J Korean Med Sci.  2020 Jun;35(21):e201. 10.3346/jkms.2020.35.e201.

Olfactory and Gustatory Dysfunction in a COVID-19 Patient with Ankylosing Spondylitis Treated with Etanercept: Case Report

Affiliations
  • 1Department of Neurology, School of Medicine, Kyungpook National University, Daegu, Korea
  • 2Division of Rheumatology, Department of Internal Medicine, School of Medicine, Kyungpook National University, Daegu, Korea

Abstract

The neurologic manifestations concerning coronavirus disease 2019 (COVID-19) are highly penetrated. Anosmia and ageusia are one of the common acute neurologic symptoms, which develop in the early stage of COVID-19. However, it is not reported that how immunosuppressive agents affect these symptoms. We report olfactory and gustatory dysfunctions in a patient with ankylosing spondylitis (AS) treated with etanercept during COVID-19. A 53-year-old female showing AS controlled with tumor necrosis factor-α inhibitor, etanercept, had been diagnosed with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, presenting cough and rhinorrhea. One month after diagnosis, she complained about hyposmia and hypogeusia two days before the seronegative conversion of SARS-CoV-2, which were confirmed by a neurological examination. We speculate that the etanercept may have delayed the development of olfactory and gustatory dysfunction in the patient.

Keyword

Severe Acute Respiratory Syndrome Coronavirus 2; Tumor Necrosis Factor-alpha; Neurologic Manifestations

Figure

  • Fig. 1 The timeline of clinical data, results of the blink reflex, and brain MRI. Clinical presentation and etanercept administration are depicted on the appropriate date. The blink reflex showed normal R1 and R2 responses bilaterally. A brain MRI revealed normal structures, including a normal frontal lobe, maxilla, sphenoid, and frontal sinus. The patient consented to publish her clinical records and images.COVID-19 = coronavirus disease 2019, MRI = magnetic resonance imaging, AS = ankylosing spondylitis.


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