Is anosmia a symptom of Covid-19?

Published Apr 8, 2020

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CAPE TOWN - The loss of smell, anosmia, as a symptom of Covid-19 can be put into the same category as fever. These are the remarks by Steven Munger, director of the University of Florida’s Centre for Smell and Taste.

However, some experts believe there is not enough evidence to support this link, like the World Health Organisation (WHO) who has not added anosmia to the list of Covid-19 symptoms.

Scientists, scholars and world leaders are scrambling to find out as much evidence as possible to reduce the spread of the disease and identify potential cases as early as possible. This is everything you need to know on the link between Covid-19 and anosmia and how you can test your smell.

The New York Times first reported that on Friday, March 20, ear, nose and throat (ENT) doctors in the United Kingdom were concerned enough to publicly warn citizens to self-isolate if they experienced anosmia. This occurred after their colleagues around the world cited the potential link between anosmia and Covid-19, despite the fact that the published data was limited.

“It could contribute to slowing transmission and save lives,” according to the president of the British Rhinological Society, Professor Claire Hopkins. She goes adds how reports from the early stages of the outbreak in China warned how ENT doctors were dying in large numbers. As sinus endoscopy procedures directly put these specialists at risk because it can prompt coughs or sneezes.

In South Korea, 600 out of 2000 confirmed cases of Covid-19 presented anosmia as their dominant symptom. two out of three confirmed cases had anosmia in Germany, and a similar pattern was reported in Italy.

In almost all cases the symptom was present in people who seemed healthy, yet could most likely be infected and as a result of no extreme symptoms, have facilitated the spread of the virus.

Dr. Marco Metra, chief of the cardiology department at a hospital in Brescia, Italy assertively adds how “almost everybody who is hospitalised has this same story”.

The pitfalls of anosmia as a symptom

Some experts argue that there is no conclusive evidence to firmly state this claim of a connection between anosmia a symptom of Covid-19.

In Germany for instance, the evidence collected relied on personal testimony as opposed to hard quantifiable evidence. It rests on a virologist who went door-to-door to 100 homes interviewing those who reported mild cases of Covid-19.

While the British study collected evidence through an online app showed nearly 347 out of 579 confirmed cases had anosmia, although less than 220 out of 1 123 negative cases reported the same symptom.

Smell loss is also a very common phenomenon long before the outbreak began due to certain habits like smoking, normal colds, and flu, as well as due to tumors, diseases like Alzheimer’s or Parkinson’s and even whiplash.

Eric Holbrook, director of rhinology at Massachusetts Eye and Ear, highlights the lack of concrete evidence and methodology behind collecting the data; “I haven’t seen a careful study that looks at when patients get the diagnosis, and how severe it is, and how long the smell loss lasts”.

“Physicians are collecting data so quickly, but a lot of it is subjective data”.

There is an understandable urgency to collect as much information as possible, to highlight this to the public in order to prevent the loss of life. Irrespective of whether there is a verified scientific link between anosmia and Covid-19, take the test and follow-up with your doctor if you are experiencing a loss of smell.

The jelly bean test

T

he scientific name of the jelly bean, or retronasal olfaction, is a process where you allow odours to rise from the back of your mouth and directly into your nasal cavity. And if you do not have any jelly beans, try using something with an intense flavour.

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Munger explains that the first thing you should do is have a jelly bean in one hand and with the other, close your nose tightly so there is no airflow.

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Then put the jelly bean in your mouth and chew while your nose is still tightly closed.

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“Let's say it's a fruit flavor jellybean: if you get the savory plus the sweetness of the jellybean you'll know you have functional taste".

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In the process of chewing, release your grip on your nose.

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You should then get all the odours at once if you do, you don’t have anosmia.

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“You'll say 'Oh! that's a lemon jellybean,' or 'Oh! that's cherry.' It's really a very dramatic, quick, 'Wow' type of response," he passionately states.

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If you get that reaction, then your sense of smell is intact.

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Munger goes on to say if you are also able to go from sweet and sour to the full flavor and know what the flavor is, then your sense of smell is probably in pretty good shape”.

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