Study finds sensory loss reliable sign of COVID-19
In a breakthrough discovery, researchers have uncovered that those with these subtle symptoms of COVID-19 are actually among the most likely to have it.
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Sudden loss of the sense of smell or taste are among the most common COVID-19 symptoms, a study shows.
An analysis of emergency department presentations reveals those with these subtle symptoms are actually among the most likely patients to have COVID-19.
It raises issues about who should present for testing to avoid a third wave.
Amid concerns many Victorians are already waiting too long to be tested, the Monash University study highlights the risk of waiting for more severe symptoms such as fever and shortness of breath.
With only 50 COVID-19 cases found among almost 3000 symptomatic Victorian and Tasmanian patients in EDs at the start of the second wave, Monash researcher Gerard O’Reilly, an Alfred hospital physician, said the analysis underlined how hard it was for doctors to identify the few patients with coronavirus.
“If somebody has a loss of smell or taste … you’d want to be testing that patient,” Associate Professor O’Reilly said.
“Some of those things that may not be prominent in people’s minds — they might be waiting for the shortness of breath, they might be waiting for the cough, they might be waiting to spike a fever at home — having an issue with their sense of smell and taste, they might dismiss that.
“But there are some things you just can’t dismiss for 24 hours and, if you have a loss of sense of smell and taste, that is a very unique feature.”
During July more than 30,000 people presented at the eight Victorian and Tasmania emergency departments, with 2917 meeting the criteria for COVID-19 testing.
The most common symptoms prompting people to be tested were cough, fever and fatigue. Half reported contact with a positive case.
Results published in the Emergency Medicine Australasia journal found only 50 of those tested had COVID-19, with 26 admitted to hospital including two needing immediate intensive care.
Although the study found there was no one symptom that could help clinicians rule out coronavirus, several symptoms made a positive likely.
Those with a loss of smell or taste plus flu-type symptoms or fever had a high chance of having COVID-19.
While the emergency department project is intended to help doctors focus testing inside hospitals, the results may also help the public to better understand when they need to be tested.
The results also highlight a conundrum for smokers and others with pre-existing health conditions.
Because the consequences of smoking are similar to symptoms of COVID-19, the chances of smokers’ symptoms stemming from coronavirus are smaller.
But despite lower rates of smokers testing positive, the consequences of being infected can be more severe, so they should continue presenting.
“Lots of people meet the criteria to get tested and so the testing criteria are generous, which is great because it means we are going to pick up COVID-19 when it comes into the hospital,” Professor O’Reilly said.
“But even in July there is a small proportion who are tested for it and meet the criteria who end up having it.
“As we go forward this will inform what the quiet time will look like. It will better inform which patients we can drop off from having to be tested when they come to the ED.”