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September 03, 2021
2 minutes to read
In patients with positive and negative SARS-CoV-2 test results, congestion and runny nose were associated with further loss of taste or odor, suggesting that these symptoms “may not be a valid marker of the positivity of the test, ”the researchers wrote.
Alain K. Koyama, ScD, Honorary Fellow of the Australian Institute of Health Innovation, and colleagues analyzed data from 59,153 completed uses of the CDC’s online Coronavirus Self-Checker tool that took place between February 2, 2021 and May 3, 2021.
Of all the uses, 43,736 were from an individual with a negative SARS-CoV-2 test result; the remaining 15,417 were from those with a positive SARS-CoV-2 test result. Most of the uses came from non-Hispanic Caucasian women between the ages of 18 and 29, according to the researchers.
The conclusions, published in JAMA Otorhinolaryngology-Head and Neck Surgery, found that congestion or runny nose was more strongly related to loss of taste and smell in people with negative SARS-CoV-2 test results (OR = 2.26; 95% CI, 2.08-2.45) than those with a positive SARS-CoV-2 test results (OR = 1.66; 95% CI: 1.54-1.79).
Additionally, cough and fever were significantly related to further loss of taste or smell in individuals with negative test results (cough: OR = 1.57; 95% CI: 1.45-1 , 69; fever: OR = 1.16; 95% CI, 1.07-1.25). This relationship did not exist among those with positive test results (cough: OR = 1.01; 95% CI, 0.94-1.09; fever: OR = 0.95, 95% CI, 0.88 to 1.02), according to the researchers. In addition, vomiting or diarrhea had a stronger association with new loss of taste or smell in those with positive test results (OR = 1.52; 95% CI, 1.4-1 , 65) compared to those with negative test results (OR = 1.23; 95% CI, 1.13-1.35).
“Limitations include possible residual confusion inherent in observational data and the possibility that the data partially reflects individuals who have used the tool multiple times and / or had been vaccinated,” Koyama and colleagues wrote. Those who used the tool “may also have been aware of loss of taste or smell as a symptom of COVID-19, which may have resulted in bias and / or loss of potency.”
Koyama and colleagues recommended that future studies seek to “elucidate whether the symptoms accompanying a new loss of taste or smell may be part of a single clinical presentation associated with a milder course of the disease.”
Perspective
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Rachel Kaye, MD
This study is interesting in that it uses a large dataset. There are some limitations, including nearly three times as many respondents had negative COVID-19 test results than positive results. Negative data from COVID-19 test results may reflect non-COVID-19 viral symptoms, which is important to note when comparing to COVID-19 symptoms. It appeared that most of the symptoms associated with loss of taste or smell were similar in both positive and negative groups, but some were more strongly associated with loss of taste or smell in the negative group. Cough and fever were not associated with loss of taste or smell in the positive group.
This study raises the question of how to compare the symptoms of loss of taste or smell in individuals who test positive for COVID-19 versus those who have tested negative. Although this is a cross-sectional study and there is some inherent bias in the study (due to self-report), this raises a very important point in that there is a significant overlap in symptoms between people who test positive for COVID-19 and those who test negative.
I want to point out that the loss of taste or smell existed before before the COVID-19 pandemic. Symptoms of viral or post-viral loss of taste or smell have already been studied. Although there is an overlap in symptoms between COVID-19 and other viruses, anyone with the symptoms listed by the CDC should be evaluated.
Rachel Kaye, MD
Otolaryngologist, ear-nose-throat specialist
RWJ Barnabas Health, New Jersey
Disclosures: Kaye does not report any relevant financial disclosure.
COVID-19 Resource Center
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