Fast Five Quiz: COVID-Related Conditions

Michael Stuart Bronze, MD; Vecihi Batuman, MD; Arlen D. Meyers, MD, MBA; Stephen Soreff, MD; Helmi L Lutsep, MD

Disclosures

March 16, 2021

According to consensus guidelines from the BRS and ENT UK, an MRI scan of the brain is not recommended for patients with isolated loss of smell and current COVID-19, regardless of duration of loss of smell. For patients without COVID and loss of smell lasting longer than 3 months, an MRI scan of the brain is recommended if endoscopy findings are normal. Likewise, for patients with unknown COVID status and isolated loss of smell lasting longer than 3 months, an MRI scan of the brain is recommended if endoscopy findings are normal.

For patients with loss of smell associated with nasal symptoms, regardless of COVID status, nasal endoscopy should be performed prior to imaging. However, given the risks associated with endoscopy and its limited availability, imaging may be requested first in selected cases. If endoscopy findings are normal, imaging is recommended (either MRI or CT scan). Unilateral lesions or suspicion of malignancy on endoscopy requires urgent investigation with MRI or CT scan. Benign findings (eg, nasal polyps) should be treated medically before considering imaging.

Alpha lipoic acid is not recommended for patients with loss of smell lasting longer than 2 weeks as an isolated symptom or following resolution of any other COVID-19 symptoms. Oral corticosteroids are not recommended for patients with loss of smell lasting longer than 2 weeks with persistent COVID-19 symptoms.

Read more about disorders of taste and smell.

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