Smell and Taste Disorders in COVID-19 Patients: Objective Testing and Magnetic Resonance Imaging in Five Cases
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COVID-19
Smell and Taste Disorders in COVID-19 Patients: Objective Testing and Magnetic Resonance Imaging in Five Cases Carmen Maria Schönegger 1
&
Sarah Gietl 1 & Bernhard Heinzle 2 & Kurt Freudenschuss 3 & Gernot Walder 1
Accepted: 19 October 2020 # Springer Nature Switzerland AG 2020
Abstract Smell and taste disorders are acknowledged as characteristic symptoms for SARS-CoV-2 infection by now. These symptoms have been linked to a neuroinvasive course of disease. In this study, we investigated five consecutive COVID-19 patients with a prolonged course of dysosmia and dysgeusia. Those with objectifiable alteration in taste or smell were subjected to MRI with contrast agent to investigate possible involvement of the central nervous system. We found dysosmia and dysgeusia to be mostly objectifiable, but no evidence for neuroinvasiveness could be detected by MRI in the late stage of the disease. Alterations in taste and smell could be objectified in most patients. Nevertheless, no evidence for a neuroinvasive potential could be identified by MRI, at least in the late stage of disease. We encourage medical professionals to conduct specialized examinations and MRIs in the acute stage of disease, which guarantees an optimum patient care. Keywords Smell and taste disorders . Objective olfactory and gustatory testing . MRI . Neuoinvasive potential
Introduction Although a lot of effort has been made in order to investigate this novel coronavirus, our knowledge about many pathogenic aspects of COVID-19 is still limited. Clinical and experimental studies proved that several coronaviruses have neuroinvasive capacities, since they show the ability to spread from the respiratory tract to the central nervous system [1]. Hypothesis of neurotropism of SARS-CoV-2 is based on COVID-19 patients with neurological manifestations. Furthermore, neurological complications up to actual damage hint neurovirulence [2]. Actual case reports substantiate this assumption. COVID-19 can cause meningitis with a fatal
Carmen Maria Schönegger and Sarah Gietl contributed equally to this work. This article is part of the Topical Collection on COVID-19 * Carmen Maria Schönegger [email protected] 1
Department of Virology, Dr. Gernot Walder GmbH, 9931 Außervillgraten 30, Austria
2
Radiology Private Clinic Kursana, Wörgl, Austria
3
HNO-CHIRURGIE-TIROL.com, Hochrum, Lienz, Austria
outcome, which was evidenced by the case of a 24-year-old man in Japan, who succumbed to the disease [3]. Brain MRI demonstrated hemorrhagic lesions that were consistent with acute necrotizing hemorrhagic encephalopathy [4]. Another manifestation of nervous system involvement is the appearance of alterations of taste and smell [5]. Anosmia and dysgeusia are by now acknowledged as significant symptoms in association with COVID-19 by the American Academy of Otolaryngology-Head and Neck Surgery (AAO-HNS) and other researches [6, 7]. Case series show a high frequency of chemosensitive disorders in patients, ranging between 19.4 and 88% [8, 9]. According to Vaira
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