Ahmad Sedaghat, MD, PhD, UC Health rhinologist and associate professor in the Department of Otolaryngology-Head and Neck Surgery at the University of Cincinnati College of Medicine, recently discussed research he is leading on smell loss as an early indicator of COVID-19 and clarified the differences between the virus’ symptoms and general spring allergies on 55KRC Cares, 550 AM radio with host, Brian Thomas.
Dr. Sedaghat specializes in inflammatory diseases of the nose and sinuses. He leads an active and world-renowned research program to better understand these diseases and how they impact patients.
Recently, his research on COVID-19 and the length of time to recover from smell loss was published in the Rhinology, official journal of the European Rhinologic Society, entitled “Time scale for resolution of olfactory dysfunction in COVID-19.”
Brian Thomas: We are in the world of COVID-19, and it seems that the list of symptoms gets longer and longer or changes day to day. Some people lose their taste and sense of smell. Others have a low-grade fever. There is a bunch of math there, so we don't know if we have COVID-19 or not. Now, you led an international study out of Switzerland, focusing on smell loss as an early symptom of COVID-19. Before you get to those findings, there's some confusion about the difference between the COVID-19 symptoms and typical spring allergies. Will you clarify this?
Dr. Sedaghat: That is completely understandable, and it's a very unfortunate time that COVID-19 has come around to coincide with allergy season. There are a couple of ways that individuals can differentiate between allergies and COVID-19. The first is with respect to the symptoms that they're experiencing. Allergies tend to be associated with very classic symptoms, such as sneezing and watery eyes. Those symptoms have really not been reported at all with COVID-19. Now, on the other end of the spectrum, COVID-19 is associated with these classic symptoms of fever and shortness of breath. Those symptoms really are not associated with allergies. So those symptoms (fever, shortness of breath) can help differentiate whether one is having allergies versus COVID-19. Initially, when COVID-19 was described first coming out of China, nasal symptoms such as stuffiness, runny nose and very minor symptoms related to COVID-19, helped push us towards allergies.
One of the things that we found in our own study was that COVID-19 patients actually can get some stuffiness and a runny nose. The symptoms tend to be much more on the mild side, and that may also help tip the balance towards allergies versus COVID-19. If you're having really severe stuffiness or a runny nose, especially if it's associated with more classic symptoms of allergies, like sneezing, for example, that may also help one figure out whether you're having allergies versus COVID-19. The other thing that can help differentiate the two is if you have a history of allergies and every year, right around this time, you start to get stuffy, have a runny nose, sneeze and you start to experience those same symptoms – again, more than likely, you're just experiencing a recurrence of the allergies.
Brian Thomas: Are there certain circumstances where people suffering from allergies can have shortness of breath or fever?
Dr. Sedaghat: Definitely not with fever. Shortness of breath can potentially occur with allergies. Although, I would say it'd be in a very specific circumstance where the person suffering from allergies is also an asthmatic and their asthma gets triggered by allergies; that's why they experienced shortness of breath. But then that situation would also be associated with wheezing and other asthma symptoms. If you were experiencing shortness of breath, you've never had shortness of breath before and you don't have asthma, then that could be a sign of COVID-19.
Brian Thomas: And you would recommend getting in touch with a healthcare provider and being tested? And now, UC Health is doing COVID-19 testing?
Dr. Sedaghat: Yes, testing is being offered all throughout the area. I'll tell you, to some degree, testing is still limited really across the whole nation. Usually, if you're having nonurgent symptoms, the first thing we always recommend, first and foremost, is to self-quarantine and then reach out to your healthcare provider. And if testing is available, then we have patients do that.
Brian Thomas: Dr. Ahmad Sedaghat led an international study regarding smell loss, and it’s an early indication of COVID-19. Is this something that would manifest itself straight on upfront?
Dr. Sedaghat: This is actually one of the most important reasons why it's necessary to know about smell loss as a symptom of COVID-19. There have been studies, including ours, that show that smell loss can be the first symptom that patients experience, and this can happen in up to a quarter of COVID-19 patients. Imagine that up to a quarter of patients will have smell loss and only smell loss as the first symptom, so that gives us a great opportunity to identify these patients early on so that we can quarantine them and prevent the spread.
Brian Thomas: That's a big red flag. Now, a listener out there maybe is saying, “Wait a second. I woke up this morning, and I lost my sense of smell.” What would you recommend that person or those people do out who have that one symptom, what do they do?
Dr. Sedaghat: The first thing to do, again, is quarantine because this is such a specific symptom for COVID-19. We want to prevent the spread. Then after that, we recommend that patients contact their healthcare providers and try to arrange testing at a convenient time.
Brian Thomas: And that [smell loss] is called ‘anosmia’?
Dr. Sedaghat: Anosmia means that your sense of smell is completely gone. The other term we will sometimes talk about it's called ‘hyposmia,’ which means that your sense of smell is diminished.
One of the things that we sought out to do in our study was to understand how severe these symptoms were. We found that the vast majority of patients who experienced some smell loss during COVID-19 experienced severe smell loss, so the vast majority are actually experiencing anosmia.
In terms of COVID-19, we find that about 60% of patients will experience some smell loss. Women in our study tended to experience more severe smell loss and tended to experience it more frequently than men. This actually has been borne out in subsequent studies as well, so studies that got published after ours found the same thing. Women tend to get it more frequently and they tend to get it more severely than men.
Brian Thomas: As far as loss of taste, is that driven by the loss of smell? If you can't smell something, then you're not going to be able to taste?
Dr. Sedaghat: For the most part, that is more than likely what's going on. It's like thinking about a black and white picture versus a color picture. You can tell in a black and white picture what things are. And that's the same thing with one’s sense of taste. You can tell what's sweet. You can tell what is salty for example, but the sense of smell gives that color, that extra layer of detail, so we tend to think of that as the flavor of food. The flavor is really brought out by one's sense of smell.
Brian Thomas: The big question on my mind, if someone is experiencing the smell loss, are they going to want to know if it’s going to come back?
Dr. Sedaghat: We have actually found that the vast majority of patients experienced complete resolution. That's great news. We find that, actually, the vast majority will experience complete resolution, and it takes about a couple of weeks.
Now, there are some patients where the recovery drags out. Most patients are going to have recovery of their sense of smell, but if it doesn't happen within two weeks, that's not necessarily a cause for concern. We did notice that there were a number of patients where recovery drags on for three weeks, four weeks, five weeks or even six weeks. So it can take a while.
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