Anosmia and loss of smell in the era of covid-19.

### What you need to know A 46 year old ophthalmologist presents with a two week history of loss of sense of smell and taste. He believes he may have been exposed to covid-19 but, at the time, did not meet the criteria for testing. With the discovery of covid-19 and as the clinical syndromes associated with this virus have been defined, many areas of practice require updating. This article is a guide to assessment and management of patients with loss of smell based on review of the current literature and guidelines from the British Rhinology Society and ENT UK, the professional membership body representing ear, nose, and throat surgery in the UK.1 Olfactory dysfunction is common: estimates of point prevalence in the general population before the covid-19 pandemic suggest that 19.1% of adults (80% in people over 75) suffer from complete or partial loss of smell.2 Causes can be broadly subdivided into conductive (physical barriers to odorants reaching the olfactory system) and sensorineural (failure of the olfactory system to detect odorants). Causes are outlined in table 1, with the more common causes in the top half of the table and less common causes in the bottom half. A comprehensive history is invaluable, especially if consultations are performed remotely. View this table: Table 1 Causes of loss of smell Points to …