No Fever or Cough... 'Loss of Smell' Could Be an Infection Warning Signal

66% in Germany, 30% in Korea Confirmed Symptoms
"Possible COVID-19 'Hidden Carriers'"

On the 16th, as the morning temperature in Seoul dropped to minus 2 degrees Celsius, continuing the below-zero cold, office workers are heading to work wearing thick clothes and masks at the Sejongno intersection in Jongno-gu, Seoul. Photo by Kang Jin-hyung aymsdream@

[Asia Economy Reporter Cho Hyun-ui] Loss of smell, or anosmia, has been suggested as a key indicator of infection with the novel coronavirus disease (COVID-19). Until now, fever and cough have been known as the main symptoms, but some experts have urged, "Even if there is no fever or cough, if you suddenly lose your sense of smell, you may be infected with COVID-19 and should enter self-quarantine."

Professor Chun Eun-mi of the Department of Respiratory Medicine at Ewha Mokdong Hospital explained in a phone interview with Asia Economy on the 23rd, "The claim that loss of smell could be a clue to COVID-19 is plausible," adding, "The virus enters our body through the nose and mouth, and this process can cause infection."

Earlier, the British Association of Otorhinolaryngology and the British Rhinological Society warned, "Patients experiencing anosmia without other symptoms may be 'hidden carriers' of COVID-19." In a joint statement, they noted that a significant number of patients in countries with large outbreaks such as China, Korea, and Italy exhibited such symptoms. In Korea, 30% of patients without or with few major suspicious symptoms like fever or cough tested positive, and in Germany, more than 66.6% of confirmed cases experienced loss of smell.

Claire Hopkins, Chair of the British Rhinological Society, said, "Recently, the number of patients experiencing loss of smell without other symptoms has surged," adding, "This is true not only in the UK but also in Iran, the United States, France, and Italy." She continued, "Just this week, I treated four patients with anosmia. Considering that normally I might see one patient a month, these individuals could be hidden carriers of COVID-19."

The problem is that loss of smell is excluded from diagnostic testing criteria. Nirmal Kumar, Chair of the British Association of Otorhinolaryngology, emphasized, "Loss of smell should be a 'screening tool' for COVID-19," stating, "Losing smell and taste without cough or fever means the COVID-19 virus is residing in the patient's nose." He added, "Even without other symptoms, if you cannot smell, you must self-quarantine for seven days," noting, "This will help slow the spread of COVID-19 and reduce the fatality rate."

Experts also expressed concern that otorhinolaryngologists are at risk of COVID-19 infection. In fact, in Wuhan, Hubei Province, China?the initial outbreak site?otorhinolaryngologists and ophthalmologists were infected with COVID-19, and some died. Chair Kumar said, "Recently, two otorhinolaryngologists in the UK were infected," adding, "It is highly likely they were infected while treating asymptomatic patients." However, in Korea, there have been no cases of group infections among otorhinolaryngologists. Professor Chun stated, "There have not been many infections among medical staff, nor cases concentrated in a specific department," adding, "Medical staff infections mainly occurred in the Daegu region and Bundang Jesaeng Hospital."