Sudden and Complete Olfactory Loss Function as a Possible Symptom of COVID-19 - JAMA

8-4-2020; 10.1001/jamaoto.2020.0832
By: Eliezer, et al.

Aim
Report a covid-19 case with complete olfactory loss

Keys

• Complete olfactory loss without nasal obstruction should alert clinician to suspect covid-19

Summary: 

• SARS-CoV-2 infects human respiratory epithelial cells. Clinical features mainly include lower respiratory tract infection (fever, dry cough, dyspnea). Higher respiratory tract symptoms are more rare. However;
• 40 year old woman presents with acute loss of olfactory function without nasal obstruction. No dysgeusia. Few days before presentation: dry cough, myalgia en cephalalgia. No fever or rhinorrhea. Normal oto- and rhinoscopy. 
  • CT-scan and MRI-scan of nasal cavity showed bilateral inflammatory obstruction of olfactory clefts. Olfactory bulbs and tracts were normal.
• Since husband of patient had covid-19 the patient underwent pCR which rendered positive results. 
• The origin of nasal cleft obstruction remains unknown but has been reported in patients following severe nasopharyngeal infection. However; no nasal obstruction in this patient. 
• Coronaviruses could invade the brain via the cribriform plate close to the olfactory bulb and the olfactory epithelium.
• Complete olfactory loss without nasal obstruction should alert clinician to suspect covid-19