Objective evaluation of the nasal mucosal secretion in COVID-19 patients with anosmia
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ORIGINAL ARTICLE
Objective evaluation of the nasal mucosal secretion in COVID-19 patients with anosmia Yuce Islamoglu 1
&
Emin Gemcioglu 2 & Ihsan Ates 2
Received: 9 September 2020 / Accepted: 15 October 2020 # Royal Academy of Medicine in Ireland 2020
Abstract Background COVID-19 is a new disease caused by the SARS-CoV-2 virus. The olfactory dysfunction linked to COVID-19 is not associated with rhinorrhea but there is no objective evaluation. Aims To evaluate nasal mucosal secretion objectively in COVID-19 patients with anosmia. Methods Fifty-two COVID-19 patients with anosmia and 51 healthy individuals included. Anosmia was diagnosed by subjective questionnaires. Nasal Schirmer test was done to the left and the right nasal cavity separately. Results All patients had anosmia and 82.6% had gustatory dysfunction. In group 1, the mean of the nasal Schirmer test results in the right cavity was 12.4 mm, 12.01 mm in the left nasal cavity. The median wetting distance (right plus left divided by two) was calculated 12.21 mm. In group 2, the mean of the nasal Schirmer test results in the right cavity was 12.1 mm, 11.8 mm in the left nasal cavity. The median wetting distance (right plus left divided by two) was calculated11.97 mm. There was no difference between the two groups in terms of nasal schirmer. Conclusion Olfactory dysfunction and gustatory dysfunction are the two of the unknown for this disease. We evaluated the nasal mucosa secretions in COVID-19 patients with anosmia objectively to evaluate if there is inflammation in the nasal mucosa. We found no difference between healthy individuals. According to our study, SARS-CoV-2 causes anosmia without causing nasal mucosal inflammation. Invasion of the olfactory bulb and central nervous system by SARS-CoV-2 may lead to anosmia in COVID-19, which may cause olfactory dysfunction. Keywords Anosmia . COVID-19 . Nasal mucosa . Nasal Schimer test . SARS-CoV-2
Introduction The acute respiratory disease caused by the SARS-CoV-2 virus was named by the World Health Organisation (WHO) as a pandemic in March 2020. The disease was named as COVID-19 (coronavirus disease 2019) [1]. COVID-19 has
* Yuce Islamoglu [email protected] Emin Gemcioglu [email protected] Ihsan Ates [email protected] 1
Department of Otolaryngology Head and Neck Surgery, Ankara City Hospital, Ankara, Turkey
2
Department of Internal Diseases, Ankara City Hospital, Ankara, Turkey
an incubation period of 1 to 14 days, mostly ranging 3– 7 days [2]. The most common symptoms of COVID-19 infection include fever, cough, and shortness of breath. Other symptoms are fatigue; vomiting; diarrhea; and less commonly runny nose, headache, sputum production, and hemoptysis. Loss of smell and taste are observed commonly in COVID-19 patients [3–6]. Respiratory viruses like rhinovirus, parainfluenza EpsteinBarr virus, and some coronaviruses may lead to an inflammatory reaction of the nasal mucosa. This inflammatory reaction cause rhinorrhea and olfactory dysfunction. The olfactory dysfunction linked to CO
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