Clinical and Radiological Evaluations of COVID-19 Patients With Anosmia: Preliminary Report

doi:10.1002/lary.28993

. 2020 Nov;130(11):2526-2531.

doi: 10.1002/lary.28993. Epub 2020 Aug 11.

Clinical and Radiological Evaluations of COVID-19 Patients With Anosmia: Preliminary Report

Jerome R Lechien^#^{1

2

3

4}, Justin Michel^#^{1

5}, Thomas Radulesco^{1

5}, Carlos M Chiesa-Estomba^{1

6}, Luigi A Vaira⁷, Giacomo De Riu⁷, Leigh Sowerby^{1

8}, Claire Hopkins^#⁹, Sven Saussez^#^{1

2

3}

Affiliations

¹ COVID-19 Task Force of the Young-Otolaryngologists of the International Federations of Oto-rhino-laryngological Societies (YO-IFOS), Marseille, France.
² Department of Human Anatomy and Experimental Oncology, Faculty of Medicine, UMONS Research Institute for Health Sciences and Technology, University of Mons (UMons), Mons, Belgium.
³ Department of Otorhinolaryngology and Head and Neck Surgery, CHU de Bruxelles, CHU Saint-Pierre, School of Medicine, Université Libre de Bruxelles, Brussels, Belgium.
⁴ Department of Otolaryngology-Head and Neck Surgery, Foch Hospital, School of Medicine, UFR Simone Veil, Université Versailles Saint-Quentin-en-Yvelines (Paris Saclay University), Paris, France.
⁵ Department of Oto-Rhino-Laryngology-Head and Neck Surgery, Aix Marseille University, APHM, IUSTI, La Conception University Hospital, Marseille, France.
⁶ Department of Otorhinolaryngology-Head and Neck Surgery, Hospital Universitario Donostia, San Sebastian, Spain.
⁷ Maxillofacial Surgery Unit, University Hospital of Sassari, Sassari, Italy.
⁸ Department of Otolaryngology-Head and Neck Surgery, University of Western Ontario, London, Ontario, Canada.
⁹ Department of Otolaryngology, King's College, London, United Kingdom.

^# Contributed equally.

PMID: 32678494
PMCID: PMC7404961
DOI: 10.1002/lary.28993

Clinical and Radiological Evaluations of COVID-19 Patients With Anosmia: Preliminary Report

Jerome R Lechien et al. Laryngoscope. 2020 Nov.

. 2020 Nov;130(11):2526-2531.

doi: 10.1002/lary.28993. Epub 2020 Aug 11.

Authors

Affiliations

¹ COVID-19 Task Force of the Young-Otolaryngologists of the International Federations of Oto-rhino-laryngological Societies (YO-IFOS), Marseille, France.
² Department of Human Anatomy and Experimental Oncology, Faculty of Medicine, UMONS Research Institute for Health Sciences and Technology, University of Mons (UMons), Mons, Belgium.
³ Department of Otorhinolaryngology and Head and Neck Surgery, CHU de Bruxelles, CHU Saint-Pierre, School of Medicine, Université Libre de Bruxelles, Brussels, Belgium.
⁴ Department of Otolaryngology-Head and Neck Surgery, Foch Hospital, School of Medicine, UFR Simone Veil, Université Versailles Saint-Quentin-en-Yvelines (Paris Saclay University), Paris, France.
⁵ Department of Oto-Rhino-Laryngology-Head and Neck Surgery, Aix Marseille University, APHM, IUSTI, La Conception University Hospital, Marseille, France.
⁶ Department of Otorhinolaryngology-Head and Neck Surgery, Hospital Universitario Donostia, San Sebastian, Spain.
⁷ Maxillofacial Surgery Unit, University Hospital of Sassari, Sassari, Italy.
⁸ Department of Otolaryngology-Head and Neck Surgery, University of Western Ontario, London, Ontario, Canada.
⁹ Department of Otolaryngology, King's College, London, United Kingdom.

^# Contributed equally.

PMID: 32678494
PMCID: PMC7404961
DOI: 10.1002/lary.28993

Abstract

Objectives/hypothesis: To investigate clinical and radiological features of olfactory clefts of patients with mild coronavirus disease 2019 (COVID-19).

Study design: Prospective non controlled study.

Methods: Sixteen COVID-19 patients were recruited. The epidemiological and clinical data were extracted. Nasal complaints were assessed through the 22-item Sino-Nasal Outcome Test. Patients underwent psychophysical olfactory testing, olfactory cleft examination, and computed tomography (CT) scans.

Results: Sixteen anosmic patients were included. The mean Sniffin' Sticks score was 4.6 ± 1.7. The majority of patients had no endoscopical abnormality, with a mean olfactory cleft endoscopy score of 0.6 ± 0.9. The olfactory clefts were opacified in three patients on the CT scan. The mean radiological olfactory cleft score was 0.7 ± 0.8. There were no significant correlations between clinical, radiological, and psychophysical olfactory testing.

Conclusions: The olfactory cleft of anosmic COVID-19 patients is free regarding endoscopic examination and imaging. The anosmia etiology is not related to edema of the olfactory cleft.

Level of evidence: 4 Laryngoscope, 130:2526-2531, 2020.

Keywords: COVID-19; anosmia; computed tomography scan; coronavirus; evaluation; imaging; olfaction; olfactory; smell; taste.

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Figures

**Fig 1**
Computed tomography (CT) scan findings of patients. Sinus CT scans of our clinical series. Each number corresponds to a patient.

See this image and copyright information in PMC

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References

1. Lechien JR, Chiesa‐Estomba CM, De Siati DR, et al. Olfactory and gustatory dysfunctions as a clinical presentation of mild‐to‐moderate forms of the coronavirus disease (COVID‐19): a multicenter European study. Eur Arch Otorhinolaryngol 2020;277:2251–2261. - PMC - PubMed
1. Hopkins C, Surda P, Kumar N. Presentation of new onset anosmia during the COVID‐19 pandemic. Rhinology 2020;58:295–298. - PubMed
1. Lechien JR, Chiesa‐Estomba CM, Place S, et al. Clinical and epidemiological characteristics of 1,420 European patients with mild‐to‐moderate coronavirus disease 2019 [published online April 30, 2020]. J Intern Med . 10.1111/joim.13089. - DOI - PMC - PubMed
1. Eliezer M, Hautefort C, Hamel AL, et al. Sudden and complete olfactory loss function as a possible symptom of COVID‐19 [published online April 8, 2020]. JAMA Otolaryngol Head Neck Surg doi: 10.1001/jamaoto.2020.0832. - PubMed
1. Netland J, Meyerholz DK, Moore S, Cassell M, Perlman S. Severe acute respiratory syndrome coronavirus infection causes neuronal death in the absence of encephalitis in mice transgenic for human ACE2. J Virol 2008;82:7264–7275. - PMC - PubMed

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[1] Lechien JR, Chiesa‐Estomba CM, De Siati DR, et al. Olfactory and gustatory dysfunctions as a clinical presentation of mild‐to‐moderate forms of the coronavirus disease (COVID‐19): a multicenter European study. Eur Arch Otorhinolaryngol 2020;277:2251–2261. - PMC - PubMed

[2] Lechien JR, Chiesa‐Estomba CM, De Siati DR, et al. Olfactory and gustatory dysfunctions as a clinical presentation of mild‐to‐moderate forms of the coronavirus disease (COVID‐19): a multicenter European study. Eur Arch Otorhinolaryngol 2020;277:2251–2261. - PMC - PubMed

[3] Hopkins C, Surda P, Kumar N. Presentation of new onset anosmia during the COVID‐19 pandemic. Rhinology 2020;58:295–298. - PubMed

[4] Hopkins C, Surda P, Kumar N. Presentation of new onset anosmia during the COVID‐19 pandemic. Rhinology 2020;58:295–298. - PubMed

[5] Lechien JR, Chiesa‐Estomba CM, Place S, et al. Clinical and epidemiological characteristics of 1,420 European patients with mild‐to‐moderate coronavirus disease 2019 [published online April 30, 2020]. J Intern Med . 10.1111/joim.13089. - DOI - PMC - PubMed

[6] Lechien JR, Chiesa‐Estomba CM, Place S, et al. Clinical and epidemiological characteristics of 1,420 European patients with mild‐to‐moderate coronavirus disease 2019 [published online April 30, 2020]. J Intern Med . 10.1111/joim.13089. - DOI - PMC - PubMed

[7] Eliezer M, Hautefort C, Hamel AL, et al. Sudden and complete olfactory loss function as a possible symptom of COVID‐19 [published online April 8, 2020]. JAMA Otolaryngol Head Neck Surg doi: 10.1001/jamaoto.2020.0832. - PubMed

[8] Eliezer M, Hautefort C, Hamel AL, et al. Sudden and complete olfactory loss function as a possible symptom of COVID‐19 [published online April 8, 2020]. JAMA Otolaryngol Head Neck Surg doi: 10.1001/jamaoto.2020.0832. - PubMed

[9] Netland J, Meyerholz DK, Moore S, Cassell M, Perlman S. Severe acute respiratory syndrome coronavirus infection causes neuronal death in the absence of encephalitis in mice transgenic for human ACE2. J Virol 2008;82:7264–7275. - PMC - PubMed

[10] Netland J, Meyerholz DK, Moore S, Cassell M, Perlman S. Severe acute respiratory syndrome coronavirus infection causes neuronal death in the absence of encephalitis in mice transgenic for human ACE2. J Virol 2008;82:7264–7275. - PMC - PubMed

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Clinical and Radiological Evaluations of COVID-19 Patients With Anosmia: Preliminary Report

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Clinical and Radiological Evaluations of COVID-19 Patients With Anosmia: Preliminary Report

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