Sudden anosmia and ageusia in a child: A COVID-19 case report

Objective: COVID-19 in children has a spectrum of clinical presentations ranging from asymptomatic infection to severe illness and death. The recognition of COVID-19 in children has been challenging due to overlap with symptoms of common respiratory and gastrointestinal tract infections. We describe isolated sudden anosmia and ageusia as an uncommon clinical presentation of a child with COVID-19. Methods: Chart of a 17-year-old male referred to a tertiary care pediatric hospital for assessment of anosmia and ageusia was reviewed. Data included relevant history and physical examination, diagnostic work up, and management. Results: The child presented with sudden anosmia and ageusia for 3 months. The patient did not have symptoms of upper respiratory tract infection or gastrointestinal infection. There was no history of trauma. Examination of the ears, nose, and throat were all unremarkable. Magnetic resonance imaging documented the presence of both olfactory bulbs and olfactory sulci. SARS-CoV-2 IgG test was positive. Anosmia was confirmed by The University of Pennsylvania Smell Identification Test with a score of 27.5%. Conclusions: The clinical picture of our patient represents a non-classical presentation of COVID-19 in a child. Clinicians should be cognizant about uncommon presentations of COVID-19 in previously asymptomatic children.