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Coronavirus Smell Loss 'different From Cold And Flu'
By Michelle RobertsHealth editor, BBC News online
The loss of smell that can accompany coronavirus is unique and different from that experienced by someone with a bad cold or flu, say European researchers who have studied the experiences of patients.
When Covid-19 patients have smell loss it tends to be sudden and severe.
And they usually don't have a blocked, stuffy or runny nose - most people with coronavirus can still breathe freely.
Another thing that sets them apart is their "true" loss of taste.
It's not that their taste is somewhat impaired because their sense of smell is out of action, say the researchers in the journal Rhinology. Coronavirus patients with loss of taste really cannot tell the difference between bitter or sweet.
Experts suspect this is because the pandemic virus affects the nerve cells directly involved with smell and taste sensation.
The main symptoms of coronavirus are:
Anyone with these symptoms should self-isolate and arrange to have a swab test to check if they have the virus. Members of their household should isolate too to prevent possible spread.
Covid symptoms: What are they and how long should I self-isolate for?Lead investigator Prof Carl Philpott, from the University of East Anglia, carried out smell and taste tests on 30 volunteers: 10 with Covid-19, 10 with bad colds and 10 healthy people with no cold or flu symptoms.
Smell loss was much more profound in the Covid-19 patients. They were less able to identify smells, and they were not able to discern bitter or sweet tastes at all.
Prof Philpott, who works with the charity Fifth Sense, which was set up to help with people with smell and taste disorders, said: "There really do appear to be distinguishing features that set the coronavirus apart from other respiratory viruses.
"This is very exciting because it means that smell and taste tests could be used to discriminate between Covid-19 patients and people with a regular cold or flu."
He said people could do their own smell and taste tests at home using products like coffee, garlic, oranges or lemons and sugar.
He stressed that diagnostic throat and nose swab tests were still essential if someone thought they might have coronavirus.
The senses of smell and taste return within a few weeks in most people who recover from coronavirus, he added.
Prof Andrew Lane is an expert in nose and sinus problems at Johns Hopkins University in the US.
He and his team have been studying tissue samples from the back of the nose to understand how coronavirus might cause loss of smell and have published the findings in the European Respiratory Journal.
They identified extremely high levels of an enzyme which were present only in the area of the nose responsible for smelling.
This enzyme, called ACE-2 (angiotensin converting enzyme II), is thought to be the "entry point" that allows coronavirus to get into the cells of the body and cause an infection.
The nose is one of the places where Sars-CoV-2, the virus that causes Covid-19, enters the body.
Prof Lane said: "We are now doing more experiments in the lab to see whether the virus is indeed using these cells to access and infect the body.
"If that's the case, we may be able to tackle the infection with antiviral therapies delivered directly through the nose."
How To Tell If You Have Covid, Flu, RSV Or Just A Cold - Key Symptoms To Look Out For
While we're no longer required to test for these winter viruses - if unwell try to stay at home and avoid contact to prevent spread of infections to more vulnerable groups
Not all viruses are easy to detect (Image: Getty Images/iStockphoto)
As temperatures plummet across the country, winter viruses will be once again making the rounds, but not all of them will be easy to detect.
Most of us will get ill at one point during the winter, and in most cases, will only ever experience mild cold or flu symptoms. In rarer cases, urgent medical care may be required.
Here are the key symptoms to look out for if you start to feel under the weather this winter - and what to do if your symptoms worsen.
How can I tell if I have Covid, the flu, Respiratory Syncytial Virus (RSV) or a common cold?
Whether you're battling the flu, Covid or the common cold, the three viruses can be hard to distinguish because they're often very similar. All report symptoms such as headaches, coughs, runny/blocked noses, sore throats, fevers, chills, achy and sore muscles. One of the more standout symptoms for Covid-19 is that patients usually experience a loss or change to their sense of taste and smell.
Almost all children are infected with RSV by the time they're two years old, and while most will only ever experience mild symptoms, urgent medical care will be needed if you or your child is having difficulty breathing, not drinking enough fluids, or if you are experiencing worsening symptoms.
Some unlucky patients with respiratory infections will be prone to vomiting and diarrhoea which may also require further attention. In any case where symptoms grow unbearable or a patient is struggling to breathe, you must seek ugent medical attention.
Dr Sam McConkey, consultant in infectious diseases at Beaumont Hospital, Dublin, explains: "It's nearly impossible to know which virus you have. For example, SARS-CvC-2 [Covid] is mostly causing coughs, headaches and sore throats now, while in 2020, before we were all vaccinated, it was causing respiratory failure and pneumonia."
Do I still need to get tested if I get ill?
According to the NHS, you are no longer required to do a COVID-19 rapid lateral flow test if you have symptoms, but if you're unwell, you should try to stay at home and avoid contact with others to prevent spreading the infection.
Dr McConkey says there is no longer a huge benefit in knowing what virus you have. He said: "The Health Protection Surveillance Centre publishes weekly data on notifiable infectious diseases (including Covid, Flu, RSV) gathered from a number of GPs throughout Ireland to monitor outbreaks. And people are tested in hospitals, so those with flu or Covid are put in single rooms or with others with the same virus but otherwise tests are unnecessary now."
Experts in the US have noted that the self-administered Covid antigen tests may not pick up the latest JN.1 variant until day four or five, at which point, the virus to may have already been spread to others.
What's the best way I can look after myself when I'm sick?
Most viruses can be cared for at home and will usually clear between two to three weeks. The usual advice is to drink plenty of fluids and to take paracetamol-based medicines to control fevers and manage pain. During this time, it's important to stay at home, avoid contact with others and keep your children at home from school to prevent the virus from spreading.
When I should seek urgent medical treatment or advice?
Some lower respiratory symptoms will require urgent medical attention, either at a GP surgery, out-of-hours doctor services or at an Emergency Department. Dr McConkey says: "If you experience uncontrollable shivering – called the rigours – in that your arms and legs are shaking and your teeth are chattering, you need prompt medical care because you are likely to have a deep-seated infection. Secondly, if you are coughing up yellow or green phlegm, you need a chest X-ray and antibiotics and thirdly, if you have shortness of breath so much that you can't finish a sentence, you need to see a GP or go to an Emergency Room."
How can I prevent catching a virus this winter?
It's important that you take the steps to protect yourself and your loved ones during flu season, with the general advice being to regularly wash your hands, sneeze into your elbow and wear a face mask in busy public spaces, such as on public transport.
Those who are vulnerable or have existing medical conditions such as COPD (chronic obstructive pulmonary disease), asthma, or those living with a young baby or a pregnant woman should avoid crowded indoor spaces for the next few weeks.
It's also recommended to keep up to date with all your Covid and flu vaccines.
Is That Cough The Flu, COVID, RSV Or A Cold? How To Tell The Symptoms And What To Do Next
Sneezing? Feeling congested? Coughing? Are these signs of flu season, RSV, a cold or allergies, or do you have COVID-19? This year, it could be any of them.
The Centers for Disease and Prevention (CDC) issued an advisory in December warning about a dangerous rise in respiratory illnesses and a dangerously low rate of vaccinations and urged healthcare providers to recommend immunizations and antiviral medications where appropriate.
Last week, the CDC listed 39 states, including Florida, that reported high or very high levels for respiratory illnesses with fever, cough and other symptoms in the week ending Dec. 30, 2023.
That includes influenza (flu), COVID-19, RSV (respiratory syncytial virus) and other viruses, but the flu has seen the largest increase. Positive lab tests for the flu rose to 17.5% of all tests given during that period nationwide.
The numbers from the Florida Department of Health show decreases in flu positivity rates and emergency room visits for the week ending Jan. 6 in most areas of the state, except for Bay, Flagler, Highlands, Martin and Taylor counties. But the percent of emergency room visits with discharge diagnoses of flu, while down from the week previous, are still considerably higher than the last three years, according to FDOH data.
The same is true for RSV, a common respiratory virus that's usually more like a cold for adults but can be dangerous for young children, babies and older adults with chronic medical conditions. ER visits for RSV have dropped down to last year's levels as of last week but over the holiday season, the number of children and adults rushed to emergency rooms was well above the rates for the past three years.
COVID-19 also has been rising back up, thanks to JN.1, a new, easily spread strain the CDC said now accounts for nearly two-thirds (61%) of all cases in the country.
Reported cases in Florida hit 43,178 in December, according to FLHealthCharts data, twice the 21,975 from the month before (although still far fewer than the 102,662 cases reported in December 2022). And that's almost certainly a fraction of the actual number, as most people self-diagnose with home tests and often do not report the results.
So what should you do if you start coughing? Without testing, it is difficult to determine whether the congestion is more than a cold, but either way, don't panic, say medical experts. Just take proper precautions.
What are the symptoms for COVID?According to the CDC, the most common symptoms of any variant of COVID-19, including JN.1, are:
Fever or chills
Cough
Sore throat
Congestion or runny nose
Headache
Muscle or body aches
Shortness of breath or difficulty breathing
Fatigue
New loss of taste or smell
Brain fog (fuzziness, difficulty thinking or focusing).
Nausea or vomiting, mild diarrhea
Some people with COVID are asymptomatic and never display any symptoms, although they can still pass it to others. And many people with COVID have mild symptoms. If symptoms arise or you've been exposed to someone with COVID, get yourself tested and, if it's positive, observe the recommended isolation and distancing methods. Ask your healthcare provider for the antiviral Paxlovid, which has been shown to be highly effective for people at risk of severe complications.
According to the CDC, if you are showing any of the following signs, seek emergency medical care immediately:
Trouble breathing
Persistent pain or pressure in the chest
New confusion
Inability to wake or stay awake
Pale, gray, or blue-colored skin, lips, or nail beds, depending on skin tone
While public urgency has lapsed concerning COVID, please note that 8,366 Floridians died last year from it and 53 have died already in 2024. Even people with mild or no symptoms at first have found themselves dealing with the debilitating effects of long COVID later.
What are the symptoms of the flu?More or less the same thing, except for the loss of taste or smell and brain fog, and not everyone will run a fever.
COVID-19 symptoms usually appear two to 14 days after exposure to the coronavirus. Flu symptoms start to show up about one to four days after exposure to an influenza virus.
However, COVID-19 can cause more serious illnesses in some people than the flu, as well as complications such as blood clots and lasting respiratory problems, and it's impossible to tell the difference without testing.
Last year, the Food and Drug Administration authorized the first over-the-counter at-home test that can detect and differentiate between flu and COVID-19.
The Lucira COVID-19 and Flu Home Test is a single-use test that can be purchased without a prescription and displays results in 30 minutes or less for influenza A, influenza B and COVID-19.
Should I get a flu shot?Yes. Influenza is a dangerous virus and flu shots, while not perfect, still help a great deal.
The CDC recommends that, with rare exceptions, everyone 6 months and older should get a flu vaccine every season. Public health experts say vaccination is vital to protect individuals and communities and to avoid burdening already overtaxed health care systems.
If you are prone to catching the flu or colds, the same methods used to prevent the spread of COVID work the same way. In 2021, when people across the nation were social distancing, wearing masks and washing their hands, the flu virtually disappeared.
Getting vaxxed: Is it safe to get a flu shot and a COVID-19 vaccine at the same time? Experts explain
What are the symptoms of RSV?Symptoms of RSV tend to show up within four to six days after infection, the CDC says, and may include:
Runny nose
Decrease in appetite
Coughing
Sneezing
Fever
Wheezing
The symptoms usually appear in stages rather than all at once, and health experts say they typically resolve on their own within a week or two. In infants under 6 months, the only discernible symptoms may be increased irritability or lethargy and breathing difficulties.
Healthy adults and infants with RSV infections generally don't need to be hospitalized, according to the CDC. However, it may be necessary if the person is having trouble breathing or is dehydrated.
What are the symptoms for a cold?Like other respiratory illnesses, the symptoms of the common cold are often coughing, sneezing, a runny or stuffy nose, a sore throat, tiredness and sometimes a fever. Symptoms usually appear one to three days after exposure to a cold-causing virus.
Unlike flu or COVID, or RSV for babies and young children, a cold is usually harmless and cold-sufferers, while miserable, generally recover in three to 10 days. But it is highly contagious, especially when "your symptoms are at their worst," according to the Cleveland Clinic.
What are Americans catching this winter? It's not just flu and COVID-19 anymore.
Other CDC recommendations to avoid respiratory illnessesWash your hands often with soap and water, or use hand sanitizer in a pinch.
Avoid crowds and poorly ventilated indoor spaces.
Stay 6 feet from people outside the home.
Wear a snugly fitting mask.
Get a flu shot and stay fully vaccinated against COVID-19 with the latest boosters.
You also should take steps to strengthen your immune system such as improving your eating habits, getting enough sleep, exercising and avoiding stress.
This article originally appeared on The Daytona Beach News-Journal: Flu, COVID-19, RSV all have similar symptoms. How to tell the difference
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