Case presentation:
32 year-Old Egyptian female gravida 3, Para 2 (G3,P2) week 23 presented to the Clinic in the primary health care center on June,2020 complaining from three days loss of smell and taste, fatigue, no fever, no respiratory or gastrointestinal symptoms. She had history of sick contact with her husband. The patient past medical history was remarkable for gestational diabetes in her second pregnancy, she is not smoker. Covid-19 PCR from Nasopharyngeal swab was positive with low antibodies level according to our local guideline which indicate quarantine. In August 2020, the patient was contacted via phone consultation, she was 28 weeks on her pregnancy, her main complaint was cacosmia that causes her nausea and vomiting sometimes, she described her complain as unpleasant sensation started 6 weeks ago, her other symptoms improved after few days from COVID-19 diagnosis yet the smell disturbances persist, it was bilateral, continuous, without discharge, sometimes as foul odor, the smell was not noticed by her surroundings, increases when smelling potent odors like perfumes, soups or cleaners. She had no previous history of any type of rhinitis, asthma, or any atopic related diagnosis. Her primary laboratory results were normal except low vitamin B12 (table.1). She was seen later by ENT, examination showed pale nasal mucosa, Mometasone nasal spray was prescribed. However, further imagining was postponed due to the pregnancy state. In October 2020 she was seen again after normal delivery and sinus Xray did not reveal any signs of chronic sinusitis, she was still complaining from cacosmia which unfortunately did not improve with the symptomatic treatment and intra-nasal corticosteroids. Currently, we are still following up the patient and she is still complaining from cacosmia.