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Loss of Smell and Taste in Mild to Moderate COVID-19
TAKE-HOME MESSAGE
- In this research letter, the investigators report on the prevalence of loss of taste and smell in patients with confirmed COVID-19. In this population, 87% reported loss of smell and 56% reported loss of taste or change in taste. These symptoms often persisted after other symptoms associated with COVID-19 resolved.
- As new research evolves regarding the constellation of symptoms associated with COVID-19, this research letter provides helpful information on a specific symptom.
– Andrea Dotson, MD, MSPH
abstract
This abstract is available on the publisher's site.
Access this abstract nowThe coronavirus 2019 (COVID-19) pandemic has spread worldwide rapidly. Commonly reported symptoms, such as fever, cough, dyspnea, fatigue, and myalgia, are nonspecific, and the lack of testing in some European countries may make the diagnosis of COVID-19 challenging. However, 2 distinctive symptoms were identified recently: loss of smell and loss of taste (1). These symptoms were not reported extensively in initial studies (2) and might help in the clinical diagnosis of COVID-19.
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Loss of Smell and Taste in 2013 European Patients With Mild to Moderate COVID-19
Ann. Intern. Med 2020 May 26;[EPub Ahead of Print], JR Lechien, CM Chiesa-Estomba, S Hans, MR Barillari, L Jouffe, S SaussezFrom MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine.
The Olfactory Manifestations of COVID-19
SARS-CoV-2 continues to surprise us with its wide range of presentations, affected organ systems, and clinical consequences. It defies comparison with the garden variety respiratory viruses that we all encounter frequently in our practices and our families. One interesting manifestation has been the alteration or total loss of the senses of smell and taste. This fits with transgenic animal studies of the original SARS virus, showing intracranial entry by way of the olfactory bulb.[1] The questions of importance to clinicians become:
Accompanying the common symptoms of headache (70.1%), myalgia (61.8%), and cough (58.4%) in a series of 2013 patients with laboratory-confirmed COVID-19 in Europe, 87.1% and 56.4% reported alterations is smell and taste, respectively.[2] Patients were recruited following their diagnosis, so some biasing is possible. The loss of smell and taste generally came with, or after the onset of other symptoms. Most had partial loss or distortion of perception. Interestingly, in a small subset of patients reporting total loss of smell and who were given an objective olfactory test, less than half (47.7%) were found to be truly anosmic. The patients were of moderate age (median = 39.5 years), and predominantly white (88.5%) and female (66.0%).
Overall, the loss or alteration of smell and taste may be common in COVID-19, but perhaps less common than reported in this study. Nevertheless, clinicians should include assessments of smell and taste in their assessments of patients with possible SARS-CoV-2. One problem emerges, however, when we consider the existing prevalence of anosmia in older individuals in the U.S. There is a steady increase in background rates of anosmia over the age of 65 years; this is more common in males than females, and more in African Americans than in white patients.[3] For example, nearly 60% of Black men and 55% of Black women aged ≥85 years are anosmic. When one considers the demographic disparities that exist in significant COVID-19 cases, the utility of smell and taste assessments may be less valuable as a pathognomonic tool.
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