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Bilateral transient olfactory bulb edema during COVID-19–related anosmia

Thomas Laurendon, Thomas Radulesco, Justine Mugnier, Mélanie Gérault, Christophe Chagnaud, Ahmed-Ali El Ahmadi, A. Varoquaux

2020Neurology149 citationsDOI

Abstract

An asymptomatic 27-year-old man was diagnosed with coronavirus disease 2019 (COVID-19) by occupational medicine after contagion (reverse transcription polymerase chain reaction [ RT - PCR ]). Four days after the diagnosis, he experienced complete anosmia and dysgeusia.1 On day 7, 1.5T MRI showed signs of bilateral olfactory bulb edema on 3D constructive interference in steady state T2-weighted imaging, demonstrated by severe enlargement2 (left: 73 mm3, right: 64 mm3) and an abnormally high signal intensity (figure). Olfactory clefts showed mild edema. The olfactory pathways, including the cortical projections (fluid-attenuated inversion recovery and diffusion-weighted imaging not shown), were normal. Sensory recovery and negative RT-PCR (positive on days 1, 2, and 10) appeared on day 14. MRI on day 24 confirmed the normalization of olfactory bulb signal and volumes (left: 22 mm3, right: 17 mm3).

Topics & Concepts

AnosmiaOlfactory bulbMedicineEdemaAsymptomaticSubclinical infectionFluid-attenuated inversion recoveryPathologyCoronavirus disease 2019 (COVID-19)Magnetic resonance imagingInternal medicineRadiologyDiseaseCentral nervous systemInfectious disease (medical specialty)Olfactory and Sensory Function StudiesAdvanced Chemical Sensor TechnologiesAllergic Rhinitis and Sensitization