Fever, dry cough, shortness of breath and/or diarrhea—these are the common symptoms doctors look for when screening possible COVID-19 patients.
But ears, nose, and throat (ENT) specialists from the United States and the United Kingdom said there is a growing anecdotal evidence that the loss of smell or “anosmia or hyposmia” and loss of taste or “ageusia or dysgeusia” could also be one of the tell-tale signs of the novel coronavirus disease (COVID-19).
“There is already good evidence from South Korea, China and Italy that significant numbers of patients with proven COVID-19 infection have developed anosmia/hyposmia. In Germany, it is reported that more than two in three 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,” the British Rhinological Society said in a statement signed by Prof Claire Hopkins, society president, and Prof Nirmal Kumar, President of ENT UK.
While these anecdotal evidence need scientific re-validation, BRS said it might help to advise patients who experience anosmia, without other respiratory symptoms, to undergo self-isolation for seven days even just to slow the spread of the disease.
“Given the potential for COVID-19 to present with anosmia, and the reports that corticosteroid use may increase the severity of infection, we would advise against use of oral steroids in the treatment of new onset anosmia during the pandemic, particularly if it is unrelated to head trauma or nasal pathology (such as nasal polyps). There is potential that if any adult with anosmia but no other symptoms was asked to self-isolate for seven days, in addition to the current symptom criteria used to trigger quarantine,” the BRS added.
The American Academy of Otolargyngology also proposes that anosmia and dysgeusia “be added to the list of screening tools for possible COVID-19 infection.”
If these symptoms appear and the patient has no allergy or rhinitis, the academy said, patient should alert doctors them for the virus and “warrant serious consideration for self isolation and testing of these individuals.”
Another disturbing trend, the academy noted, is that there is an “evolving evidence that otolaryngologists are among the highest risk group when performing upper airway surgeries and examinations.”
“A high rate of transmission of Covid-19 to otolaryngologists has been reported from China, Italy and Iran, many resulting in death,” it said.
Two ENT specialists in Britain who have been infected with the coronavirus are in critical condition, Dr. Hopkins noted.
