “hidden carrier” of the coronavirus, even if they have no other symptoms, according to evidence compiled by leading rhinologists in the UK.
In South Korea, China, and Italy, about a third of patients who have tested positive for COVID-19 have also reported a loss of smell – known as anosmia or hyposmia – leading ear, nose, and throat experts in the UK have reported.
“In South Korea, where testing has been more widespread, 30% of patients testing positive have had anosmia as their major presenting symptom in otherwise mild cases,” the president of the British Rhinological Society Professor, Clare Hopkins, and the president of the British Association of Otorhinolaryngology, professor Nirmal Kumar, said in a joint statement.
The professors said that many patients around the world who have tested positive for COVID-19 are presenting only the symptoms of loss of smell and taste – without the more commonly recognised symptoms of high fever and coughing.
“There have been a rapidly growing number of reports of a significant increase in the number of patients presenting with anosmia in the absence of other symptoms,” the statement says. “Iran has reported a sudden increase in cases of isolated anosmia, and many colleagues from the US, France, and Northern Italy have the same experience.”
The lack of other recognised symptoms in these cases may mean they are unly to be tested and isolated, meaning they could be contributing to the rapid spread of the disease worldwide.
“These patients may be some of the hitherto hidden carriers that have facilitated the rapid spread of COVID-19,” they added.
Young people may not present common coronavirus symptoms
Professor Kumar told Sky News that younger patients in particular may demonstrate only a loss of smell or taste, without demonstrating the more commonly recognised coronavirus symptoms of high fever and persistent coughs.
“In young patients, they do not have any significant symptoms such as the cough and fever, but they may have just the loss of sense of smell and taste, which suggests that these viruses are lodging in the nose,” he said.
The professors called for anyone presenting the symptoms of loss of taste or smell to self-isolate for seven days to prevent the further spread of the disease.
Smell and Taste Disorders
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The most common smell and taste disorders are:
Anosmia. Loss of sense of smell
Ageusia. Loss of sense of taste
Hyposmia. Reduced ability to smell
Hypogeusia. Reduced ability to taste sweet, sour, bitter, or salty things
In other disorders, odors, tastes, or flavors may be misread or distorted. They may cause you to detect a bad odor or taste from something that is normally pleasant to taste or smell. These disorders can affect quality of life. They may also be a sign of underlying disease.
Problems with taste and smell can suggest certain health problems, such as:
High blood pressure
Nervous system diseases, such as:
What causes smell and taste disorders?
Some people are born with these disorders, but most are caused by:
Illness (for example, cold or flu, sinus infection, and allergies)
Dental or mouth problems
Exposure to certain chemicals
Exposure to radiation therapy for head or neck cancer
Cocaine snorted through the nose
Odor-sensitive cells can warn of us of dangers and let us know when something is pleasant to eat. However, because they are so sensitive, they can easily die when exposed to the outside world. Geneticist Randall Reed and his team seek to understand how they can regenerate so quickly. This will prevent people from losing their sense of smell in a time of danger.
Symptoms can range from the not being able to smell or taste at all to the reduced ability to smell or taste specific things that are sweet, sour, bitter or salty. In some cases, normally pleasant tastes or smells may become unpleasant.
How are smell and taste disorders diagnosed?
Along with a complete medical history and physical exam, other test may include:
Measuring the lowest strength of a chemical that a person can recognize
Comparing tastes and smells of different chemicals
“Scratch and sniff” tests
“Sip, spit, and rinse” tests where chemicals are applied to specific areas of the tongue
How are smell and taste disorders treated?
Your healthcare provider will figure out the best treatment for you :
How old you are
Your overall health and medical history
How sick you are
How well you can handle specific medicines, procedures, or therapies
How long the condition is expected to last
Your opinion or preference
Treatment may include:
Stopping or changing medicines that contribute to the disorder
Correction of the underlying medical problem
Surgical removal of obstructions that may be causing the disorder
What are the complications of smell and taste disorders?
While both smell and taste disorders affect quality of life, smell disorders can be dangerous. They damage your ability to detect such things as:
Spoiled food and beverages
Taste disorders can affect nutrition and lead to weight loss and malnutrition. It can also harm the immune system and worsen other medical conditions.
Key points about smell and taste disorders
The loss of the senses of smell and taste are the most common smell and taste disorders.
Other disorders include the reduced ability to smell or taste specific substances that are sweet, sour, bitter or salty.
For some people, normally pleasant tastes or smells may become unpleasant.
Treatments for smell and taste disorders often include treating the underlying cause.
Smell and taste disorders can affect quality of life and should be treated.
Tips to help you get the most from a visit to your healthcare provider:
Know the reason for your visit and what you want to happen.
Before your visit, write down questions you want answered.
Bring someone with you to help you ask questions and remember what your provider tells you.
At the visit, write down the name of a new diagnosis, and any new medicines, treatments, or tests. Also write down any new instructions your provider gives you.
Know why a new medicine or treatment is prescribed, and how it will help you. Also know what the side effects are.
Ask if your condition can be treated in other ways.
Know why a test or procedure is recommended and what the results could mean.
Know what to expect if you do not take the medicine or have the test or procedure.
If you have a follow-up appointment, write down the date, time, and purpose for that visit.
Know how you can contact your provider if you have questions.