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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  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

Recently, 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, while in South Korea, where testing has been more widespread, 30 percent 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.

In a statement to its members, the The American Academy of Otolaryngology- Head and Neck Surgery said 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 and in addition, consider self-isolation and testing these individuals.

Symptom tough to distinguish from other viruses

According to Dr. Holbrook, an ear, nose and throat (ENT) surgeon who researches ways to treat permanent smell loss, it’s unknown what causes the symptom. Inflammation or damage to the olfactory nerve caused by the coronavirus might reduce or eliminate 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 temporarily disabling the nerve, or preventing odors from getting in the nose,” said Dr. Holbrook.

Often people who have 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. He added that a challenge for doctors and people with this symptom are that other upper respiratory infections, such as influenza or a cold, might cause reduced or lost 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.

Thankfully, 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 with COVID-19. He plans to study in Boston hospitals whether this symptom can be used as a diagnostic marker for patients with the virus.

Said Dr. Holbrook, “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.

 

0 Comments

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  1. Avatar

    ADDISU

    thank you

    • Avatar

      Ryan Jaslow

      Thanks for reading!

  2. Avatar

    Maria Ettore

    It’s there any new research for patients suffering from Anosmia. I visited Mass Eye & Year 3 years ago for my loss of smell and taste after a bad cold and the ENT didn’t offer much information or hope. Hopefully, more attention and research will come now that these symptoms exist from Covid-19 victims and help everyone who suffers from this.
    thank you

  3. Avatar

    Richard Pesavento

    I’m an ophthalmologist and MEEI alum. I had covid, tested positive, 6 weeks ago. I completely lost all sense of smell (not all bad) and most of my sense of taste early on. This was associated with very mild URI symptoms. I have completely recovered and most of my sense of taste has returned, but my sense of smell is still reduced. I wonder if this could be neurological with the possibility of some permanent deficit.

  4. Avatar

    Meghan

    Can anyone speak on whether there’s a link between multiple ear/Eustachian tube surgeries, chronic ear infection, and long-term loss of smell/taste? Thank you.

  5. Avatar

    Lauren

    I tested positive for COVID-19 back in May and had mild symptoms, but also experienced loss of smell/taste.
    It is now going on 6 months later and my smell and taste have not returned. Wondering if there is any new info on how long this symptom may last for and if I will ever fully gain my sense of smell/taste back??

    • Avatar

      Ryan Jaslow

      Hi Lauren, thanks for reading and your comment. We checked with Dr. Holbrook. Since COVID-19 is a new disease, researchers are learning as they go along and more information and studies come out. Prior to COVID-19, however, it was not unusual for patients to have smell loss after a viral infection for 8 months to a year before there are signs of recovery.