Anosmia in Case of COVID-19 Patients: Dilemmas Faced in Neurotrauma Care

Abstract

The new coronavirus (COVID-19/SARS-CoV-2) and the associated pandemic is continuously presenting new challenges, and with a growing body of evidence, multiple clinical settings have been created for the neurosurgeons. 1 In fl ammation and demyelination are two pathobiological mechanisms resulting from the entry of the SARS-CoV-2 into the central nervous system (CNS). 2,3 Although cranial nerve involvement was not mentioned in the fi rst reports, in the weeks after the pandemic, it was clinicallycharacterized that patients with COVID-19 can develop anosmia. 4,5 This demonstrates the neuroinvasive potential of this unusual pathogen. 6 Studies suggest that approximately 25 to 30% of patients with severe cranial neurotrauma develop anosmia. 7 The etiologic mechanism of posttraumatic anosmia is a determining factor in recovery. 8 The presence of anosmia in patients with traumatic brain injury (TBI) and concomitant history of COVID-19/SARS-CoV-2 can present a diagnostic challenge. It becomes more challenging as many pathologies, that is, in fl ammatory, neurodegenerative pathologies, medications, and viral infections can also cause anosmia