Lack of Taste, Smell Can Aid Early Identification of Patients With COVID-19

An important consideration in control COVID-19 infection is identifying infected patients as soon as possible, so they can be quarantined. Mounting evidence of a link between loss of taste and smell and the novel coronavirus could help pharmacists and other health professionals do that. Here is more information.

MILAN, ITALY – As one of the most accessible healthcare professionals for most patients, pharmacists have an opportunity to detect potential COVID-19 cases and, therefore, help prevent transmission.

More data on the link between lost taste and smell with novel coronavirus infection can help do that. An article in JAMA Otolaryngology- Head& Neck Surgery addresses whether there are relevant sinonasal manifestations associated with the onset of COVID-19.

Italian researchers from Humanitas University conducted a survey study of 204 patients with coronavirus disease 2019, determining that taste reduction was present in 554% of patients, while smell reduction was present in 41.7% of patients. Yet, severe nasal obstruction was uncommon at the onset of the disease, affecting only 7.8% of patients.

“The findings suggest that coronavirus disease 2019 should be suspected when severe reduction of taste and smell are present in the absence of nasal obstruction,” the authors advise, adding, “Early diagnosis of coronavirus disease 2019 (COVID-19) may help control the diffusion of the disease into the population.”

The retrospective telephone survey study investigated patients diagnosed with COVID-19 from March 5 to March 23, 2020; participants all had been hospitalized or discharged from a single referral center, the study excluded patients who were unable to answer because they were intubated, receiving noninvasive ventilation, or deceased or if they were unreachable by telephone.

Of 359 consecutive patients, 204 fulfilled the inclusion criteria; 76 were unable to answer, 76 were unreachable by telephone, and 3 refused.

Researchers sought to measure sinonasal manifestations reported before COVID-19 diagnosis with a validated questionnaire: Italian Sino-Nasal Outcome Test 22 (I-SNOT-22). If reduction of taste and/or smell was documented by item 5 of the I-SNOT-22, the study team made further inquiries to score them separately on a scale from 0 to 5, with 0 indicating no problem and 5 indicating a problem as bad as it can be.

Patients enrolled were 53.9% male with a mean age of 52.6. Their median I-SNOT-22 total score was 21 (range, 0-73).

Researchers report that I-SNOT-22 identified 116 patients (56.9%) with reduction of taste and/or smell, 113 (55.4%) with taste reduction (median score, 5; range, 2-5), and 85 (41.7%) with smell reduction (median score, 5; range, 1-5). Overall, 82 patients (40.2%) reported both, they said.

Results indicate that severe reduction of taste was present in 81 patients (39.7%), and severe reduction of smell was present in 72 patients (35.3%). Only 12 patients (14.8%) with severe taste reduction and 12 patients (16.7%) with severe smell reduction reported severe nasal obstruction.

The authors note that severe reduction of taste and smell was more prevalent in female vs male patients (odds ratios, 3.16 [95% CI, 1.76-5.67] vs 2.58 [95% CI, 1.43-4.65]) and middle-aged vs younger patients (effect sizes, 0.50 [95% CI, 0.21-0.78] vs 0.85 [95% CI, 0.55-1.15]). Yet, they documented no significant association between smoking habits and severe reduction of taste (odds ratio, 0.95; 95% CI, 0.53-1.71) and/or smell (odds ratio, 0.65; 95% CI, 0.35-1.21).

“The findings of this telephone survey study suggest that reduction of taste and/or smell may be a frequent and early symptom of COVID-19,” the study concludes. “Nasal obstruction was not commonly present at the onset of the disease in this study.”

The authors suggest that healthcare professionals could “play a pivotal role in identifying potential COVID-19 in patients at an early stage if taste and/or smell alterations manifest and in suggesting quarantine before confirmation or exclusion of the diagnosis.”

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