Importance of SARs-Cov-2 anosmia: From phenomenology to neurobiology

• Published in: Comprehensive psychiatry 2020-07, Vol.100, p.152184-152184, Article 152184
• Main Author: Pallanti, Stefano
• Format: Article
• Language: English
• Subjects: Ageusia - virology; Anosmia; Asymptomatic; Betacoronavirus; Brain; Consciousness; Coronavirus - isolation & purification; Coronavirus Infections - complications; Coronavirus Infections - diagnosis; Coronaviruses; COVID-19; Cytokines; Disease; Early symptoms; Female; Humans; Hypogeusia; Infections; Male; Musculoskeletal system; Nervous system; Neurobiology; Neurosciences; Olfaction disorders; Olfaction Disorders - virology; Otolaryngology; Pandemics; Patients; Phenomenology; Pneumonia, Viral - complications; Pneumonia, Viral - diagnosis; Quality of Life; Quarantine; SARS-CoV-2; Severe acute respiratory syndrome coronavirus 2; Smell; Taste Disorders - virology; Viral infections; Well being
• ISSN: 0010-440X; 1532-8384
• DOI: 10.1016/j.comppsych.2020.152184

Anosmia and hypogeusia, the inability or decreased ability to smell and taste, have been reported as common complaints in SARS-CoV-2 patients who were still in an asymptomatic phase. These impairments affect the ability to sense odors in foods and the environment, obviously affecting quality of life, related to social interactions and general well-being. The British Association of Otorhinolaryngology (ENT-UK) considers loss of sense of smell in their list of COVID-19's markers of infection. Here we present two cases in which early manifestations of anosmia and hypogeusia were experienced with psycho-sensorial and atmospheric phenomena. Psychiatrists, neurologists and physicians in general should be aware of this symptom presentation in order to avoid mistreatment, given that persistent olfactory dysfunction might increase the risks of nutritional deficit and lead to development of adjustment disorders. All clinicians should be aware that the presentation of SARS-CoV-2's symptoms goes far beyond respiratory and sensorial dimensions and involves psychosensorial and neurological dimensions; these clinical observations could shed light on the neurobiological substrates involved in COVID-19 disease. •Anosmia and hypogeusia can occur before respiratory symptoms in SARS-CoV-2 patients.•Beyond sensory impairment, psycho-sensorial phenomena can have pervasive impact.•Psychiatrists and neurologists should be aware of the different dimensions of COVID-19’s symptoms to avoid mistreatment.•Neuropsychiatry and neurobiological substrates of SARS-CoV-2 should be further investigated.