Article ; Online: Acute Olfactory Dysfunction-A Primary Presentation of COVID-19 Infection.
2020 Volume 99, Issue 9, Page(s) 94–98
Abstract: COVID-19 is a zoonotic illness caused by a new strain of coronavirus and has recently been declared a pandemic by the World Health Organization, with an estimated fatality rate of 1% to 2%. Early identification and isolation of patients in the ... ...
| Abstract | COVID-19 is a zoonotic illness caused by a new strain of coronavirus and has recently been declared a pandemic by the World Health Organization, with an estimated fatality rate of 1% to 2%. Early identification and isolation of patients in the preliminary infective stage has been a mainstay of most governmental strategies in order to limit transmission. Four otherwise healthy patients presented to a specialist open access Ear, Nose & Throat Clinic in central London with acute total or subtotal loss of their sense of smell in a single one-week period, coinciding with rapid escalation of COVID-19 infection in the indigenous population. The diagnosis was confirmed by the validated University of Pennsylvania Smell Identification Test (UPSIT) in 3. Endoscopic examination and magnetic resonance imaging (2 cases) excluded a range of alternative potential pathological conditions. Covid-19 antibody testing carried out 6 to 8 weeks after the onset of nasal symptoms showed positive immunoglobulin G antibodies in 3 of the 4 patients. Acute severe anosmia is therefore almost certainly an unusual presenting local nasal feature of a COVID-19 viral infection. All 4 patients achieved significant partial olfactory recovery by one week after treatment with subjective ratings of 40% to 85% of normal (mean 60%) and complete olfaction recovery after 2 to 3 weeks in all 4 patients. The significance, possible pathogenesis, and public health implications are highlighted and discussed. |
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| MeSH term(s) | Acute Disease ; Adult ; Antibodies, Viral ; Betacoronavirus ; COVID-19 ; COVID-19 Testing ; Clinical Laboratory Techniques ; Coronavirus Infections/complications ; Coronavirus Infections/diagnosis ; Female ; Glucocorticoids/therapeutic use ; Humans ; Immunoglobulin G ; Male ; Olfaction Disorders/diagnosis ; Olfaction Disorders/drug therapy ; Olfaction Disorders/etiology ; Pandemics ; Pneumonia, Viral/complications ; Pneumonia, Viral/diagnosis ; Recovery of Function ; SARS-CoV-2 |
| Chemical Substances | Antibodies, Viral ; Glucocorticoids ; Immunoglobulin G |
| Keywords | covid19 |
| Language | English |
| Publishing date | 2020-08-06 |
| Publishing country | United States |
| Document type | Journal Article |
| ZDB-ID | 750153-5 |
| ISSN | 1942-7522 ; 0145-5613 |
| ISSN (online) | 1942-7522 |
| ISSN | 0145-5613 |
| DOI | 10.1177/0145561320940119 |
| Database | MEDical Literature Analysis and Retrieval System OnLINE |
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