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Tbf cebm couldn't hope to find much about the connection between C 19 and anosmia yet. All that can be said is there might very well be one, and then again there might not. But a lot of the clinical day to day empirical knowledge is going to be exactly that for a while. We are to a great extent relying on anecdotal evidence from ICU people around the world right now while the studies are being conducted and results rolling in. For instance, all my colleagues who have tested positive that I know of, have experienced reduced sense of smell. Only 6 people but right now everyone, including me, is even more liable to bias than usual and I'm pretty sure it's going to be accepted as a symptom some people with the disease are likely to experience. Another piece of the puzzle so to speak.
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russmeyer
TL;DR version:
ENT UK is probably not as trustworthy as CEBM, neither is EMCRIT.
I'm going to say (at least 1) potentially controversial things here, so lets preface it with:
I am in no way belittling C19. I have had a very shocking few days at work.
I'm not calling into doubt whether anyone has or doesn't have C19- I can't make a diagnosis over the web and I wouldn't want to even try (see 6)
Where I dip into conjecture I will make it obvious.
I am just as susceptible to some of the things I will conjecture below.
I don't think we will really have a good understanding of the Signs+Symptoms until we have had a few years to reflect on it
I think the take home message of what I say should be: If you feel unwell at the moment, and you can't put a finger on it, its probably best to isolate- for the safety of the community- and be very vigilant for the hallmarks of a severe case (Fever, Cough, DIB).
Anecdotally- we are getting very discordant presentations, but as a majority, they fit the pattern above.
OK-
ENT UK is [hopefully] not as trustworthy as NICE/ PHE.
CEBM is [hopefully] more rigorous with data handling than EMCRIT. It is after all the Center for Evidence Based Medicine.
[conjecture]- given its openness about methodology, it should be. [/conjecture]
[somewhat conjecture]
Doctors, inherently, balance Evidence and Empiricism in day to day work. You learn weird quirks to be additive to clinical suspicion of a disease and these are not quantifiable.
EMCRIT is a relatively small group of specialists who are susceptible to the addition of this subjective distortion as the rest of us.
It would be nice to think of Anosmia as Pathognomonic. I like Pathognomonic symptoms. They make life less chaotic. Hell, its even a fun word to say.
[/somewhat conjecture]
[conjecture]
Finally- I promised something controversial.
I feel there must be an element of conversion disorder (this is the wrong disease name but so is mass psychogenic illness so I'll leave it in the middle ground between the two) in the reported, incomplete symptomatology of C19. I don't think this is something that is avoidable, as it is a truly frightening illness, and there has been no avoidance of reported symptoms.
[/conjecture]
Anyways- keep safe. All of you.