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Loss of Sense of Smell and Taste an early symptom in COVID-19: JAMA Network


picture by mohamed hassan courtesy of

This from an article summary in JAMA Network on June 18:

This survey study of 204 patients with coronavirus disease 2019 found that taste reduction was present in 55.4% of patients, whereas smell reduction was present in 41.7% of patients. Severe nasal obstruction was uncommon at the onset of the disease (7.8%).

The subjects were Italian patients with COVID-19 diagnosed from March 5 to March 23 and who were contacted by telephone afterwards.  They had an early onset of loss of smell and taste (taste is mostly dependent on sense of smell, but is more noticeable), usually before they were diagnosed with the disease and before symptoms of fever, cough, and shortness of breath occurred.  They also had a low incidence of nasal obstruction, which obviously would impair sense of smell.  The significance of this finding is that the virus appears to invade the nose and specifically nasal nerves early in the course of disease.  This symptom should be looked at early when asking whether a patient has COVID-19.

It has become more apparent that, in severe cases, the virus will also invade the brain and cause encephalitis– which may be overlooked in cases where the patient is so ill that they are placed on a ventilator.  The neurological symptoms may be masked by drugs used to sedate the patient in order to facilitate ventilation.  The symptoms that at-home patients relate– night-time hallucinations and nightmares– may also be related to neurological involvement.

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