CASE SUMMARY
Anosmia tends to manifest during the early stages of coronavirus disease
2019 (COVID-19).1 A 42-year-old male patient was
hospitalized for intermittent fever, dry cough, and malaise. On the
third day of hospitalization, real-time reverse
transcriptase–polymerase chain reaction analysis of his nasopharyngeal
samples yielded a positive result for severe acute respiratory syndrome
coronavirus 2; thus, the patient was diagnosed with COVID-19 and treated
with 400 mg lopinavir every 12 h for 2 weeks. After 1 week of
hospitalization, the patient reported losing his sense of smell in both
nasal cavities. Based on olfactory function tests, he was diagnosed with
complete anosmia and olfactory function tests evaluate the degree of
anosmia more objectively,2 which is helpful during the
follow-up of patients to evaluate treatment response. Magnetic resonance
brain imaging showed no abnormalities (Figure 1). Thereafter, treatment
with 5000 IU of Citoneurin (Vitamin B1 [thiamine hydrochloride], 100
mg/day; Vitamin B6 [pyridoxine hydrochloride], 100 mg/day; Vitamin
B12 [cyanocobalamin], 5000 mcg/day) orally and olfactory training,
which consists of inhaling identified flasks containing cinnamon,
cloves, and lavender for 15 minutes/day were prescribed. Repeated
exposure to an odorant may modulate the regenerative capacity of the
olfactory receptors.3 Subjective signs of anosmia
began to improve 12 days later. Two weeks after lopinavir therapy, the
patient recovered from most symptoms of COVID-19; and forty days after
initiation of B-complex vitamins and olfactory training, he recovered
from anosmia. We conclude that B-complex vitamins and olfactory training
may be effective for the treatment of COVID-19–related anosmia.