Conditional Dysosmia: a Very Unpleasant Symptom Causing Severe Anorexia and Breathing Problems in Covid-19: a Case Report

Conditional Dysosmia: a Very Unpleasant Symptom Causing Severe Anorexia and Breathing Problems in Covid-19: a Case Report

Abdulmohsin Younus Saleem1 and Abdul-Wahab Al-Allaf2*

1Early detection childhood disabilities centre, Otolaryngology Department, Duhok, Iraq.
2Rheumatology Section, Department of Rheumatology, Hamad Medical Institute, Doha, Qatar.

The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is a new coronavirus that is highly contagious and responsible for the ongoing pandemic disease; coronavirus disease (COVID-19). The disease was first identified in December 2019, and the World Health Organization declared the pandemic on the 11th of March 2020. Although individuals infected with SARS-CoV-2 may be asymptomatic, the disease can present as an upper respiratory tract illness. In the majority of the cases, it is of a mild type, however, some patients experience severe viral pneumonia that leads to respiratory failure, and, in some cases to death.

A COVID-19 diagnosis is confirmed by viral RNA detection in nasopharyngeal swab specimens; nonetheless, in some countries, COVID-19 tests are not available for screening and are only used to diagnose severe cases. Since 31 December 2019 and as of 17 October 2020 and in accordance with the applied case definitions and testing strategies in the affected countries 39 400 032 cases of COVID-19 have been reported, including 1 105 353 deaths [1].

The main way to control the spread of COVID-19 is to prevent human-to-human transmission, which can be achieved through a combination of public health measures, including the rapid identification and isolation of infected people [1].

Diagnostic suspicion is based on nonspecific symptoms, such as fever, odynophagia, head-  ache, and dry cough which are present in almost all acute respiratory virus cases [2].

Anosmia, which may be associated with the loss of taste, has been initially observed in European cases and seems to be a more specific symptom of COVID-19. Thus, during the pandemic, individuals with these symptoms should be tested for COVID-19; when tests are not available, isolation of the patient is indicated [3].

It should also be noted that olfactory dysfunction significantly influences the physical well-being, quality of life, safety, and nutritional status of those affected. And it becomes a greater problem when it becomes permanent. Yet, very little is known about olfactory dysfunction in COVID-19. Through our case report and review of the subject of the olfactory dysfunction, we would like to contribute to the existing knowledge and clinical evolution and to reinforce the importance of this manifestation from the patient prospected, and in the diagnosis and control of the disease from Otolaryngological point of view.

We, self-reported an Anosmia turned to Dysosmia (in Otolaryngeal senior consultant) and in one of his patient with anosmia which was followed by Dysosmia as well. This occurred in August 2020 and September 2020 in Duhok, Iraq.

Keywords: Conditional Dysosmia, COVID-19, case report

Free Full-text PDF

How to cite this article:

Abdulmohsin Younus Saleem and Abdul-Wahab Al-Allaf. Conditional Dysosmia: a Very Unpleasant Symptom Causing Severe Anorexia and Breathing Problems in Covid-19: a Case Report. International Journal of Case Reports, 2020; 4:174. DOI: 10.28933/ijcr-2020-10-2905


1. World Health Organization. Coronavirus disease 2019 (COVID-19). Situation Report-91. World Health Organization. 2020.
2. Guan WJ, Zhong NS. Clinical characteristics of Covid-19 in China. Reply. N Engl J Med 2020;382:1708–20.
3. 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 Otorhino- laryngol 2020;277:2251–61.
4. Donald Leopold, Distortion of Olfactory Percep- tion: Diagnosis and Treatment Chemical Senses, Volume 27, Issue 7, September 2002, Pages 611–5.
5. Frasnelli, J (2004). “Clinical presentation of qualitative olfactory dysfunction”. Eur Arch Otorhinolaryngol. 261 (7): 411–5.
6. Doty, R (2009). “The olfactory system and its disorders”. Seminars in Neurology. 29 (1): 74–81.
7. Bonfils, P; Avan, P; Patrick Faulcon; David Malinvaud (2005). “Distorted odorant perception analysis of a series of 56 patients with parosmia”. Arch Otolaryngol Head Neck Surg. 131 (2): 107–12.
8. Suzuki M, Saito K, Min WP, et al. Identification of viruses in patients with postviral olfactory dysfunction. Laryngoscope 2007;117:272–7.
9. Hwang CS. Olfactory neuropathy in severe acute respiratory syndrome: report of a case. Acta Neurol Taiwan 2006;15:26–8.
10. Villalba NL, Maouche Y, Ortiz MBA, et al. Anos-mia and dysgeusia in the absence of other respiratory diseases: should COVID-19 infection be considered? Eur J Case Rep Intern Med 2020;7:001641.
11. Abbas Ali Pourmomeny, Sahar Asadi. Manage- ment of Synkinesis and Asymmetry in Facial Nerve Palsy: A Review Article. October 2014. Iranian Journal of Otorhinolaryngology 26(77):251-6.
12. Zhao Y, Zhao Z, Wang Y, et al. Single-cell RNA expression profiling of ACE2, the putative receptor of Wuhan 2019-nCov. BioRxiv 2020.

Terms of Use/Privacy Policy/ Disclaimer/ Other Policies:
You agree that by using our site, you have read, understood, and agreed to be bound by all of our terms of use/privacy policy/ disclaimer/ other policies (click here for details).

This work and its PDF file(s) are licensed under a Creative Commons Attribution-NonCommercial 4.0 International License.