RESUMEN
Coronavirus disease (COVID-19) is often characterized by abnormal olfactory and gustatory symptoms in adults; however, detailed studies on pediatric patients with COVID-19 are extremely limited. A 13-year-old Japanese girl presented with fever and cough, and after 2 days, her olfactory and taste sensations suddenly disappeared. A real-time reverse transcriptase-polymerase chain reaction (RT-PCR) test for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) was performed using a nasopharyngeal swab. Because a positive result was seen, she was admitted on the 7th day of illness. On admission, the visual analogue scale (VAS) score for smell and taste was 0 of 100%. An intravenous olfaction test using prosultiamine (Alinamin test) was performed on the 15th day of illness to evaluate olfaction, and an increase in latency (33 seconds) and a decrease in duration (55 seconds) were observed. In the odor identification test using 12 different odor cards, only 7 odors were correctly identified. On the 18th day of illness, SARS-CoV-2 tested negative in the RT-PCR test; simultaneously, the VAS score for smell and taste fully improved to 100 of 100%. On the 77th day of illness, full recovery was confirmed in the Alinamin test (latency, 7 seconds; duration, 82 seconds). In this present case, an improvement in olfactory and gustatory dysfunctions was observed with negative results in RT-PCR test for SARS-CoV-2.
Asunto(s)
Infecciones por Coronavirus/diagnóstico , Trastornos del Olfato/etiología , Neumonía Viral/diagnóstico , Trastornos del Gusto/etiología , Adolescente , Betacoronavirus/aislamiento & purificación , COVID-19 , Infecciones por Coronavirus/complicaciones , Femenino , Humanos , Japón , Trastornos del Olfato/diagnóstico , Pandemias , Neumonía Viral/complicaciones , Reacción en Cadena de la Polimerasa de Transcriptasa Inversa , SARS-CoV-2 , Olfato , Gusto , Trastornos del Gusto/diagnósticoRESUMEN
OBJECTIVE: This study aimed to clarify the correlation between olfactory disorder severity and radiological findings in patients with chronic rhinosinusitis (CRS) in the preoperative stage. METHODS: From 2007 to 2014, 272 adult patients (163 men, 109 women; age range 22-80 years) with olfactory disorder due to bilateral CRS who were scheduled to undergo primary endoscopic sinus surgery (ESS) were enrolled. Two groups were studied: eosinophilic CRS (ECRS, n=193); and non-ECRS (n=79). T&T olfactometer recognition and intravenous olfaction tests were used. Computed tomography (CT) scores for sinuses and olfactory clefts (OC) were applied. Correlations between olfactory acuity and CT score were statistically analysed. RESULTS: In both groups, recognition threshold correlated significantly with CT score. Recognition threshold and CT score were significantly more severe in ECRS than in non-ECRS. CT score at OC showed the strongest correlation with recognition threshold. CT scores for total sinuses and OC in patients showing a positive response to the intravenous olfaction test (239 patients) were significantly milder than those in the negative group (29 patients), but ethmoid CT score was not. CONCLUSION: Olfactory disorder severity correlated significantly with CT opacification. Olfactory disorder and CT findings were more severe in patients with ECRS than in those with non-ECRS.