350 Infectious Disorders - Drug Targets, 2020, Vol. 20, No. 3 Editorial/Letter to Editor EDITORIAL/LETTER TO EDITOR Isolated Anosmia as a Presentation of COVID-19: An Experience in a Referral Hospital Dear Prof. Sabatier The outbreak of COVID-19 caused by the novel severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) that began in Wuhan, China, has rapidly spread, with many confirmed cases in all around the world. Also, there is a wide range of respiratory presentations for COVID-19 cases that have been identified from common to uncommon manifestations, including dyspnea, chest tightness, cough, sputum, rhinorrhea, anorexia, weakness, and vomiting [1-6]. One of the features of this infection is the appearance of neurological symptoms. This condition can lead to anosmia by affecting the peripheral nervous system [7-13]. Herein, we report a case series, namely isolated onset anosmia, which can be considered highly suspicious for COVID-19. Seven outpatients people, whose only complaint was isolated anosmia, went to a referral hospital in Tehran. Of seven patients, five (71.4%) were men and two (28.6%) were women. The age range was 25 to 31 years. They had no underlying disease such as coronary artery disease (CAD), hypertension, diabetes mellitus (DM), asthma, chronic sinusitis and chronic obstructive pulmonary disease (COPD). They had no history of smoking and addiction. They did not develop any further symptoms like fever, cough, shortness of breath, or myalgia. All of them were in contact with patients with definite COVID-19 diagnosis. Because the people were outpatients, Corona PCR was not checked for them. They did not have leukopenia, lymphopenia, or increased level of C-reactive protein (CRP) in the laboratory profile. These people had anosmia for 3 to 5 weeks. Two patients whose initiated hydroxychloroquine 200 mg every 12 hours for five days, the anosmia were recovered sooner. No other cause for anosmia was found in the follow-up. Therefore, we report the existence of a symptom of COVID-19 infection: isolated anosmia and urge the clinicians to consider this symptom in current daily management. REFERENCES [1] Zhu N, Zhang D, Wang W, Li X, Yang B, Song J, et al. A novel coronavirus from patients with pneumonia in China, 2019. N Engl J Med. 2020; 382(8): 727-733. doi: 10.1056/NEJMoa2001017 PMID: 31978945 [2] Mehraeen E, Hayati B, Saeidi S , Heydari M , Seyedalinaghi S. Self-Care Instructions for People Not Requiring Hospitalization for Coronavirus Disease 2019 (COVID-19), Arch Clin Infect Dis. Online ahead of Print ; 15(COVID-19):e102978. doi: 10.5812/archcid.102978. [3] Asadollahi-Amin A, Hasibi M, Ghadimi F, Rezaei H, Seyedalinaghi S. Lung Involvement Found on Chest CT Scan in a Pre- Symptomatic Person with SARS-CoV-2 Infection: A Case Report. Trop Med Infect Dis. 2020; Trop Med Infect Dis. 2020; 5(2). doi: 10.3390/tropicalmed5020056. 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Anosmia and ageusia are emerging as symptoms in patients with COVID-19: What does the current evidence say? Ecancermedicalscience. 2020 Apr 3;14:ed98. doi: 10.3332/ecancer.2020.ed98. [9] Kowalski LP, Sanabria A, Ridge JA, Ng WT, de Bree R, Rinaldo A, et al. COVID-19 pandemic: Effects and evidence-based recommendations for otolaryngology and head and neck surgery practice. Head Neck. 2020 Apr 9. doi: 10.1002/hed.26164. [10] Gane SB, Kelly C, Hopkins C. Isolated sudden onset anosmia in COVID-19 infection. A novel syndrome? Rhinology. 2020 Apr 2. doi: 10.4193/Rhin20.114. [11] Lüers JC, Kluكmann JP, Guntinas-Lichius O. The Covid-19 pandemic and otolaryngology: What it comes down to? Laryngorhinootologie. 2020 Mar 26. doi: 10.1055/a-1095-2344. [12] Walker A, Hopkins C, Surda P. The use of google trends to investigate the loss of smell related searches during COVID-19 outbreak. Int Forum Allergy Rhinol. 2020 Apr 11. doi: 10.1002/alr.22580. [13] Ghiasvand F, Ghadimi M, Ghadimi F, Safarpour S, HosseinzadehR, SeyedAlinaghi S, Symmetrical polyneuropathy in Coronavirus Disease 2019 (COVID-19),IDCases(2020), doi:https://doi.org/10.1016/j.idcr.2020.e00815. Dr. Fereshteh Ghiasvand (Editor) Liver transplantation Research Center, Department of Infectious Diseases, Imam Khomeini Hospital Complex, Tehran University of Medical Sciences, Tehran, Iran. Dr. SeyedAhmad SeyedAlinaghi (Editor) Iranian Research Center for HIV/AIDS, Iranian Institute for Reduction of High Risk Behaviors, Tehran University of Medical Sciences, Tehran, Iran. 2212-3989/20 $65.00+.00 © 2020 Bentham Science Publishers