A case series of patients, including a consultant rhinologist, who all experienced a loss of smell associated with confirmed or suspected COVID-19

• Main Authors: David E.J. Whitehead, Christine Kelly, N. Ahmad
• Format: Article
• Language: English
• Published: Stichting NASE 2020-05-01
• Series: Rhinology Online
• Subjects: anosmia; autonomic dysfunction; autonomic nervous system; coronavirus; covid-19; heart rate variability; hyposmia; olfactory loss; smell training; snot-22
• Online Access: https://www.rhinologyonline.org/Rhinology_online_issues/manuscript_72.pdf

Background: Non-invasive detection of carriers of COVID-19 virus remains elusive. A decrease in sense of smell appears to be a potential marker of the disease. However, it is not the most frequently reported complaint and there may be more novel early markers of disease. Methodology: We present a case series of patients, including a consultant rhinologist who all experienced a loss of smell associated with confirmed or suspected COVID-19. Results: A consultant rhinologist presented with a delayed sudden onset anosmia, four days after testing positive for coronavirus whilst also exhibiting evidence of autonomic dysfunction prior to rRT-PCR diagnosis and during the time period during which smell suddenly deteriorated. Sudden loss of smell can occur within a 3-hour window and a transient increase in SNOT-22 score was also noted at the time of loss. Conclusions: Transient hyposmia or anosmia appear to be an early warning sign or marker symptom associated with COVID-19. Smell can be lost rapidly but appears to recover for many. For others a variety of novel treatments exist. There may be more sensitive or specific signs associated with the disease.