Smell or taste loss the first or only symptom of COVID-19 among nearly 40% of survey respondents

A paper by VCU researchers published in Otolaryngology — Head and Neck Surgery highlights a need for greater testing, the paper’s lead author says.

A person smells food cooking in a pan. [View Image] Researchers at the Smell and Taste Disorders Center at VCU Health have released preliminary results of an ongoing survey of participants who have experienced loss of smell or taste since January or who have had a positive COVID-19 diagnosis. (Getty Images)

A change in sense of smell or taste was the first or only symptom for nearly 40% of respondents to a recent survey about COVID-19, according to preliminary results published by Virginia Commonwealth University researchers in the journal Otolaryngology — Head and Neck Surgery on May 19.

The paper, “Subjective Changes in Smell and Taste During the COVID-19 Pandemic: A National Survey — Preliminary Results,” was written by lead author Daniel Coelho, M.D., professor in the Department of Otolaryngology  — Head and Neck Surgery at VCU School of Medicine. It discusses preliminary results from a national study conducted by researchers at the Smell and Taste Disorders Center at VCU Health.

While other recent papers focus on smell or taste loss for COVID-19 patients, this study takes a broader view and includes respondents who have a change in smell or taste without a COVID-19 diagnosis.

“Evaluating all patients regardless of testing status may provide a clearer picture of the disease, especially in patients who don’t have the more classic symptoms of sore throat, shortness of breath, etc.,” Coelho said. “Despite recognition by health organizations as a cardinal symptom of COVID-19, it appears that many patients with smell and taste loss are still not being tested at all.”

Of the 220 respondents from across the U.S., 93 (42%) were diagnosed with COVID-19 and 127 (58%) were not. Most, but not all, participants had other symptoms suggestive of COVID-19 at the time of their smell or taste loss.

Among all participants, 83 (37.7%) noticed changes in smell or taste as their only or first presenting symptom: 54 (65.1%), both smell and taste loss; 22 (26.5%), change in smell alone; and 7 (8.4%), change in taste alone. According to the paper, patients with only smell and taste changes were less likely to be tested or diagnosed than patients with additional symptoms.

“We hope that these findings help to raise awareness among health care providers that changes in smell and taste, even in the absence of other major symptoms, should raise the suspicion of COVID-19 enough to warrant formal testing,” said Coelho, the G. Douglas Hayden Professor of Otologic and Neurotologic Skull Base Surgery.

The paper’s results are part of a longitudinal study of smell and taste recovery related to COVID-19. The Smell and Taste Disorders Center’s study team launched the study in early April before the Centers for Disease Control and Prevention declared that loss of smell, called anosmia, or loss of taste, called ageusia, are potential symptoms of COVID-19.

The team includes Coelho; Evan Reiter, M.D., the center’s medical director and professor of otolaryngology; Richard Costanzo, Ph.D., the center’s research director and professor emeritus in the Department of Physiology and Biophysics; and Zachary Kons, a rising third-year medical student at VCU.

The study is still enrolling participants at go.vcu.edu/covidsmell and is open to anyone who has had a change in their sense of smell or taste since January or has had a positive COVID-19 diagnosis.

“These are preliminary findings of an ongoing longitudinal cohort study — a powerful research method that sets our study apart,” Coelho said. “Over time, with better understanding of the risk factors, natural course of the disease and effects of treatment, we hope to gain increased understanding of all post-viral smell loss, a relatively common but poorly understood condition.”

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