Your nose may know more when it comes to COVID-19

UC expert says loss of smell could be an early indicator of infection

A University of Cincinnati ear, nose and throat specialist says your nose may hold a clue in identifying COVID-19. The loss of smell may be a key indicator.

Physicians are increasingly recognizing the importance of the nasal cavity in determining the physiology of COVID-19, explains Ahmad Sedaghat, an associate professor in the UC College of Medicine’s Department of Otolaryngology-Head and Neck Surgery and an UC Health physician specializing in diseases of the nose and sinuses.

“COVID-19 is not associated with the symptoms that are typically associated with a viral cold such as nasal blockage or mucus production,” says Sedaghat. “This distinction is also why it is fairly easy to distinguish COVID-19 from seasonal allergies."

“COVID-19 is associated with a fairly unique combination of nasal symptoms: a sudden loss of one’s sense of smell, also known as ‘anosmia,’ without nasal obstruction,” said Sedaghat. “The occurrence of sudden onset anosmia without nasal obstruction is highly predictive of COVID-19 and should trigger the individual to immediately self-quarantine with presumptive COVID-19.”

Most individuals experiencing COVID-19 report symptoms two to 14 days after exposure such as fever, cough and shortness of breath. Medical assistance is needed if individuals have trouble breathing, persistent pressure or pain in the chest or confusion or inability to rouse, according to the Centers for Disease Control and Prevention. For most, recovery comes without assistance.

Sedaghat’s conclusions are available online in the scholarly journal Laryngoscope Investigative Otolaryngology, where he explains that anosmia without nasal obstruction is “a highly specific indicator of COVID-19.”

Ahmad Sedaghat, MD, in the UCGNI.

Dr. Ahmad Sedaghat shown in the UC Gardner Neuroscience Institute.

His findings are based on his review of 19 studies which describe the sinus and nasal disorders reported in relation to the current coronavirus plaguing the nation. Sedaghat’s published paper also references a recent study led by Paris physicians Dominique Salmon and Alain Corré, which shows that out of a group of 55 patients presenting with anosmia without nasal obstruction 94% were found to test positive for COVID-19 by nasal swabbing and polymerase chain reaction tests.

Sedaghat said COVID-19 can be spread when the virus, if present in the body, is produced in the lining of the nose and then released into mucus. “When someone sneezes, this mucus — which contains the virus — is aerosolized outwards. Similarly, if someone wipes their nose and then touches surfaces without washing their hands first, that could lead to spread of COVID-19,” explains Sedaghat.

Loss of smell can occur during anytime an individual is infected with COVID-19, but when this occurs as an initial symptom it is particularly instructive, says Sedaghat.

“A sudden loss of one’s sense of smell wouldn’t trigger most people to think they have COVID-19,” explains Sedaghat. “These individuals could continue business as usual and spread the disease as a carrier. The guidelines for when to formally test for COVID-19 remain fluid in the setting of limited tests. But if someone experiences anosmia without nasal obstruction, aside from quarantining, it would not be unreasonable to reach out to one’s primary care physician about getting tested.”

Sedaghat says the nasal cavity is likely the major site of entry and infection by COVID-19 since at least 90% of inhaled air enters the body through the nose. “Nasal virus production is at very high levels and tends to occur early in the disease process while patients are still asymptomatic or having very mild symptoms,” he says.

Other co-authors in the study include Dr. Isabelle Gengler and Dr. James Wang, both residents in the UC Department of Otolaryngology-Head and Neck Surgery, along with Dr. Marlene Speth from Kantonsspital Aarau in Aarau, Switzerland. None of the study authors have conflicts of interest or financial investments to disclose.

Featured image at top of coronavirus/Unsplash.

Next Lives Here

The University of Cincinnati is classified as a Research 1 institution by the Carnegie Commission and is ranked in the National Science Foundation's Top-35 public research universities. UC's graduate students and faculty investigate problems and innovate solutions with real-world impact. Next Lives Here.

Related Stories

1

Examining medication hesitancy to treat childhood anxiety...

December 5, 2022

University of Cincinnati researchers have published a new study examining factors behind the decision to begin or decline medication treatment for childhood anxiety disorders after cognitive behavioral therapy did not lead to improvement.

2

WLWT: Hospital systems working through multiple viruses spiking

December 2, 2022

Hospitals in the Cincinnati area are dealing with what some are calling a 'tripledemic' of RSV, COVID-19 and the flu. WLWT reported that according to the Health Collaborative, COVID-19 hospitalizations across Ohio counties in greater Cincinnati are at 176 patients. That's 41 more than Friday. About 180 people are hospitalized with the flu. It's a major spike from the week before. One of the experts cited by WLWT is Carl Fichtenbaum, MD, of the Division of Infectious Diseases at the UC College of Medicine.

3

Victoria Morgan encourages Cincinnatians to stay healthy and...

November 29, 2022

You may know Victoria Morgan as the recently retired Artistic Director of the Cincinnati Ballet, but now she has a new goal: helping Cincinnatians stay healthy and active as they age. The Osher Center for Integrative Health at the University of Cincinnati hosted a Movement as Medicine Event on November 3, 2022 at the UC Gardner Neuroscience Institute featuring Victoria’s VM workout.

Debug Query for this