Scentless, but not Senseless—Opt for Testing When Patients Complain About Lack of Smell

Evidence that alterations in a patient’s senses of smell and taste were common in COVID-19 infection was abundant at the outset of the pandemic. It was also completely anecdotal, and sometimes refuted in early studies. Now that more cases have amassed and more in-depth research completed, however, it seems clear that such alterations are, in fact, strong (but not universal) indicators that a patient has been infected with the virus. JAMA Otolaryngology – Head & Neck Surgery just published a study revealing that 35% of patients who tested positive for the virus complained of olfactory dysfunction, gustatory dysfunction, or both, compared with 4% who reported those complaints but did not have the virus. The take-home point for urgent care clinicians is that while disruptions in smell and taste do not predict diagnostic certainty, they are key pieces of evidence that a patient is symptomatic with COVID-19 and should be tested, and should self-quarantine in the absence of a negative test result.