About 80% of people with acute SARS-CoV-2 infection during the original and Alpha waves of the COVID-19 pandemic reported losing their sense of smell. That olfactory loss is not just a nuisance, it can lead to weight loss, worsen patients’ quality of life and impedes their ability to identify dangers such as gas leaks, smoke or spoiled food.
Research relating to loss of smell often relies on patients’ self-reporting. In a study published today in JAMA Network Open, researchers administered to patients the University of Pennsylvania Smell Identification Test, which quizzes their ability to identify scratch-and-sniff smells in a booklet. Following testing, researchers classified patients as having hyposmia (reduced ability to detect odors), severe microsmia (dramatically reduced sense of smell) or anosmia (no ability to detect smells).
Here are the key takeaways that otolaryngologists and other physicians need to know, as reported in the JAMA Network Open study, “Olfactory Dysfunction After SARS-CoV-2 Infection in the RECOVER Adult Cohort.”
Question: What are patterns of olfactory dysfunction in adults after SARS-CoV-2 infection?
Findings: In this cohort study, 1,111 of 1,393 SARS-CoV-2-infected participants who reported loss in or change of smell or taste a mean of two years after infection (80%) had hyposmia on formal testing, a total of 321 (23%) had severe microsmia or anosmia, and the mean age- and sex-standardized score was at the 16th percentile. Hyposmia was also present in 1,031 of 1,563 participants (66%) with prior infection but no self-reported change or loss (mean: 23rd percentile).
Meaning: These findings suggest that occult hyposmia following infection with SARS-CoV-2 is common, and olfactory testing should be considered after infection to diagnose olfactory dysfunction and counsel patients about the risks of smell loss.
AMA members can explore a range of peer-reviewed research and clinical information published by the JAMA Network™, which brings JAMA together with JAMA Network Open and 11 specialty journals. Published continuously since 1883, JAMA is one of the most widely circulated, peer-reviewed, general medical journals in the world. If you are an AMA member or interested in becoming one, learn how to access these educational materials and innovative tools.
Other notable findings this week in the JAMA Network
“Medicare Part D Coverage and Costs for Glucagon-Like Peptide-1 Receptor Agonists,” published in JAMA®. From 2020 to 2025, prior authorization for glucagon-like peptide-1 receptor agonists (GLP-1RAs) became near universal and out-of-pocket costs rose substantially in 2025, as plans increasingly required coinsurance. Although the rise in prior authorization may reflect efforts to curtail off-label GLP-1RA use, recent increases in out-of-pocket costs likely resulted from broader shifts to coinsurance affecting many high-cost drugs.
“School Provision of Universal Free Meals and Blood Pressure Outcomes Among Youths,” published in JAMA Network Open. This cohort study of schools matched to child and adolescent patient medical records from a large network of community health organizations found that school participation in the Community Eligibility Provision was associated with a net reduction in blood pressure outcomes. These findings add to mounting evidence that universal free school meals may be associated with improved child health.
“Low-Dose Aspirin for Individualized Cancer Prevention in Older Adults,” published in JAMA Oncology. The findings of this analysis suggest that the individualized treatment effect of low-dose aspirin on cancer prevention in older adults varies by participant characteristics. Further study is needed to fully understand the implications of these findings.
“Insurance Dynamics During Childhood in the Fragmented US Health System,” published in JAMA. An estimated three in four U.S. children relied on publicly subsidized insurance (Medicaid, Children’s Health Insurance Program [CHIP] or Marketplace) or experienced a period without any insurance by their 18th birthday in the post-Affordable Care Act (ACA), pre-pandemic policy environment. Substantial state heterogeneity in childhood uninsurance underscores the critical role of Medicaid policies.
What AMA members get with JAMA Network
The subscription cost of JAMA is included with your AMA membership, plus unlimited digital access to all JAMA Network journals, including: JAMA, JAMA Network Open, JAMA Cardiology, JAMA Dermatology, JAMA Internal Medicine, JAMA Neurology, JAMA Oncology, JAMA Ophthalmology, JAMA Otolaryngology–Head and Neck Surgery, JAMA Pediatrics, JAMA Psychiatry, and JAMA Surgery.
The online journals include many helpful features for students, residents and fellows, including full-text PDFs, clinical challenges, archived editions, audio and video author interviews where authors give their perspectives on a study’s objectives, findings and implications.
There are several ways physicians can leverage resources from the JAMA Network to help them in their clinical practice:
- Take CME courses and earn AMA PRA Category 1 Credit™.
- Fulfill maintenance of licensure (MOL) and CME requirements on JN Learning™, the home for all JAMA Network CME.
- Read concise summaries of clinical guidelines and recommendations in a streamlined format designed for today’s busy physicians.
- Access one-page articles that present key facts in patient-friendly terms to support you and your patients.
