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    1 Comment for this article
    Loss of smell in COVID
    Amos Korczyn, MD, MSc | Tel Aviv University, Tel Aviv, Israel
    The recent paper by Spinato et al, “Alterations in Smell or Taste in Mildly Symptomatic Outpatients With SARS-CoV-2 Infection”, claims that COVID patients frequently reported loss of both smell and taste. The loss of smell is non-specific and could result from previous nasal disease, smoking or preclinical Parkinson disease. Unfortunately, there was no control group (for example, matched group of subjects who were found to be negative for SARS-CoV-2).

    More disturbing is the statement that patients lost their sense of taste. This was based solely on patients’ reports during a telephone interview. People who lose their sense of smell
    frequently complain of loss of taste but clinical examination demonstrates intact taste.

    While loss of smell is quite likely because the nasal mucosa can be invaded by the SARS-CoV-2, there is no explanation for the reported loss of taste which is likely to be a misinterpretation by the patients.
    Research Letter
    April 22, 2020

    Alterations in Smell or Taste in Mildly Symptomatic Outpatients With SARS-CoV-2 Infection

    Author Affiliations
    • 1Section of Otorhinolaryngology, University of Padova, Treviso, Italy
    • 2Unit of Cancer Epidemiology, Aviano National Cancer Institute, IRCCS, Aviano, Italy
    • 3Section of Otorhinolaryngology, University of Padova, Padova, Italy
    • 4Guy’s and St Thomas’ Hospitals, London, United Kingdom
    JAMA. 2020;323(20):2089-2090. doi:10.1001/jama.2020.6771

    Since December 2019, a pandemic of coronavirus disease 2019 (COVID-19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has spread globally.1 A spectrum of disease severity has been reported, with main symptoms that include fever, fatigue, dry cough, myalgia, and dyspnea. Previous strains of coronavirus have been demonstrated to invade the central nervous system through the olfactory neuroepithelium and propagate from within the olfactory bulb.2 Furthermore, nasal epithelial cells display the highest expression of the SARS-CoV-2 receptor, angiotensin-converting enzyme 2, in the respiratory tree.3

    Despite anecdotal reports of anosmia, only 1 study to our knowledge has evaluated the prevalence of smell and taste disturbance in hospitalized patients with COVID-19, reporting an overall prevalence of 34% but without data on timing of onset in relation to other symptoms.4