- Acute anosmia appears to be an early symptom of COVID-19 disease and commonly occurs independently of rhinitis, according to findings of a German cohort study that has not yet undergone peer-review.
Why this matters
- Consider coronavirus testing in patients presenting with unusual, sudden loss of smell and taste without severe nasal blockage, especially patients age
- 500 patients; mean age, 41.3 (range, 18-86) years.
- 466 tested RT-PCR negative for SARS-CoV-2; 34 tested positive.
- 64.7% (22/34) of patients who tested positive complained of sudden olfactory impairment.
- Timing of the loss relative to other symptoms:
- 1-2 days before other symptoms: n=1.
- Simultaneously: n=4.
- 1-7 days after: n=14;
- Unsure: n=3.
- Patients with anosmia were younger (P=.04) vs patients without it.
- Smell visual analogue scale: −6.8±2.3 (median±standard deviation), nasal breathing, −1.1±1.6.
- 45.5% vs 80.9% (SARS-CoV-2 positive vs negative) complained of rhinorrhea.
- Nasal airflow changes were more pronounced in patients with smell loss complaints testing negative vs positive (P<.001>
- Olfactory function changes were more severe in patients testing SARS-CoV-2 positive (P=.023).
- Smell loss as sole symptom: 65% sensitivity, 90% specificity, 32% positive predictive value, 97% negative predictive value.
- Cross-sectional controlled cohort analysis of olfactory loss frequency, diagnostic value of symptom, among outpatients in Germany presenting for coronavirus testing during a 2-week period.
- Funding: None.
- Self-report/recall bias.
- Temporal relationship unclear.