key: cord-0742408-y0w6iv6g
authors: Nasir, Saad; Iftikhar, Pulwasha Maria
title: Association of COVID-19 with Anosmia and Hypogeusia
date: 2020-06-12
journal: Am J Med Sci
DOI: 10.1016/j.amjms.2020.06.012
sha: 5ddd95c9d6f27f53425c6a488ce39d10ab308f17
doc_id: 742408
cord_uid: y0w6iv6g

nan

This includes employment, consultancies, honoraria, stock ownership or options, expert testimony, grants or patents received or pending, or royalties.

Corresponding Author: Pulwasha Maria Iftikhar.

Email: Pulwasha.iftikhar18@stjohns.edu There is a growing concern among physicians because of an increase in reported cases of anosmia in COVID-19 patients, which suggests neurological involvement. Respiratory epithelium (RE) and Olfactory epithelium (OE) are the two components of nasal epithelium. 5

Olfactory sensory neurons (OSN) in the OE recognize odor and convey signals to the brain via olfactory bulbs. Sustentacular cells, arising from the basal stem cells, maintain the structural integrity of the OE. SARS-CoV-2 enters cells by interacting with the ACE2 proteins on the target cells and uses proteases such as TMPRSS2. Bann et al. analyzed RNA-seq data sets to determine the expression of these genes in OE of mouse and human for CoV entry. Their investigation shows that these two key genes are not present in the OE of both mouse and human. However, olfactory supportive cells, stem cells, and perivascular cells express ACE2 and TMPRSS2-and suggest it as the mechanism of CoV cellular entry in OE. 5 In some patients, anosmia and hypogeusia could be the presenting symptoms. 6 However, we need robust data to validate this correlation in COVID-19. The reports largely come from regions with more vigorous testing, including the United States, China, South Korea, Italy, Germany, and Iran [4] . In the formerly described strain of the coronavirus, 10-15% of patients report anosmia, but the incidence is much higher in the novel SARS-CoV-2, and in South Korea alone, 30% of patients reported these symptoms. 6 Otolaryngologists now suggest that anosmia could be a warning sign in patients with COVID-19, and they should undergo self-isolation to avoid the risk of spreading the disease. 7 Through this report, we highlight the association of COVID-19 with anosmia and hypogeusia, so that health care professionals can promptly test the individuals for novel SARS-CoV-2 and manage them accordingly. As the number of cases are rising rapidly around the world, effective screening and diagnostic modalities can help infected individuals to self-quarantine and seek medical attention when required. We suggest a data-driven approach to understand the neurological manifestations and to predict the prognosis of anosmia in this ongoing pandemic as it is still unexplored and thus, can provide useful information regarding the disease course and help clinicians to chart the way forward.

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