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JAMA Insights
Clinical Update
May 20, 2020

Olfactory Dysfunction in COVID-19: Diagnosis and Management

Author Affiliations
  • 1Smell and Taste Clinic, Department of Otorhinolaryngology, TU Dresden, Dresden, Germany
  • 2UCL Ear Institute, University College London, London, United Kingdom
JAMA. 2020;323(24):2512-2514. doi:10.1001/jama.2020.8391

As of May 1, 2020, more than 3 000 000 people worldwide have been infected with the novel coronavirus, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The CDC has highlighted key symptoms that may suggest coronavirus disease 2019 (COVID-19), including cough, shortness of breath or difficulty breathing, fever, chills, muscle pain, sore throat, and new loss of smell or taste.1

The inclusion of loss of smell or taste among these symptoms follows the emergence of evidence that suggests that COVID-19 frequently impairs the sense of smell. For example, in a study from Iran, 59 of 60 patients hospitalized with COVID-19 were found to have an impaired sense of smell according to psychophysical olfactory testing.2 Olfactory dysfunction (OD), defined as the reduced or distorted ability to smell during sniffing (orthonasal olfaction) or eating (retronasal olfaction), is often reported in mild or even asymptomatic cases; in a study from Italy, 64% of 202 mildly symptomatic patients reported impaired olfaction.3

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