Sudden anosmia and ageusia in a child: A COVID-19 case report

Wang, Ellen; Ulualp, Seckin O.; Liu, Christopher; Veling, Maria C.

doi:10.1016/j.xocr.2021.100267

Cited by 4 publications

(7 citation statements)

References 22 publications

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“…Enhancement was reported based on T1-weighted images following administration of gadolinium-based contrasts. First author (Ref) MRI (n) PNS CT (n) PET/CT, PET/MRI (n) Politi et al( 4 ) OB and right Hyperintensity in the rectus gyrus cortex, subtle hyperintensity of OB s Aragao et al( 5 ) Hypointensity in OB ( 1 ), enhancement in OB ( 4 ) Chiu et al( 6 ) Volume reduction in OB Correa et al( 7 ) Bilateral enhancement of OB Eliezer et al( 8 ) Normal olfactory cleft ( 1 ), olfactory cleft obstruction ( 19 ) (bilateral: 17, right: 1, left: 1) Hatipoglu et al( 9 ) Normal OB morphology and signal intensity ( 3 ) Kandemirli et al( 10 ) -Olfactory cleft opacification ( 17 ) (partial ( 16 ), total ( 1 )) -OB morphology: normal ( 8 ), mild irregularity with preserved J shape ( 2 ), contour lobulations ( 5 ), rectangular shape ( 8 ) -OB signal intensity: normal ( 2 ), diffusely increased signal ( 9 ), hyperintense foci ( 16 ), hyperintense foci with halo ( 5 ), microhemorrhages ( 4 ) -Olfactory tract signal abnormality ( 7 ), olfactory cortex signal abnormality ( 5 ), olfactory nerve morphology: normal ( 13 ), evident clumping ( 8 ), thinning with scarcity ( 2 ) Olfactory cleft opacification: partial ( …”

Section: Resultsmentioning

confidence: 99%

“…Of the total of 218 findings on MRI, both morphology and signal intensity of OB were normal in 68/218 (31.2%) ( Figure 2 ), which were the most common overall MRI finding ( 9 , 10 , 11 , 12 , 13 , 14 , 15 , 22 , 23 , 24 , 25 , 26 , 27 ). OB morphology and signal was normal in 28/80 (35%) in the early and in 26/85 (30.6%) on late imaging, similarly constituting the most common findings on both early and late imaging.…”

Section: Resultsmentioning

confidence: 99%

“…The exact pathophysiology of COVID-19-induced anosmia is not fully understood ( 1 , 2 , 3 ). Various imaging modalities have been used to assess the olfactory dysfunction in COVID-19, mainly by imaging OB and OC, such as with magnetic resonance imaging (MRI) ( 4 , 5 , 6 , 7 , 8 , 9 , 10 , 11 , 12 , 13 , 14 , 15 , 16 , 17 , 18 , 19 , 20 , 21 , 22 , 23 , 24 , 25 , 26 , 27 , 28 ), computed tomography (CT) of paranasal sinuses ( 29 , 30 , 31 , 32 ), or with functional modalities such as positron emission tomography (PET) of brain ( 15 , 22 , 33 ). These studies have reported a variety of findings, which are at times divergent.…”

Section: Introductionmentioning

confidence: 99%

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A Systematic Review of Imaging Studies in Olfactory Dysfunction Secondary to COVID-19

et al. 2021

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Rationale and Objectives Hyposmia/anosmia is common among patients with COVID-19. Various imaging modalities have been used to assess olfactory dysfunction in COVID-19. In this systematic review, we sought to categorize and summarize the imaging data in COVID-19-induced anosmia. Material and Methods Eligible articles were included after a comprehensive review using online databases including Google scholar, Scopus, PubMed, Web of science and Elsevier. Duplicate results, conference abstracts, reviews, and studies in languages other than English were excluded. Results In total, 305 patients undergoing MRI/functional MRI (177), CT of paranasal sinuses (129), and PET/CT or PET/MRI scans ( 14 ) were included. Out of a total of 218 findings reported on MRI, 80 were reported on early (≤ 1 month) and 85 on late (> 1 month) imaging in relation to the onset of anosmia. Overall, OB morphology and T2-weighted or FLAIR signal intensity were normal in 68/218 (31.2%), while partial or complete opacification of OC was observed in 60/218 (27.5%). T2 hyperintensity in OB was detected in 11/80 (13.75%) and 18/85 (21.17%) on early and late imaging, respectively. Moreover, OB atrophy was reported in 1/80 (1.25%) on early and in 9/85 (10.58%) on late imaging. Last, among a total of 129 CT scans included, paranasal sinuses were evalualted in 88 (68.21%), which were reported as normal in most cases (77/88, [87.5%]). Conclusion In this systematic review, normal morphology and T2/FLAIR signal intensity in OB and OC obstruction were the most common findings in COVID-19-induced anosmia, while paranasal sinuses were normal in most cases. OC obstruction is the likely mechanism for olfactory dysfunction in COVID-19. Abnormalities in OB signal intensity and OB atrophy suggest that central mechanisms may also play a role in late stage in COVID-19-induced anosmia.

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Section: Resultsmentioning

confidence: 99%

Section: Resultsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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A Systematic Review of Imaging Studies in Olfactory Dysfunction Secondary to COVID-19

et al. 2021

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“…Clinical Ear, Nose and Throat evaluation (ENT), when performed, consisted of endoscopy and olfactometry with the Sniffin' sticks test [13,15,29,30], three-odorant Quick Smell Identification Test [17] or University of Pennsylvania Smell Identification Test (UPSIT) [30]. Seventeen out of 25 retrieved studies did not perform ENT evaluation and olfactometry [13,[18][19][20][21][22][23][24][25][26][27][31][32][33][34][35][36]. The time that had elapsed from symptom onset to MRI evaluation ranged from 3 days [29] to 6 months [22].…”

Section: Literature Reviewmentioning

confidence: 99%

“…Normal OB volume was found among 71 patients [16,17,21,22,26,27,30,31,[34][35][36]. A lots of these patients [16,17,21,27,30,35] underwent the MRI within the first month after infection; two authors performed the MRI after three [36] and six months [22], and three authors did not report the time elapsed between hyposmia and the MRI [26,31,34]. A case report revealed a transient augmented OB volume 7 days after SARS-CoV-2 infection that returned to a normal volume 24 days after [28].…”

Section: Literature Reviewmentioning

confidence: 99%

Magnetic Resonance Imaging Confirmed Olfactory Bulb Reduction in Long COVID-19: Literature Review and Case Series

et al. 2022

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An altered sense of smell and taste was recognized as one of the most characteristic symptoms of coronavirus infection disease (COVID-19). Despite most patients experiencing a complete functional resolution, there is a 21.3% prevalence of persistent alteration at 12 months after infection. To date, magnetic resonance imaging (MRI) findings in these patients have been variable and not clearly defined. We aimed to clarify radiological alterations of olfactory pathways in patients with long COVID-19 characterized by olfactory dysfunction. A comprehensive review of the English literature was performed by analyzing relevant papers about this topic. A case series was presented: all patients underwent complete otorhinolaryngology evaluation including the Sniffin’ Sticks battery test. A previous diagnosis of SARS-CoV-2 infection was confirmed by positive swabs. The MRIs were acquired using a 3.0T MR scanner with a standardized protocol for olfactory tract analysis. Images were first analysed by a dedicated neuroradiologist and subsequently reviewed and compared with the previous available MRIs. The review of the literature retrieved 25 studies; most cases of olfactory dysfunction more than 3 months after SARS-CoV-2 infection showed olfactory bulb (OB) reduction. Patients in the personal case series had asymmetry and a reduction in the volume of the OB. This evidence was strengthened by the comparison with a previous MRI, where the OBs were normal. The results preliminarily confirmed OB reduction in cases of long COVID-19 with an altered sense of smell. Further studies are needed to clarify the epidemiology, pathophysiology and prognosis.

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COVID-19 Infection in Children: Diagnosis and Management

Zhu

Ang

2022

Curr Infect Dis Rep

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Purpose of Review Due to the rapidly changing landscape of COVID-19, the purpose of this review is to provide a concise and updated summary of pediatric COVID-19 diagnosis and management. Recent Findings The relative proportion of pediatric cases have significantly increased following the emergence of the Omicron variant (from < 2% in the early pandemic to 25% from 1/27 to 2/3/22). While children present with milder symptoms than adults, severe disease can still occur, particularly in children with comorbidities. There is a relative paucity of pediatric data in the management of COVID-19 and the majority of recommendations remain based on adult data. Summary Fever and cough remain the most common clinical presentations, although atypical presentations such as “COVID toes,” anosmia, and croup may be present. Children are at risk for post-infectious complications such as MIS-C and long COVID. Nucleic acid amplification tests through respiratory PCR remain the mainstay of diagnosis. The mainstay of management remains supportive care and prevention through vaccination is highly recommended. In patients at increased risk of progression, interventions such as monoclonal antibody therapy, PO Paxlovid, or IV remdesivir × 3 days should be considered. In patients with severe disease, the use of remdesivir, dexamethasone, and immunomodulatory agents (tocilizumab, baricitinib) is recommended. Children can be at risk for thrombosis from COVID-19 and anticoagulation is recommended in children with markedly elevated D-dimer levels or superimposed clinical risk factors for hospital associated venous thromboembolism.

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Sudden anosmia and ageusia in a child: A COVID-19 case report

Cited by 4 publications

References 22 publications

A Systematic Review of Imaging Studies in Olfactory Dysfunction Secondary to COVID-19

A Systematic Review of Imaging Studies in Olfactory Dysfunction Secondary to COVID-19

Magnetic Resonance Imaging Confirmed Olfactory Bulb Reduction in Long COVID-19: Literature Review and Case Series

COVID-19 Infection in Children: Diagnosis and Management

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