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Research ArticleHead and Neck Imaging
Open Access

Olfactory Bulb Signal Abnormality in Patients with COVID-19 Who Present with Neurologic Symptoms

S.B. Strauss, J.E. Lantos, L.A. Heier, D.R. Shatzkes and C.D. Phillips
American Journal of Neuroradiology October 2020, 41 (10) 1882-1887; DOI: https://doi.org/10.3174/ajnr.A6751
S.B. Strauss
aFrom the Department of Radiology (S.B.S., J.E.L., L.A.H., C.D.P.), Weill Cornell Medical College, New York-Presbyterian, New York, New York
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J.E. Lantos
aFrom the Department of Radiology (S.B.S., J.E.L., L.A.H., C.D.P.), Weill Cornell Medical College, New York-Presbyterian, New York, New York
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L.A. Heier
aFrom the Department of Radiology (S.B.S., J.E.L., L.A.H., C.D.P.), Weill Cornell Medical College, New York-Presbyterian, New York, New York
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D.R. Shatzkes
bDepartment of Radiology (D.R.S.), Zucker School of Medicine at Hofstra/Northwell, Lenox Hill Hospital and The New York Head and Neck Institute, New York, New York
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C.D. Phillips
aFrom the Department of Radiology (S.B.S., J.E.L., L.A.H., C.D.P.), Weill Cornell Medical College, New York-Presbyterian, New York, New York
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Abstract

BACKGROUND AND PURPOSE: Unique among the acute neurologic manifestations of Severe Acute Respiratory Syndrome coronavirus 2, the virus responsible for the coronavirus disease 2019 (COVID-19) pandemic, is chemosensory dysfunction (anosmia or dysgeusia), which can be seen in patients who are otherwise oligosymptomatic or even asymptomatic. The purpose of this study was to determine if there is imaging evidence of olfactory apparatus pathology in patients with COVID-19 and neurologic symptoms.

MATERIALS AND METHODS: A retrospective case-control study compared the olfactory bulb and olfactory tract signal intensity on thin-section T2WI and postcontrast 3D T2 FLAIR images in patients with COVID-19 and neurologic symptoms, and age-matched controls imaged for olfactory dysfunction.

RESULTS: There was a significant difference in normalized olfactory bulb T2 FLAIR signal intensity between the patients with COVID-19 and the controls with anosmia (P = .003). Four of 12 patients with COVID-19 demonstrated intraneural T2 signal hyperintensity on postcontrast 3D T2 FLAIR compared with none of the 12 patients among the controls with anosmia (P = .028).

CONCLUSIONS: Olfactory bulb 3D T2 FLAIR signal intensity was greater in the patients with COVID-19 and neurologic symptoms compared with an age-matched control group with olfactory dysfunction, and this was qualitatively apparent in 4 of 12 patients with COVID-19. Analysis of these preliminary finding suggests that olfactory apparatus vulnerability to COVID-19 might be supported on conventional neuroimaging and may serve as a noninvasive biomarker of infection.

ABBREVIATIONS:

COVID-19
coronavirus disease 2019
OB
olfactory bulb
SARS-CoV-2
Severe Acute Respiratory Syndrome coronavirus 2
  • © 2020 by American Journal of Neuroradiology

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American Journal of Neuroradiology: 41 (10)
American Journal of Neuroradiology
Vol. 41, Issue 10
1 Oct 2020
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Cite this article
S.B. Strauss, J.E. Lantos, L.A. Heier, D.R. Shatzkes, C.D. Phillips
Olfactory Bulb Signal Abnormality in Patients with COVID-19 Who Present with Neurologic Symptoms
American Journal of Neuroradiology Oct 2020, 41 (10) 1882-1887; DOI: 10.3174/ajnr.A6751

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Olfactory Bulb Signal Abnormality in Patients with COVID-19 Who Present with Neurologic Symptoms
S.B. Strauss, J.E. Lantos, L.A. Heier, D.R. Shatzkes, C.D. Phillips
American Journal of Neuroradiology Oct 2020, 41 (10) 1882-1887; DOI: 10.3174/ajnr.A6751
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