Sanjeet Rangarajan

 

Dr. Sanjeet Rangarajan is an assistant professor of Otolaryngology – Head and Neck Surgery and director of the Division of Rhinology and Endoscopic Skull Base Surgery at the University of Tennessee Health Science Center. 

Loss of smell may be an important clue in COVID-19 infection

By Updated: March 26, 2020 1:55 PM CT | Published: March 26, 2020 1:54 PM CT

As the epicenter of the COVID-19 pandemic establishes itself in the United States, more details regarding the clinical course of those infected with the novel coronavirus overseas are emerging. Common symptoms such as fever, cough and shortness of breath are touted by the Centers for Disease Control and Prevention (CDC) as clues that a person could be infected.

In addition, however, there are new reports that patients with sudden anosmia, a loss of one’s sense of smell, could be infected with the virus. A team of British otolaryngologists (ear, nose, and throat surgeons) revealed this week that up to two-thirds of COVID-19 patients in Germany experienced a sudden loss of smell, and that reports from China, South Korea, Italy and Iran corroborated these findings.

Anecdotal reports of this finding are also emerging in the United States, as Utah Jazz center Rudy Gobert-Bourgarel disclosed this week on Twitter that he developed loss of smell and taste after contracting the coronavirus. I learned that an individual I trained with in residency tested positive for the virus, also after experiencing a sudden loss of smell.

As an otolaryngologist who specializes in rhinology, my clinical practice centers solely on those who suffer from diseases of the nose and sinuses, including disorders of taste and smell. In general, patients may present with loss of smell for a variety of reasons including blockage in airflow, chronic sinus infections, tumors, nasal polyps and infections with common cold viruses.

A complete loss of smell, however, is a rare finding – something I may see in my clinic at the University of Tennessee Health Science Center only five to 10 times per year. In the report issued by the British otolaryngologists, they indicated they saw a significant increase in patients with anosmia, up to 16 times more than they would usually expect.

<strong>Sanjeet Rangaraja</strong>

Sanjeet Rangaraja

Raising awareness of this potentially common, but yet to be publicized symptom of coronavirus infection has become a priority amongst physicians in my specialty. The American Academy of Otolaryngology – Head and Neck Surgery, released a position statement on March 22, 2020, proposing that sudden alterations in smell and taste be added to the list of screening questions and tools for possible COVID-19 infection, especially in those who may be otherwise asymptomatic.

While the CDC has yet to adopt these symptoms as official qualifications for COVID-19 testing, we recommend that patients without previous sinus/nasal disorders who experience a sudden loss of smell be vigilant for the development of additional symptoms and consider proactively self-isolating. Keeping in touch with your physician (via telephone) to let them know about any concerning symptoms is also a must.

Our understanding of this virus, how it spreads, and the ways we might be able to mitigate its effects on our society is in a constant state of evolution, with each week looking completely unlike the one before. The evidence for or against different diagnostic criteria for infection will undoubtedly change, but one fact is clear. To end this pandemic and preserve the health of our society, we must focus on decreasing the rate of infection.

Focusing on identifying, testing, and isolating symptomatic individuals is an important way to prevent obviously sick patients from spreading the virus in the community. Equally important, however, is identifying asymptomatic carriers of the virus who may be unknowingly shedding the virus and preventing us from “flattening the curve.”

Memphis Mayor Jim Strickland’s “Safer at Home” executive order is an important step in decreasing the spread of COVID-19 by these individuals, protecting vulnerable populations, and preserving the capacity of our health care system. The emergence of diagnostic criteria like anosmia, and the rapid dissemination of new information amongst health care providers on the front lines of this pandemic, will hopefully help too.  

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coronavirus COVID-19

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