Lost sense of smell may be clue to coronavirus infection

Doctors urge those with diminished senses to self-isolate.

A mother who was infected with the coronavirus couldn’t smell her baby’s full diaper. Cooks who can usually name every spice in a restaurant dish can’t smell curry or garlic, and food tastes bland. Others say they can’t pick up the sweet scent of shampoo or the foul odor of kitty litter.

Anosmia, the loss of sense of smell, and ageusia, an accompanying diminished sense of taste, have emerged as peculiar telltale signs of COVID-19, the disease caused by the coronavirus, and possible markers of infection.

On Friday, British ear, nose and throat doctors, citing reports from colleagues around the world, called on adults who lose their senses of smell to isolate themselves for seven days, even if they have no other symptoms, to slow the disease’s spread. The published data is limited, but doctors are concerned enough to raise warnings.

“We really want to raise awareness that this is a sign of infection and that anyone who develops loss of sense of smell should self-isolate,” Professor Claire Hopkins, president of the British Rhinologi- cal Society, wrote in an email. “It could contribute to slowing transmission and save lives.”

She and Nirmal Kumar, pres- ident of ENT UK, a group representing ear, nose and throat doctors in Britain, issued a joint statement urging health care workers to use personal protective equipment when treating any patients who have lost their senses of smell, and advised against performing nonessential sinus endoscopy procedures on anyone, because the virus replicates in the nose and the throat and an exam can prompt coughs or sneezes that expose the doctor to a high level of virus.

Two ear, nose and throat specialists in Britain who have been infected with the corona- virus are in critical condition, Hopkins said. Earlier reports from Wuhan, China, where the coronavirus first emerged, had warned that ear, nose and throat specialists as well as eye doctors were infected and dying in large numbers, Hopkins said.

The British physicians cited reports from other countries indicating that significant numbers of coronavirus patients experienced anosmia, saying that in South Korea, where testing has been widespread, 30% of 2,000 patients who tested positive experienced anosmia as their major presenting symptom (these were mild cases).

The American Academy of Otolaryngology on Sunday posted information on its website saying that mounting anecdotal evidence indicates that lost or reduced sense of smell and loss of taste are significant symptoms associated with COVID-19, and that they have been seen in patients who ultimately tested positive with no other symptoms.

The symptoms, in the absence of allergies or sinusitis, should alert doctors to screen patients for the virus and “warrant serious consideration for self isolation and testing of these individuals,” the academy said.

Dr. Rachel Kaye, an assistant professor of otolaryngology at Rutgers, said colleagues in New Rochelle, New York, which has been the center of an outbreak, first alerted her to the smell loss associated with the coronavirus, sharing that patients who had first complained of anosmia later tested positive for the coronavirus. “This raised a lot of alarms for me personally,” Kaye said, because those patients “won’t know to self quarantine.”