COVID-19: Loss of smell a 'highly reliable indicator' of infection

Loss of smell or taste should now be considered globally as a criterion for self-isolation, testing, and contact tracing, researchers say.

Published: October 2, 2020 at 8:43 am

Four out of five people with sudden loss of smell or taste tested positive for COVID-19 antibodies, new research has suggested.The findings suggest an acute loss of smell or taste is a highly reliable virus indicator, scientists say.

They add that loss of smell or taste should now be considered globally as a criterion for self-isolation, testing and contact tracing.

Researchers at UCL and UCLH (University College London Hospitals NHS Foundation Trust) assessed health data from primary care centres in London.They found that 78 per cent of people who reported sudden loss of smell and/or taste at the height of the pandemic had COVID-19 antibodies.Of these people, 40 per cent did not have a cough or fever.

According to the researchers, it is the first time such a figure has been calculated.

“As we approach a second wave of infections, early recognition of COVID-19 symptoms by the public together with rapid self-isolation and testing will be of vital importance to limit the disease’s spread," said lead author Professor Rachel Batterham, of UCL Medicine and UCLH.

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“While people in the UK who experience sudden onset loss of smell or taste are advised to self-isolate and seek a test, at a global level few countries recognise this symptom as a COVID-19 indicator – most focus on fever and respiratory symptoms," she added.

“Our findings show that loss of smell and taste is a highly reliable indicator that someone is likely to have COVID-19 and if we are to reduce the spread of this pandemic, it should now be considered by governments globally as a criterion for self-isolation, testing, and contact tracing.”

Between 23 April and 14 May, researchers sent texts to people registered with a number of primary care centres in London who had reported sudden loss in their sense of smell and/or taste.

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A total of 590 participants enrolled via a web-based platform and responded to questions about loss of smell and taste and other COVID-19–related symptoms.Of these, 567 then had a consultation with a healthcare professional who confirmed the history of their symptoms and supervised a test to find out if they had coronavirus antibodies.

The study, published in PLOS Medicine, found that 77.6 per cent of 567 people with smell and/or taste loss had antibodies for SARS-CoV-2, the virus that causes COVID-19.Of these, 39.8 per cent did not have a cough or fever, and participants with loss of smell were three times more likely to have SARS-CoV-2 antibodies, compared with those with loss of taste.

“Our research suggests a key public health message should be: people who notice a loss in their ability to smell everyday household odours such as garlic, onions, coffee, and perfumes should self-isolate and seek a coronavirus PCR swab test,” Prof Batterham added.

What causes anosmia?

The medical term for having no sense of smell is ‘anosmia’. People can be born with no sense of smell, due to genetic factors, but most lose it later in life, sometimes permanently. Anosmia has many causes, including head injury, dementia, nasal polyps, and even snake bites.

But the most common cause, accounting for up to 40 per cent of cases, is a viral infection. Indeed, one reported symptom of the coronavirus disease COVID-19 is a loss of smell.

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