Inflammatory olfactory neuropathy in two patients with Covid-19
Abstract Coronavirus disease 2019 (Covid-19) caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) emerged as a public health emergency recently, leading to fatal respiratory failure in a number of patients. The clinical manifestation of Covid-19 is manifold, cardio-respiratory symptoms and multiorgan failure being the most critical. Anosmia was reported to be an early symptom in a significant number of Covid-19 patients and is frequently the only symptom without underlying nasal congestion. Here we present neuropathological work-up of olfactory epithelium and associated olfactory nerves from two patients succumbing to Covid-19, one of which was anosmic. We show that SARS-CoV-2 infection is associated with inflammation in the olfactory epithelium and leads to axonal damage in olfactory structures of the CNS - potentially explaining anosmic symptoms.