COVID-19 and olfactory dysfunction - an ENT perspective to the current COVID-19 pandemic

ABSTRACT

The current COVID-19 or Sars-CoV-2 pandemic increased awareness of hyposmia or anosmia, as this can be an accompanying symptom. In mild cases, anosmia without rhinorrhea can be the only presenting symptom of this infection. Timely identification can lead to early detection of otherwise asymptomatic carriers. History taking and essential clinical assessment with appropriate protective measures can be performed in patients in whom COVID-19 is suspected. Patients with anosmia without nasal obstruction should be considered COVID-19 suspect and this should initiate testing or self-isolation. As for treatment of hyposmia or anosmia, the authors do not advise treatment with systemic corticosteroids in patients with COVID-19. Based on expert opinion, nasal corticosteroids can be considered, with a preference for spray formulation. Patients who were already using topical or inhalation corticosteroids for proven pre-existing disease (such as asthma and/or allergy) should be advised to continue their maintenance therapy. ENT (Ear Nose Throat) focus on hyposmia and anosmia should be continued, to gain additional knowledge of the disease mechanisms of COVID-19 and improve follow-up, not only on the pneumological aspects but also to evaluate the impact on quality of life of potentially long-term side effects caused by anosmia.