2020-03-25 11:57:111 Oct 2018 01:53 AM EST
By Laura Tucker, Staff writer; Image: Nose and mouth (Image source: Public domain)
With COVID-19 still being a relatively new coronavirus, everything is not known about it yet. Doctors are still identifying new symptoms. A new symptom that has been added to the list is a sudden loss of taste or smell, according to medical groups that represent ear, nose, and throat specialists.
The American Academy of Otolaryngology-Head and Neck Surgery and ENT UK both cited an increasing number of cases worldwide in new warnings. These patients tested positive for COVID-19, yet only had the symptom of a lost or altered sense of smell (anosmia) or taste (dysgeusia).
The American Academy of Otolaryngology-Head and Neck Surgery wrote in a statement: "Anecdotal evidence is rapidly accumulating from sites around the world that anosmia and dysgeusia are significant symptoms associated with the COVID-19 pandemic."
Claire Hopkins, president of the British Rhinological Society, and Nirmal Kumar, president of ENT UK, reported that two large epicenters — China and Italy — along with South Korea, all reported "significant numbers" of patients who tested positive for COVID-19 with lost or reduced sense of smell.
They added that "in Germany it is reported that more than two in three confirmed cases have anosmia. In South Korea, where testing has been more widespread, 30 percent of patients testing positive have had anosmia as their major presenting symptom in otherwise mild cases."
The American Academy of Otolaryngology-Head and Neck Surgery advise that these symptoms should be added to the list of previously known symptoms when screening patients for COVID-19. ENT UK suggests that the new symptom should be a signal to health-care professionals to wear personal protective equipment.
The most common symptoms are fever, fatigue, and a dry cough. One particularly troubling symptom is difficulty breathing. That shows up in one in six patients. Some patients also experience aches and pains, nasal congestion, runny nose, sore throat, and diarrhea.
In older individuals and those dealing with other medical issues, COVID-19 is likely to develop into something more serious, and some patients are infected yet never develop any symptoms. The World Health Organization suggests that those with a fever, cough, and difficulty breathing seek medical attention.
While other viral infections or season allergies could cause the loss of smell or taste, having those symptoms without other respiratory illnesses warrants "serious consideration of self-isolation and testing of these individuals," said the American Academy of Otolaryngology-Head and Neck Surgery.
The American company's executive president and CEO, Dr. James C. Denneny III, noted that some patients experience the loss of smell or taste early in their COVID-19 infection, yet others develop the symptom further down the road.
"The symptoms are clearly not as common as cough, fever, and shortness of breath, but in the absence of a known cause for the smell disorder, this symptom may be an additional identifier for infected patients," he said in a statement.
27-year-old Noelle Ruiz first experienced a more typical symptom of a 101-degree fever, though that went away within 24 hours. Within a time frame of six days, a headache and cough became more serious with chest pain, extreme fatigue, and an inability to catch her breath.
"I couldn't really take a deep breath; I didn't feel like I had enough air in my lungs," said Ruiz. But she also had other symptoms: "I lost taste, food wasn't appetizing, I couldn't smell anything."
When patients have the seasonal flu, Dr. Gregory Levitin, an otolaryngologist at New York Eye and Ear Infirmary of Mount Sinai, said they can have a cluster of symptoms in the beginning. These include a cough, fever, congestion, fatigue, and loss of smell or taste.
He wrote in an email to USA TODAY that "what is most unusual about this new finding is that the loss of smell or taste was the only presenting symptom in a group of patients under the age of 40 who ultimately tested positive for the COVID-19 virus."
The Utah Jazz center, Rudy Gobert, who tested positive for the virus a few weeks ago tweeted that he'd lost his sense of smell and taste and hasn't "been able to smell anything for the last four days."
Denneny and Levitin believe anosmia causes damage to nerves in the naval cavity. "It is unclear whether this is due to direct injury or swelling, but the symptom of anosmia from a viral illness is typically sudden and does not often respond to treatment with steroids or antiviral medications," added Levitin.
Denney said it's possible that some patients could recover their sense of smell in full, or they could permanently lose it. It's also possible that they end up with something in between the two.
"While it is too early to determine how patients affected by COVID-19 will recover, given what we know, it would be reasonable to hope that they would do as well as patients affected by the seasonal flu in years past," noted Levitin.
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