Is Anosmia-Ageusia in COVID-19 Patients Associated with Neuro-Philic Virus Mutant and Mild Respiratory Involvement?

Abstract

Introduction and Objective: In COVID-19, sudden onset anosmia-ageusia can be observed in patients, regardless of other rhinologic symptoms or prominent nasal symptoms. In our clinical follow-ups, it has drawn our attention that patients presenting with anosmia-ageusia have milder pulmonary symptoms and milder progression. It was thought that this group of patients were infected with neurosensitive SARS-CoV-2 and the study was planned based on this hypothesis. We present our results to contribute to the literature because our study may be a practical screening approach in patient follow-up, may provide predictions of disease progression, and isolation period can be determined. Materials and Methods: The study was conducted in March 2020, by interviewing recorded patients via phone. Patients’ anosmia-ageusia characteristics, hospitalizations, and recorded Thoracic Computed Tomography (CT) reports were evaluated. The reports were analyzed by a single physician and CT positivity was reported and grouped as mild, moderate and severe. Results: A total of 1438 patients were included in the study. Of the patients, 47.8% were male and 52.0% were male, while the mean age was 44.33 ∓ 16.01 years. In terms of educational levels, patients were found to be elementary (25.6%) and high school (20.7%) graduates at most. Discussion and Conclusion: Hospitalization rates of patients presenting with anosmia-ageusia were lower and their disease progression were milder. We suggest that there are mainly neuro- or pulmonary-sensitive variants of the virus. This characteristic is of great importance for the long-term follow-up of these patients and predictions of complications. Patients presenting with a sudden development of anosmia-ageusia should be considered as positive patients. Quarantine and isolation periods should be extended in these patients, keeping in mind the prolonged RT-PCR positivity as well. Besides, it should be noted that these patients are more likely to develop central nervous system complications and they should be followed up.