Acute Olfactory Dysfunction-A Primary Presentation of COVID-19 Infection

Area of Science:

• Otolaryngology
• Infectious Diseases
• Virology

Background:

• COVID-19, a pandemic illness, has an estimated fatality rate of 1-2%.
• Early identification and isolation are key public health strategies to limit transmission.
• A rapid increase in COVID-19 cases was observed in London.

Purpose of the Study:

• To investigate acute severe anosmia as a potential presenting symptom of COVID-19.
• To evaluate the diagnostic utility of smell identification tests and imaging in suspected cases.
• To assess the recovery of olfactory function following COVID-19 infection.

Main Methods:

• Four patients presented with acute total or subtotal loss of smell.
• Diagnosis confirmed using the University of Pennsylvania Smell Identification Test (UPSIT).
• Endoscopic examination and MRI excluded other pathologies; COVID-19 antibody testing performed.

Main Results:

• Three of four patients had confirmed COVID-19 via positive IgG antibodies 6-8 weeks post-symptom onset.
• Acute severe anosmia was identified as an unusual nasal manifestation of COVID-19.
• All patients experienced significant partial olfactory recovery within one week, with complete recovery in 2-3 weeks.

Conclusions:

• Acute severe anosmia can be an early, localized nasal symptom of COVID-19.
• Olfactory dysfunction in COVID-19 patients shows potential for significant recovery.
• This finding has implications for early COVID-19 detection and public health management.