Lost Sense of Smell May Be Peculiar Clue to Coronavirus Infection
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A mother who was infected with the coronavirus couldn’t smell her baby’s full diaper. Cooks who can usually name every spice in a restaurant dish can’t smell curry or garlic, and food tastes bland. Others say they can’t pick up the sweet scent of shampoo or the foul odor of kitty litter.
Anosmia, the loss of sense of smell, and ageusia, an accompanying diminished sense of taste, have emerged as peculiar telltale signs of Covid-19, the disease caused by the coronavirus, and possible markers of infection.
On Friday, British ear, nose and throat doctors, citing reports from colleagues around the world, called on adults who lose their senses of smell to isolate themselves for seven days, even if they have no other symptoms, to slow the disease’s spread. The published data is limited, but doctors are concerned enough to raise warnings.
“We really want to raise awareness that this is a sign of infection and that anyone who develops loss of sense of smell should self-isolate,” Prof. Claire Hopkins, president of the British Rhinological Society, wrote in an email. “It could contribute to slowing transmission and save lives.”
“我们真的希望提高人们的意识，这是感染的迹象，任何失去嗅觉的人都应该自我隔离，”英国鼻科学会(British Rhinological Society)主席克莱尔·霍普金斯(Claire Hopkins)教授在电子邮件中写道。“这可能有助于减缓传播和拯救生命。”
She and Nirmal Kumar, president of ENT UK, a group representing ear, nose and throat doctors in Britain, issued a joint statement urging health care workers to use personal protective equipment when treating any patients who have lost their senses of smell, and advised against performing nonessential sinus endoscopy procedures on anyone, because the virus replicates in the nose and the throat and an exam can prompt coughs or sneezes that expose the doctor to a high level of virus.
她和英国另一个代表耳鼻喉医生的组织耳鼻喉英国(ENT UK)的主席尼马尔·库马尔(Nirmal Kumar)发表联合声明，敦促医护人员在对失去嗅觉的病人治疗时使用个人防护装备，并建议不要对任何人进行非必要的鼻窦内窥镜诊疗，因为病毒会在鼻腔和喉咙内复制，做检查时会促使患者咳嗽或打喷嚏，令医生暴露于高水平的病毒之下。
Two ear, nose and throat specialists in Britain who have been infected with the coronavirus are in critical condition, Dr. Hopkins said. Earlier reports from Wuhan, China, where the coronavirus first emerged, had warned that ear, nose and throat specialists as well as eye doctors were infected and dying in large numbers, Dr. Hopkins said.
The British physicians cited reports from other countries indicating that significant numbers of coronavirus patients experienced anosmia, saying that in South Korea, where testing has been widespread, 30 percent of 2,000 patients who tested positive experienced anosmia as their major presenting symptom (these were mild cases).
The American Academy of Otolaryngology on Sunday posted information on its website saying that mounting anecdotal evidence indicates that lost or reduced sense of smell and loss of taste are significant symptoms associated with Covid-19, and that they have been seen in patients who ultimately tested positive with no other symptoms.
美国耳鼻喉科学会(American Academy of Otolaryngology)周日在官网发布信息说，越来越多的轶事证据(anecdotal evidence)表明，嗅觉丧失或减少以及味觉的丧失，是和新型冠状病毒肺炎相关的重要症状，它们已出现在最终检测呈阳性、无其他症状的患者身上。
The symptoms, in the absence of allergies or sinusitis, should alert doctors to screen patients for the virus and “warrant serious consideration for self isolation and testing of these individuals,” the academy said. The organization has reminded its members that the Centers for Disease Control and Prevention has urged all clinicians to prioritize urgent and emergency visits for the next several weeks and to reschedule elective and routine procedures.
在没有过敏或鼻窦炎的情况下，这些症状应该提醒医生对患者进行病毒筛查，并“认真考虑让这些人进行自我隔离和检测”，该学会说。该组织提醒成员，美国疾病控制与预防中心(Centers for Disease Control and Prevention)已敦促所有临床医生在未来几周内优先安排急诊，并重新安排选择性手术和常规手术。
“There is evolving evidence that otolaryngologists are among the highest risk group when performing upper airway surgeries and examinations,” said a notice posted on the academy’s website on Friday. “A high rate of transmission of Covid-19 to otolaryngologists has been reported from China, Italy and Iran, many resulting in death.”
Dr. Rachel Kaye, an assistant professor of otolaryngology at Rutgers, said colleagues in New Rochelle, N.Y., which has been the center of an outbreak, first alerted her to the smell loss associated with the coronavirus, sharing that patients who had first complained of anosmia later tested positive for the coronavirus. “This raised a lot of alarms for me personally,” Dr. Kaye said, because those patients “won’t know to self quarantine.”
“Most ENTs have on their own accord tried to scale down,” she said, adding that her department at Rutgers had already started using personal protective equipment and stopped performing nonessential exams.
In the areas of Italy most heavily affected by the virus, doctors say they have concluded that loss of taste and smell is an indication that a person who otherwise seems healthy is in fact carrying the virus and may be spreading it to others.
“Almost everybody who is hospitalized has this same story,” said Dr. Marco Metra, chief of the cardiology department at the main hospital in Brescia, where 700 of 1,200 inpatients have the coronavirus. “You ask about the patient’s wife or husband. And the patient says, ‘My wife has just lost her smell and taste but otherwise she is well.’ So she is likely infected, and she is spreading it with a very mild form.”
A study from South Korea, where widespread testing has been done, found that 30 percent of some 2,000 patients who tested positive for the coronavirus reported experiencing anosmia.
Hendrik Streeck, a German virologist from the University of Bonn who went from house to house in the country’s Heinsberg district to interview coronavirus patients, has said in interviews that at least two-thirds of the more than 100 he talked to with mild disease reported experiencing loss of smell and taste lasting several days.
来自波恩大学(University of Bonn)的德国病毒学家亨德里克·斯特雷克(Hendrik Streeck)在该国的海因斯贝格地区挨家挨户走访冠状病毒感染者，期间与他交谈的100多名轻症患者中，至少有三分之二的人持续数天失去嗅觉和味觉。
Another physician who studied a cluster of coronavirus patients in Germany said in an email that roughly half of the patients had experienced a smell or taste disorder, and that the sensory loss usually presented after the first symptoms of respiratory illness, but could be used to distinguish people who should be tested.
Dr. Clemens Wendtner, a professor of medicine at the Academic Teaching Hospital of Ludwig-Maximilians University of Munich, said that the patients regained their ability to smell after a few days or weeks, and that the loss occurred regardless of how sick they got or whether they were congested. Using nasal drops or sprays did not help, Dr. Wendtner said.
慕尼黑大学教学医院(Academic Teaching Hospital of Ludwig-Maximilians University of Munich)的医学教授克莱门斯·文特纳(Clemens Wendtner)说，患者在几天或几周后恢复了嗅觉，并且失嗅与患病轻重或是否有鼻塞无关。文特纳说，使用滴鼻剂或喷雾是没有用的。
Several American patients who have had symptoms consistent with the coronavirus, but who have not been tested or are still awaiting test results, described losing their senses of smell and taste, even though their noses were clear and they were not congested.
Andrew Berry, 30, developed a fever and body aches about 10 days ago, and then a sore throat and debilitating headaches. He tested negative for influenza and has not gotten the result of a coronavirus test taken four days ago, but his physician was convinced that he had the virus, he said.
Now, Mr. Berry said, he literally cannot smell the coffee.
“Even with a clear nose, I just realized I couldn’t smell the food that I was cooking, and I couldn’t taste the food that I was making,” said Mr. Berry, a tattoo artist based in Orlando, Fla. He was cooking a plantain dish with onions and vinegar, yet he could not smell it.
Amy Plattmier, a woman from Brooklyn, was not tested for the coronavirus during a recent illness, but her husband then became sick and had a positive test. Ms. Plattmier said she usually had a very sensitive nose, but now could barely smell anything — not the bleach she was using to clean the counters, which usually makes her feel nauseated, or the dog’s accident in the bathroom, which she cleaned up.
Mr. Berry has also lost some weight, because he has not had much of an appetite. “Hopefully it’s not a prolonged effect,” he said. “I can imagine it changes the quality of life.”