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COVID-19 and Loss of Smell: A Mass. Eye and Ear Expert Weighs in

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Eric Holbrook, MD, comments on the reports of loss in smell and taste related to the new coronavirus.

Emerging reports suggest a loss of smell might be a symptom to be aware of amid the ongoing coronavirus pandemic. According to numerous media outlets, doctors are reporting a reduced loss of smell and taste, or anosmia, in a large percentage of people who test positive for the new coronavirus, COVID-19.

Dr. Eric Holbrook, director of Rhinology at Massachusetts Eye and Ear and co-Director of the Sinus Center, spoke to Focus and several news organizations this week to explain what anosmia is, what causes it, and when people should seek help if they’re experiencing a loss in smell.

Flag raised for ear, nose and throat doctors

This week, ENT UK, the British  Association of Otorhinolaryngology said in a guidance that in countries with high coronavirus rates including South Korea, China, Italy, Iran and France, significant numbers of patients who tested positive for COVID-19 infection have developed anosmia, or a reduced ability to smell (hyposmia).

“We really want to raise awareness that this is a sign of infection and that anyone who develops loss of sense of smell should self-isolate,” Prof. Claire Hopkins, president of the British Rhinological Society, told The New York Times. “It could contribute to slowing transmission and save lives.”

In Germany more than two out of three cases have anosmia. In South Korea, where testing has been more widespread, 30 percent of confirmed cases have reported loss of smell as their major symptom in otherwise mild cases.

“The unique part of this association is that the reports are coming from patients who are COVID-19-positive, and in some cases, they’re having the smell loss when their symptoms are pretty mild,” Dr. Holbrook told MassLive.

The American Academy of Otolaryngology- Head and Neck Surgery added in a statement to its U.S. members that a loss or reduction in smell and taste, in the absence of a respiratory disease such as allergies, an acute or a chronic sinus infection (sinusitis), should alert physicians to the possibility of COVID-19 infection and in addition, consider self-isolation and testing these individuals.

Symptom tough to distinguish from other viruses

According to ear, nose and throat surgeon Dr. Holbrook, who researches ways to treat permanent smell loss, it’s unknown whether inflammation or damage to the olfactory nerve caused by the coronavirus results in a reduced or eliminated sense of smell.

“It may be caused by the viral infection, and the reaction to the tissue around it, or the virus could be causing an inflammatory response and temporary disabling the nerve or preventing odors from getting in the nose,” said Dr. Holbrook.

Often, people who reported smell loss have noted a loss in taste too. Given smell and taste are used in combination to sense flavor, it can be hard to distinguish the difference, Dr. Holbrook said. A challenge for doctors and people with this symptom are there are other upper respiratory viral infections, such as influenza, that might cause a reduced or lost sense of smell.

“One of the things I think a lot of physicians and patients are struggling with is trying to determine whether these mild symptoms are related to, say, allergies or a mild cold,” Dr. Holbrook told STAT.

In the case of COVID-19, he points to reports that indicate patients appear to be recovering from loss of smell within about two weeks. 

What are ENT doctors looking at next?

Dr. Holbrook told the Associated Press that these reports have been a hot topic among researchers and doctors, but “we don’t have hard evidence right now” about how often smell loss occurs in people infected with the pandemic virus. He added that he is aiming to set up a study in people being tested for the coronavirus at Boston-area hospitals, to determine whether this symptom can be used as a diagnostic marker for the disease.

“If anyone is experiencing sudden smell loss, especially in the context of the other symptoms being reported for the coronavirus, including fever and breathing problems, this may raise suspicion for possible COVID-19 and that person should contact their primary care doctor.”

Read more in:

Associated Press

STAT

MassLive

Hear an interview with Dr. Holbrook on WBZ NewsRadio.

About Our Expert

Doctor headshotEric Holbrook, MD, specializes in complex sinus and endoscopic skull base surgery. He sees patients in the Mass. Eye and Ear Sinus Center, located at our main campus in Boston.

 

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