Recent reports from China and Europe have agreed that a sinus complaint, rhinitis, nasal congestion and a loss of smell may be early symptoms of Coronavirus. Many of these patients remain with minimal only symptoms but the loss of smell may turn out to be long term. Loss of smell is termed Anosmia (complete loss of smell sense) or Hyposmia (reduced smell sense)
Currently the CDC is not recommending patients with mild smell loss or other mild or moderate symptoms to undergo testing for COVID-19. I’m certain though as testing becomes more available this may be recommended.
The smelling nerves, or olfactory nerves, have small nerve ending receptors in the roof of the nose. the very top of the nasal cavity is where the sense of smell happens. Furthermore, the mouth and tongue can taste only 5 flavors (bitter, sour, sweet, salty, umami and arguably piquant). The olfactory nerve endings provide chemical receptors to detect hundreds of thousands of other scents, adding flavor complexity to our foods.
We have found that patients who notice a sense of smell decline, but still “taste normally” probably have a mild loss of smell. Patients with complete loss of taste often have more severe smell loss. There are anecdotal bedside tests for smell loss, as well as the UP-SIT scratch and sniff test that can be done in the doctor’s office.
Many of the patients with a mild viral sinusitis, or rhinitis, will have mild findings on CT scan but will have notable swelling at the olfactory tissues.
Right now the concern about Anosmia and Coronavirus is interesting because it is a finding that many of the minimally-symptomatic patients might have, and might indicate a carrier of the infection. This is a developing topic right now, so not entirely much is known yet. We pray that our country gets a good handle on the illness soon and we minimize the lives lost. Thank you for the interest and be well! -Dr. Aaron Rogers