key: cord-0967593-z4737093
authors: Lechner, Matt; Counsell, Nicholas; Liu, Jacklyn; Eynon-Lewis, Nicholas; Paun, Santdeep; Lund, Valerie J; Jayaraj, Sam; Philpott, Carl
title: Anosmia and hyposmia in health-care workers with undiagnosed SARS-CoV-2 infection
date: 2020-08-06
journal: Lancet Microbe
DOI: 10.1016/s2666-5247(20)30096-3
sha: 20d66b70abbacb11ed7bd8b12effd5eb33575676
doc_id: 967593
cord_uid: z4737093

nan

www.thelancet.com/microbe Vol 1 August 2020 e150

Losing sense of smell or taste and developing COVID-19 were strongly associated. Participants who lost their sense of smell or taste were more likely to have a positive SARS-CoV-2 test than those who did not report these symptoms (odds ratio 4·9, 95% CI 1·4-17·1, p=0·01). 97 participants responded to a follow-up survey done between May 22 and 27, 2020; 45 (46%) reported that they had completely regained their sense of smell or taste, 41 (42%) had recovered partially, and seven (7%) had not recovered (not applicable for four [4%] responders). 71 (73%) of 97 responders had continued to work as normal. Around two-thirds of participants reported loss of sense of smell or taste in the previous 2 months, which is highly indicative of SARS-CoV-2 infection (appendix p 2). In comparison, the prevalence of self-reported smell loss varies between 1·4% and 15·3% across published studies. 4, 5 To date, testing for health-care workers in the National Health Service has been scarce and only recently has been made more widely available. Thus, a large proportion of healthcare workers might have already been infected with SARS-CoV-2 and had only mild symptoms, resulting in only a small number of health-care workers being tested. In conclusion, awareness and early recognition of anosmia and hyposmia is needed to identify, urgently test, and isolate affected health-care workers to prevent further spread of disease.

On May 18 2020, Public Health England added new loss of taste or smell to the recognised symptoms associated with COVID-19, consistent with those listed by the Centers of Disease Control and Prevention (Atlanta, GA, USA) and WHO. 1,2 The identification of loss of sense of smell as a symptom of severe acute respiratory syndrome corona virus 2 (SARS-CoV-2) is particularly important for frontline health-care workers who are at high risk of both contracting and spreading SARS-CoV-2. 3 A n o n y m o u s s e l f -r e p o r t e d question naires were distributed to staff at Barts Health NHS Trust (London, UK). In total, 262 healthcare workers from four hospitals completed the questionnaire between April 17 and 23, 2020, of whom, 59% were women, 58% were younger than 40 years, and 6% were older than 60 years, provi ding a representative sample of the patient-facing workforce. 73 (28%) of 262 participants had been tested for SARS-CoV-2; 56 of whom had a confirmed positive test by PCR. 168 (64%) of 262 responders reported losing their sense of smell or taste in the previous 2 months, with 94 (48%) reporting mild symptoms, 93 (48%) reporting moderate symptoms, and seven (4%) reporting severe symptoms.

Statement from the UK Chief Medical Officers on an update to coronavirus symptoms

Centers for Disease Control and Prevention. Coronavirus disease 2019. Symptoms

Anosmia as a presenting symptom of SARS-CoV-2 infection in healthcare workersa systematic review of the literature, case series, and recommendations for clinical assessment and management

Position paper on olfactory dysfunction

The epidemiology of olfactory disorders

See Online for appendix