Isolated loss of smell (LOS)
A) Patients with COVID infection (regardless of LOS duration)
An MRI scan of brain is not recommended
B) Patients with no COVID infection (LOS more than 3 months)
An MRI scan of brain is recommended if endoscopy is normal
C) Patients with unknown COVID status (LOS more than 3 months)
An MRI scan of brain is recommended if endoscopy is normal
Loss of smell (LOS) associated with nasal symptoms (regardless of COVID status)
Nasal endoscopy should be performed prior to imaging. However given the risks surrounding endoscopy and limited availability, imaging may be requested first in selected cases.
If endoscopy is normal, further imaging is recommended (either MRI or CT).
Unilateral lesions or suspicion of malignancy on endoscopy needs urgent investigation with MRI/CT.
Benign findings (eg nasal polyps) should be treated medically before considering imaging.