Addition of taste and smell loss to COVID-19 screening

April 23, 2020-As evidence pile Present as a symptom of sudden loss of smell or taste COVID-19, And there are more calls to screen for these symptoms.

Many new publications show a high percentage of infected people COVID-19 Reporting a loss of odor and taste, the authors fussed to recognize these symptoms as potential indicators of infection.

In particular, it is believed that these signs may be present in many asymptomatic people COVID-19, So asking about them, SARS-CoV-2 virus in the absence of other symptoms.

Nevertheless, the World Health Organization (WHO) does not list loss of smell or taste as a potential symptom. SARS-CoV-2 infection.

But with the Centers for Disease Control and Prevention Prevention (CDC) added “new loss of taste and smell” as a symptom. COVID-19 Information page.

James C. Denneny III, MD, Executive Vice President and CEO of the American Academy of Otorhinolaryngology — Head and Neck Surgery (AAO-HNS), believes the condition may be an early warning signal.

And there’s no downside to checking these, Denny said Medscape Medical News.

“Given the fact that this does not require surgery, biopsy, or specific treatment, I think the benefits of getting it early are great,” he said. “The downside to using it as a symptom, and virtually zero if anyone doesn’t know it has it.”

Claire Hopkins, MD, President of the British Rhinological Society and colleagues Lancet infection, I agree.

“Doctors are evaluating patients with acute loss of odor or taste, especially in the context of nasal patents. Airway, Requires a high suspicious indicator for the incident SARS-CoV-2 infection. “

They also said that, in contrast to other respiratory infections, Nasal congestion Or rhinorrhea. “

Latest publication discovers loss of smell and taste is common

Carol H. Yang, MD, an otolaryngologist and head and neck surgeon at the University of California San Diego, believes that sudden loss of odor and taste is considered to be a fairly specific marker. COVID-19.

A survey of patients visiting the University of California San Diego Health Care Center found that SARS-In the CoV-2 test, Yan and co-workers found 68% (59/40) COVID-19Positive patients reported olfactory disorders, and 71% (59/42) reported taste disorders.

Of the 203 people in the “Control” group, PCR-SARS-CoV-2 negative, only 16% loss of olfaction, 17% loss of taste International forum Allergies & Nasal science.

“Based on our research, if you have a smell or a loss of taste, you are 10 times more likely to be infected with COVID-19 than other causes of infection. The most common first signs remain heat, But Malaise Another very common initial symptom is continued odor and taste loss. “

“COVID-19 is very Contagious Virus. This study supports the need to recognize odor and loss of taste as early signs of COVID-19. “

Yang said Medscape Medical News Another, as yet unpublished, analysis shows that the sudden loss of odor and taste may be “more representative of mild illness.”

Therefore, she argued that inspecting and isolating these people could help prevent the spread of COVID-19.

Based on Yan’s report and other case reports, the UC San Diego Health system suddenly lost all tastes and odors to all callers of the COVID-19 hotline, and to all visitors and staff in the past few weeks. If asked, she explained.

Ahmad R. Sedaghat, MD, PhD at the University of Cincinnati, Ohio, sees a similar view.

With a new systematic review of the topic published on April 14th in Laryngoscope otolaryngology, Sedagat and colleagues write: “Anosmia without nasal obstruction (complete loss of olfaction), in particular, appears to be a very specific indicator of COVID-19.”

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“ These individuals run their business as normal, ” says Sedagatt, because a sudden loss of olfaction doesn’t necessarily lead to people thinking they have COVID-19, especially if they remain asymptomatic. Then, as a carrier, you can spread the disease. “

“If you have anorexia without nasal obstruction other than quarantine, it’s not unjustified to have your doctor do the testing,” he said in a statement.

Symptom checker adds weight

Several organizations around the world are beginning to collect symptom reports from patients and clinicians, shedding more light on the sudden loss of taste and smell as a potential flag for COVID-19.

April 14 Weekly morbidity and mortality In a CDC report on COVID-19 infections among health care workers, of the 5000 people who reported symptoms, 750 (16%) wrote “loss of smell and taste” as “other” symptoms.

Meanwhile, the COVID Symptom Tracker smartphone app was co-created by the Massachusetts General Hospital, Boston, Stanford University, California, and King’s College (London, UK), and monitors about 2.5 million people at the time of the press. Similar results have been obtained.

In the 400,000 preprint publications that reported one or more symptoms on the tracker from March 24-29, 18% lost their sense of smell or taste — more than the reported 10%. heat, But much less than the reported 53% Malaise.

Only 1702 out of 400,000 received the COVID-19 test.

Of them, 579 were positive and 1123 were negative.

The organizer estimated that 59% of those who were positive reported a loss of odor or taste, whereas only 18% were negative.

“When combined with other symptoms, people with loss of smell and taste seem to be three times more likely to have COVID-19, according to our data,” Kings College gene said. The symptom tracker website, described by Tim Spector, MD, an epidemiologist and principal investigator of the app.

“They should therefore be self-isolated for seven days to reduce the spread of the disease,” he urged.

Anosmia is an early symptom of many COVID-19 patients

On March 25, AAO-HNS also began collecting data from doctors and patients through a web-based 16-question symptom tracking tool.

Denney said he received more than 500 reports of sudden loss of taste and smell.

Report on the first 237 responses published in Otolaryngology-Head and neck surgery, Odorlessness (serious loss of olfaction) was found in 73% of subjects prior to COVID-19 diagnosis and was the first symptom in 27% of those subjects.

The latter decision was “the single most important finding,” Denney said, pointing out that loss of smell and taste is a “sentinel symptom.”

Anosmia was tested in only 40% of cases.

Half of the reports came from otolaryngologists, but many came from other medical disciplines, especially family medicine.

Only 2% of reports from the first group of patients were based on the response by April 3.

Denney said the patient received more reports, attributed to widespread media coverage of the loss of taste and smell.

The reason why SARS-CoV-2 interferes with taste and smell is not completely clear. More general Virus favorite influenza Other coronaviruses can also cause odor and taste loss.

So far, the sensory recovery of SARS-CoV-2 seems to be faster than other sensations VirusSuggests a potentially different mechanism of action, Yan said. The patients studied in San Diego, California recovered sensations within a few weeks to a month.

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