Clinical and Radiological Evaluations of COVID ‐19 Patients With Anosmia: Preliminary Report

  1. Jerome R. Lechien
  2. Justin Michel
  3. Thomas Radulesco
  4. Carlos M. Chiesa‐Estomba
  5. Luigi A. Vaira
  6. Giacomo De Riu
  7. Leigh Sowerby
  8. Claire Hopkins
  9. Sven Saussez

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Abstract

To investigate clinical and radiological features of olfactory clefts of patients with mild coronavirus disease 2019 (COVID‐19).

Study Design

Prospective non controlled study.

Methods

Sixteen COVID‐19 patients were recruited. The epidemiological and clinical data were extracted. Nasal complaints were assessed through the 22‐item Sino‐Nasal Outcome Test. Patients underwent psychophysical olfactory testing, olfactory cleft examination, and computed tomography (CT) scans.

Results

Sixteen anosmic patients were included. The mean Sniffin' Sticks score was 4.6 ± 1.7. The majority of patients had no endoscopical abnormality, with a mean olfactory cleft endoscopy score of 0.6 ± 0.9. The olfactory clefts were opacified in three patients on the CT scan. The mean radiological olfactory cleft score was 0.7 ± 0.8. There were no significant correlations between clinical, radiological, and psychophysical olfactory testing.

Conclusions

The olfactory cleft of anosmic COVID‐19 patients is free regarding endoscopic examination and imaging. The anosmia etiology is not related to edema of the olfactory cleft.

Level of Evidence

4 Laryngoscope , 130:2526–2531, 2020

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  1. Version published to 10.1002/lary.28993
  2. ScreenIT

    SciScore for 10.1101/2020.05.20.20106633: (What is this?)

    Please note, not all rigor criteria are appropriate for all manuscripts.

    Table 1: Rigor

    Institutional Review Board StatementIRB: The Jules Bordet Institute approved the study protocol (Central Ethics Committee, IJB-0M011-3137).
    Consent: Patients were invited to participate and informed consent was obtained once inclusion criteria were met.
    Randomizationnot detected.
    Blindingnot detected.
    Power Analysisnot detected.
    Sex as a biological variablenot detected.

    Table 2: Resources

    Software and Algorithms
    SentencesResources
    Statistical Analyses: Statistical analyses were performed using the Statistical Package for the Social Sciences for Windows (SPSS version 22,0; IBM Corp, Armonk, NY, USA).
    Statistical Package for the Social Sciences
    suggested: (SPSS, RRID:SCR_002865)
    SPSS
    suggested: (SPSS, RRID:SCR_002865)

    Results from OddPub: We did not detect open data. We also did not detect open code. Researchers are encouraged to share open data when possible (see Nature blog).

    Results from LimitationRecognizer: We detected the following sentences addressing limitations in the study:
    The limitation of this study is the small numbers and variable duration from onset of symptoms to CT-scan and endoscopy, unavoidable due to the restrictions on both travel and access to imaging and endoscopy. In order to mitigate against this, Sniffin’Sticks testing was repeated within 10 days of imaging, and on the day of endoscopy. Furthermore, in order to minimize contact time and reduce risk of contamination, only the identification part of the Sniffin’Sticks assessment was made; however as identification was shown to be severely impaired in obstructed olfactory cleft disease,13 we believed this would have sufficient sensitivity. Future studies should ideally include MRI, although both reported cases have failed to demonstrate any significant findings in the acute phase, and as changes in the olfactory bulb and cortex are related to the duration of post-viral olfactory loss,20 such changes will likely only be detected with delayed MRI.

    Results from TrialIdentifier: No clinical trial numbers were referenced.

    Results from Barzooka: We did not find any issues relating to the usage of bar graphs.

    Results from JetFighter: We did not find any issues relating to colormaps.

    Results from rtransparent:
    • Thank you for including a conflict of interest statement. Authors are encouraged to include this statement when submitting to a journal.
    • Thank you for including a funding statement. Authors are encouraged to include this statement when submitting to a journal.
    • No protocol registration statement was detected.

    About SciScore

    SciScore is an automated tool that is designed to assist expert reviewers by finding and presenting formulaic information scattered throughout a paper in a standard, easy to digest format. SciScore checks for the presence and correctness of RRIDs (research resource identifiers), and for rigor criteria such as sex and investigator blinding. For details on the theoretical underpinning of rigor criteria and the tools shown here, including references cited, please follow this link.

  3. Version published to 10.1101/2020.05.20.20106633v1 on medRxiv