Postmortem Histopathologic Investigation of Olfactory Dysfunction in COVID-19

Anosmia appears to be caused by SARS-CoV-2 infection of sustentacular (support) cells of the olfactory mucosa without directly affecting olfactory sensory neurons.

Loss of smell (anosmia) was recognized as a symptom early in the COVID-19 pandemic, yet its mechanism remains unknown almost 2 years later. Khan et al. adapted a surgical procedure to harvest olfactory mucosa (OM) and respiratory mucosa (RM) from patients who had recently died from COVID-19. Tissue was analyzed for SARS-CoV-2 by in situ RNA hybridization and fluorescence immunohistochemistry. Among 68 COVID-19 cases, SARS-CoV-2 was detected in 30 (referred to as “informative cases”) but not in the remaining 38 cases, or in 2 convalescent cases (died from other causes months after COVID-19) or 15 control patients (negative for SARS-CoV-2 before death; died from other causes). All but one informative case died within 16 days of diagnosis.

In 9…

Reviewing Author

George Sakoulas, MD

Disclosures

Consultant/Advisory BoardParatek Pharmaceuticals; Nestle Corp.; AbbVie; Shionogi

Speaker’s BureauAllergan/AbbVie; Paratek Pharmaceuticals; Nestle Corp.

RoyaltiesUpToDate

Editorial BoardsAntimicrobial Agents and Chemotherapy; Open Forum Infectious Diseases