Uncommon Presentation of COVID-19 in Pediatric Patients: Anosmia

Abstract

Objective The novel coronavirus disease 2019 (COVID-19) infection was declared as a pandemic by the World Health Organization on March 11, 2020. Although the complaint of anosmia is well described in adult patients, there is limited knowledge in pediatric patients. We aim to evaluate the epidemiological characteristics and clinical findings of children with anosmia in COVID-19-positive pediatric patients.

Methods Patients diagnosed with COVID-19 infection at 1 month to 18 years of age, who admitted to Meram Faculty of Medicine of Necmettin Erbakan University between March and June 2020, were retrospectively reviewed, and the patients who had anosmia or developed anosmia during follow-up were then included in the study. The diagnosis was established by polymerase chain reaction (PCR).

Results A total of 71 patients were diagnosed with COVID-19 and 14 (19.7%) of them had anosmia. Mean patient age was 14.07 (range: 10–16) years. Six of our 14 (42.8%) patients had anosmia at the time of diagnosis and anosmia developed in the follow-up among eight patients. The mean duration of anosmia in our patients was 6.9 ± 3.8 days. Recovery time was 1 to 4 days in four patients (28.5%), 5 to 8 days in four patients (28.5%), and 9 to 14 days in six patients (42.8%).

Conclusion In this article, it was emphasized that anosmia can be the sole manifestation or concomitant with other symptoms in children with COVID-19 disease. Care and attention is important to identify COVID-19 patients at an early stage of the disease and limit the spread of the virus.

Keywords

anosmia - COVID-19 - polymerase chain reaction - children

Publication History

Received: 15 September 2020

Accepted: 22 December 2020

Article published online:
18 February 2021

• References

• 1 Lu H, Stratton CW, Tang YW. Outbreak of pneumonia of unknown etiology in Wuhan, China: The mystery and the miracle. J Med Virol 2020; 92 (04) 401-402
• 2 Paraskevis D, Kostaki EG, Magiorkinis G, Panayiotakopoulos G, Sourvinos G, Tsiodras S. Full-genome evolutionary analysis of the novel corona virus (2019-nCoV) rejects the hypothesis of emergence as a result of a recent recombination event. Infect Genet Evol 2020; 79: 104212
• 3 World Health Organization. WHO Director-General's remarks at the media briefing on 2019-nCoV on 11 February 2020. Accessed 11 February 2020 at: https://www.who.int/dg/speeches/detail/who-director-general-s-remarks-at-the-media-briefing-on-2019-ncov-on-11-february-2020
• 4 World Health Organization. WHO Director-General's opening remarks at the media briefing on COVID-19 - 11 March 2020. Accessed 11 June 2020 at: https://www.who.int/director-general/speeches/detail/who-director-general-s-opening-remarks-at-the-media-briefing-on-covid-19---11-march-2020
• 5 TR Ministry of Health. COVID-19 status report. Accessed November 30, 2020 at: https://covid19.saglik.gov.tr/
• 6 Republic of Turkey, Ministry of Health. COVID-19 situation report, Turkey. Accessed June 30, 2020 at: https://dosyamerkez.saglik.gov.tr/Eklenti/37743,covid-19-situation-report-v4pdf.pdf?
• 7 Hoang A, Chorath K, Moreira A. et al. COVID-19 in 7780 pediatric patients: a systematic review. EClinicalMedicine 2020; 24: 100433
• 8 Götzinger F, Santiago-García B, Noguera-Julián A. et al; ptbnet COVID-19 Study Group. COVID-19 in children and adolescents in Europe: a multinational, multicentre cohort study. Lancet Child Adolesc Health 2020; 4 (09) 653-661
• 9 Mak PQ, Chung KS, Wong JS, Shek CC, Kwan MY. Anosmia and ageusia: not an uncommon presentation of COVID-19 infection in children and adolescents. Pediatr Infect Dis J 2020; 39 (08) e199-e200
• 10 Rusetsky YY, MeYtel Y, Babayan AR, Malyavina US. [Otorhinolaryngological aspects of the disease course in children infected with SARS-CoV-2 virus] (in Russian). Vestn Otorinolaringol 2020; 85 (02) 63-66
• 11 Mao L, Jin H, Wang M. et al. Neurologic manifestations of hospitalized patients with coronavirus disease 2019 in Wuhan, China. JAMA Neurol 2020; 77 (06) 683-690
• 12 Fantozzi PJ, Pampena E, Di Vanna D. et al. Xerostomia, gustatory and olfactory dysfunctions in patients with COVID-19. Am J Otolaryngol 2020; 41 (06) 102721
• 13 Suzuki M, Saito K, Min WP. et al. Identification of viruses in patients with postviral olfactory dysfunction. Laryngoscope 2007; 117 (02) 272-277
• 14 Lechien JR, Chiesa-Estomba CM, De Siati DR. et al. Olfactory and gustatory dysfunctions as a clinical presentation of mild-to-moderate forms of the coronavirus disease (COVID-19): a multicenter European study. Eur Arch Otorhinolaryngol 2020; 277 (08) 2251-2261
• 15 Yan CH, Faraji F, Prajapati DP, Boone CE, DeConde AS. Association of chemosensory dysfunction and COVID-19 in patients presenting with influenza-like symptoms. Int Forum Allergy Rhinol 2020; 10 (07) 806-813
• 16 Qi F, Qian S, Zhang S, Zhang Z. Single cell RNA sequencing of 13 human tissues identify cell types and receptors of human coronaviruses. Biochem Biophys Res Commun 2020; 526 (01) 135-140
• 17 Sungnak W, Huang N, Bécavin C. et al; HCA Lung Biological Network. SARS-CoV-2 entry factors are highly expressed in nasal epithelial cells together with innate immune genes. Nat Med 2020; 26 (05) 681-687
• 18 Netland J, Meyerholz DK, Moore S, Cassell M, Perlman S. Severe acute respiratory syndrome coronavirus infection causes neuronal death in the absence of encephalitis in mice transgenic for human ACE2. J Virol 2008; 82 (15) 7264-7275
• 19 Li W, Zhang C, Sui J. et al. Receptor and viral determinants of SARS-coronavirus adaptation to human ACE2. EMBO J 2005; 24 (08) 1634-1643
• 20 Ludvigsson JF. Systematic review of COVID-19 in children shows milder cases and a better prognosis than adults. Acta Paediatr 2020; 109 (06) 1088-1095