Smell, taste and COVID-19: testing is essential. 2021

Christopher H Hawkes
From the Department of Neuroimmunology, Blizard Institute, Queen Mary University of London, 4 Newark St, London E1 2AT, UK.

During the COVID-19 pandemic, it became clear that smell and taste (chemosensory) disturbance is very common in the early stages of disease. This article addresses (i) why COVID-19 specifically targets the modalities of smell and possibly taste and what is the mechanism, (ii) what is the frequency of smell and taste loss and (iii) what is the overall prognosis. It is suggested that mouth-breathers may be at particular risk of COVID-19. Symptom-based questionnaires are likely to under-estimate the prevalence of chemosensory impairment by as much as 50%. The prevalence of smell loss is so high that a person who has normal olfaction on formal testing is unlikely to be infected significantly with Cov-2. Furthermore, someone without symptoms who has an abnormal smell test could still be infected and liable to spread the disease. Brief, low-cost, olfactory tests are available that would permit a high throughput in field stations and airports. A normal result might obviate the need for a nasopharyngeal swab for the Cov-2 virus.

UI MeSH Term Description Entries
D006801 Humans Members of the species Homo sapiens. Homo sapiens,Man (Taxonomy),Human,Man, Modern,Modern Man
D000086382 COVID-19 A viral disorder generally characterized by high FEVER; COUGH; DYSPNEA; CHILLS; PERSISTENT TREMOR; MUSCLE PAIN; HEADACHE; SORE THROAT; a new loss of taste and/or smell (see AGEUSIA and ANOSMIA) and other symptoms of a VIRAL PNEUMONIA. In severe cases, a myriad of coagulopathy associated symptoms often correlating with COVID-19 severity is seen (e.g., BLOOD COAGULATION; THROMBOSIS; ACUTE RESPIRATORY DISTRESS SYNDROME; SEIZURES; HEART ATTACK; STROKE; multiple CEREBRAL INFARCTIONS; KIDNEY FAILURE; catastrophic ANTIPHOSPHOLIPID ANTIBODY SYNDROME and/or DISSEMINATED INTRAVASCULAR COAGULATION). In younger patients, rare inflammatory syndromes are sometimes associated with COVID-19 (e.g., atypical KAWASAKI SYNDROME; TOXIC SHOCK SYNDROME; pediatric multisystem inflammatory disease; and CYTOKINE STORM SYNDROME). A coronavirus, SARS-CoV-2, in the genus BETACORONAVIRUS is the causative agent. 2019 Novel Coronavirus Disease,2019 Novel Coronavirus Infection,2019-nCoV Disease,2019-nCoV Infection,COVID-19 Pandemic,COVID-19 Pandemics,COVID-19 Virus Disease,COVID-19 Virus Infection,Coronavirus Disease 2019,Coronavirus Disease-19,SARS Coronavirus 2 Infection,SARS-CoV-2 Infection,Severe Acute Respiratory Syndrome Coronavirus 2 Infection,COVID19,2019 nCoV Disease,2019 nCoV Infection,2019-nCoV Diseases,2019-nCoV Infections,COVID 19,COVID 19 Pandemic,COVID 19 Virus Disease,COVID 19 Virus Infection,COVID-19 Virus Diseases,COVID-19 Virus Infections,Coronavirus Disease 19,Disease 2019, Coronavirus,Disease, 2019-nCoV,Disease, COVID-19 Virus,Infection, 2019-nCoV,Infection, COVID-19 Virus,Infection, SARS-CoV-2,Pandemic, COVID-19,SARS CoV 2 Infection,SARS-CoV-2 Infections,Virus Disease, COVID-19,Virus Infection, COVID-19
D000086582 Anosmia Complete or severe loss of the subjective sense of smell. Loss of smell may be caused by many factors such as a cold, allergy, OLFACTORY NERVE DISEASES, viral RESPIRATORY TRACT INFECTIONS (e.g., COVID-19), aging and various neurological disorders (e.g., ALZHEIMER DISEASE). Hyposmia,Loss of Smell,Smell Loss
D000086742 COVID-19 Testing Diagnosis of COVID-19 by assaying bodily fluids or tissues for the presence of COVID-19 antibodies, SARS-COV-2 antigens or the VIRAL RNA of SARS-COV-2. 2019 Novel Coronavirus Disease Testing,2019 Novel Coronavirus Testing,2019-nCoV Disease Testing,2019-nCoV Infection Testing,2019-nCoV Testing,COVID-19 Diagnostic Testing,COVID-19 Virus Testing,COVID19 Testing,COVID19 Virus Testing,Coronavirus Disease 2019 Testing,Coronavirus Disease-19 Testing,SARS Coronavirus 2 Testing,SARS-CoV-2 Testing,Severe Acute Respiratory Syndrome Coronavirus 2 Testing,2019 nCoV Disease Testing,2019 nCoV Infection Testing,2019 nCoV Testing,2019-nCoV Disease Testings,2019-nCoV Infection Testings,2019-nCoV Testings,COVID 19 Diagnostic Testing,COVID 19 Testing,COVID 19 Virus Testing,COVID-19 Diagnostic Testings,COVID-19 Testings,COVID-19 Virus Testings,COVID19 Testings,COVID19 Virus Testings,Coronavirus Disease 19 Testing,Coronavirus Disease-19 Testings,Diagnostic Testing, COVID-19,Disease Testing, 2019-nCoV,Infection Testing, 2019-nCoV,SARS CoV 2 Testing,SARS-CoV-2 Testings,Testing, 2019-nCoV,Testing, 2019-nCoV Disease,Testing, 2019-nCoV Infection,Testing, COVID-19,Testing, COVID-19 Virus,Testing, COVID19,Testing, COVID19 Virus,Testing, Coronavirus Disease-19,Testing, SARS-CoV-2,Virus Testing, COVID-19,Virus Testing, COVID19
D012903 Smell The ability to detect scents or odors, such as the function of OLFACTORY RECEPTOR NEURONS. Olfaction,Sense of Smell,Smell Sense
D013649 Taste The ability to detect chemicals through gustatory receptors in the mouth, including those on the TONGUE; the PALATE; the PHARYNX; and the EPIGLOTTIS. Gustation,Taste Sense,Gustations,Sense, Taste,Senses, Taste,Taste Senses,Tastes
D013651 Taste Disorders Conditions characterized by an alteration in gustatory function or perception. Taste disorders are frequently associated with OLFACTION DISORDERS. Additional potential etiologies include METABOLIC DISEASES; DRUG TOXICITY; and taste pathway disorders (e.g., TASTE BUD diseases; FACIAL NERVE DISEASES; GLOSSOPHARYNGEAL NERVE DISEASES; and BRAIN STEM diseases). Taste Disorder, Primary,Taste Disorder, Secondary,Taste Dysfunction,Taste, Metallic,Taste Disorder, Anterior Tongue,Taste Disorder, Posterior Tongue,Taste Disorder, Primary, Bitter,Taste Disorder, Primary, Salt,Taste Disorder, Primary, Sweet,Taste Disorder, Secondary, Bitter,Taste Disorder, Secondary, Salt,Taste Disorder, Secondary, Sweet,Dysfunction, Taste,Metallic Taste,Metallic Tastes,Primary Taste Disorder,Primary Taste Disorders,Secondary Taste Disorder,Secondary Taste Disorders,Taste Disorder,Taste Disorders, Primary,Taste Disorders, Secondary,Tastes, Metallic
D063189 Symptom Assessment Evaluation of manifestations of disease. Symptom Evaluation,Assessment, Symptom,Assessments, Symptom,Evaluation, Symptom,Evaluations, Symptom,Symptom Assessments,Symptom Evaluations

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