COVID-19-induced anosmia associated with olfactory bulb atrophy

Neuroradiology - Tập 63 - Trang 147-148 - 2020
Andrew Chiu1, Nancy Fischbein1, Max Wintermark1, Greg Zaharchuk1, Paul T. Yun2, Michael Zeineh1
1Division of Neuroradiology, Department of Radiology, Stanford University, Stanford, USA
2Menlo Medical Clinic Stanford HealthCare, Menlo Park, USA

Tóm tắt

As the global COVID-19 pandemic evolves, our knowledge of the respiratory and non-respiratory symptoms continues to grow. One such symptom, anosmia, may be a neurologic marker of coronavirus infection and the initial presentation of infected patients. Because this symptom is not routinely investigated by imaging, there is conflicting literature on neuroimaging abnormalities related to COVID-19-related anosmia. We present a novel case of COVID-19 anosmia with definitive olfactory bulb atrophy compared with pre-COVID imaging. The patient had prior MR imaging related to a history of prolactinoma that provided baseline volumes of her olfactory bulbs. After a positive diagnosis of COVID-19 and approximately 2 months duration of anosmia, an MRI was performed that showed clear interval olfactory bulb atrophy. This diagnostic finding is of prognostic importance and indicates that the olfactory entry point to the brain should be further investigated to improve our understanding of COVID infectious pathophysiology.

Tài liệu tham khảo

Buschhüter D, Smitka M, Puschmann S, Gerber JC, Witt M, Abolmaali ND, Hummel T (2008) Correlation between olfactory bulb volume and olfactory function. Neuroimage 42(2):498–502 Rombaux P, Mouraux A, Bertrand B, Nicolas G, Duprez T, Hummel T (2006) Olfactory function and olfactory bulb volume in patients with postinfectious olfactory loss. Laryngoscope 116:436–439 Yao L, Yi X, Pinto JM, Yuan X, Guo Y, Liu Y, Wei Y (2018) Olfactory cortex and olfactory bulb volume alterations in patients with post-infectious olfactory loss. Brain Imaging Behav 12:1355–1362 Brann DH, Tsukahara T, Weinreb C et al (2020) Non-neuronal expression of SARS-CoV-2 entry genes in the olfactory system suggests mechanisms underlying COVID-19-associated anosmia. BioRxiv published online May 18. https://doi.org/10.1101/2020.03.25.009084(preprint) Politi LS, Salsano E, Grimaldi M (2020) Magnetic resonance imaging alteration of the brain in a patient with coronavirus disease 2019 (COVID-19) and anosmia. JAMA Neurol published online May 29. https://doi.org/10.1001/jamaneurol.2020.2125 Chung MS, Choi WR, Jeong HY, Lee JH, Kim JH (2018) MR Imaging-based evaluations of olfactory bulb atrophy in patients with olfactory dysfunction. AJNR Am J Neuroradiol 39(3):532–537