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Published on April 10, 2020

Is loss of smell a COVID-19 symptom?

COVID-19 Smell Loss

New evidence from other countries shows that some patients who have tested positive for COVID-19 have lost their sense of smell, a condition called anosmia. With that in mind, the American Academy of Otolaryngology has called for anosmia to be added to the list of screening tools physicians use. They have also created an Anosmia Reporting Tool for Clinicians to help track how common the symptom is with those who are sick with the novel virus.

“This new evidence suggests numbers as high as 30 percent of patients losing their sense of smell,” said otolaryngologist Douglas Mann, MD, at Upper Cape Ear, Nose & Throat in Falmouth. “I don’t think anybody knows what is causing this yet, but viruses have been known to directly affect the olfactory nerve in other cases. Having a viral infection is one of the known reasons for people to lose their sense of smell.”

In light of this news, Dr. Mann thinks that doctors should be screening for anosmia along with other symptoms such as a fever, cough, shortness of breath and headaches. He also advises any patients who lose their sense of smell to call their doctor right away and to self-quarantine.

Even if they don’t have other symptoms that are serious, they could be a carrier to pass the disease to others, according to a hypothesis put forward by ENT UK, the professional membership body representing ear, nose and throat surgery and related specialties in the United Kingdom. That hypothesis is based on the facts emerging out of South Korea, where anosmia was the major presenting symptom in 30 percent of otherwise mild cases in patients who tested positive.

“It’s another clue that may very well get officially added to the list of reasons for people to be tested,” Dr. Mann said.

Loss of Taste, Too?

In addition to watching for changes to the sense of smell, people should be alert to ageusia, or a diminished sense of taste, because the two go hand in hand. Remember the advice to pinch your nostrils closed when you were a child being forced to eat something you didn’t like? That trick works for a reason.

“The sense of smell is what gives us the ability to distinguish tastes between things that are similar,” Dr. Mann said. “It gives us our fine distinction of taste, like the difference between an apple and a pear. Both are sweet, and they are both crunchy to the mouth, but what tells us the difference is our sense of smell.”

People lose their sense of smell for various reasons. The most common one is if their sinuses and nose become very swollen because of an acute sinus infection, a bacterial sinus infection or a chronic sinus condition involving the growth of benign nasal polyps inside the nose. There is also a gradual decline in the sense of smell as we age, according to Dr. Mann.

Check With Your Doctor

Losing your sense of smell is important as a possible sign of COVID, but it should be evaluated by a doctor to rule out other conditions as well, he said.

“So far, they are saying the loss of smell is a temporary condition with COVID, which is not always the case with viral illnesses,” said Dr. Mann. “In other illnesses, such as nasal polyps, it can be treated. If you get treatment with anti-inflammatory medications, like steroids, or surgery you can get your sense of smell back. Nobody is recommending it with COVID, but people with other conditions can be treated.”

Dr. Mann advises people to contact their primary care physician first. Then if necessary, your doctor can refer you to an ENT specialist for further evaluation.

“I think it’s important for everybody to know that even though the offices may be closed, their doctors are still there to help them,” he said. “That goes for the primary care physicians and the specialists. We haven’t disappeared. Cape Cod Healthcare has given the doctors an iPad to use to have virtual visits, so we are ready to talk to people.”