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    <div class="highwire-article-citation highwire-citation-type-highwire-article node79457--5" data-node-nid="79457" id="top-node-79457--6341833164" data-pisa="ajnr;ajnr.A6932v1" data-pisa-master="ajnr;ajnr.A6932" data-apath="/ajnr/early/2020/10/29/ajnr.A6932.atom" data-hw-author-tooltip-instance="highwire_author_tooltip"><div class="highwire-cite highwire-cite-highwire-article highwire-citation-jcore-article-title-complete clearfix has-author-tooltip highwire-citation-highwire-article-top-a">
  
  
      <div class="highwire-cite-overline"><span  class="highwire-cite-metadata-article-type highwire-cite-metadata">Reply</span><span class="separator-pipe"></span><span  class="highwire-cite-metadata-art-cat highwire-cite-metadata"><span class="wrapper">LETTER</span></span></div>
  
      <div class="highwire-cite-access"><span class="highwire-citation-access"><i class="highwire-access-icon highwire-access-icon-open-access open-access hw-icon-open-access" title="Open Access" aria-hidden="true"></i><span  class="element-invisible highwire-access-icon highwire-access-icon-open-access" style="">Open Access</span></span></div>
  
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    	<div class="highwire-cite-authors"><span  class="highwire-citation-authors"><span class="highwire-citation-author first" data-delta="0">S.B. Strauss</span>, <span class="highwire-citation-author" data-delta="1">J.E. Lantos</span>, <span class="highwire-citation-author" data-delta="2">C.D. Phillips</span>, <span class="highwire-citation-author" data-delta="3">A. Gupta</span> and <span class="highwire-citation-author" data-delta="4">E. Lin</span></span></div>
  
    	<div class="highwire-cite-metadata"><span  class="highwire-cite-metadata-journal highwire-cite-metadata">American Journal of Neuroradiology </span><span  class="highwire-cite-metadata-date highwire-cite-metadata">October 2020,  </span><span  class="highwire-cite-metadata-doi highwire-cite-metadata">DOI: https://doi.org/10.3174/ajnr.A6932 </span></div>
  
  
  
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<div id="hw-article-author-popups-top-node-79457--6341833164" style="display: none;"><div class="author-tooltip-0"><div class="author-tooltip-name">S.B. Strauss </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>a</span>Department of RadiologyWeill Cornell MedicineNew York, New York</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=S.B.%2BStrauss%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Strauss%20S&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link"><a href="/search/author1%3AS.B.%2BStrauss%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li><li class="author-orcid-link last"><a href="https://orcid.org/0000-0001-7766-2721" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for S.B. Strauss</a></li></ul></div><div class="author-tooltip-1"><div class="author-tooltip-name">J.E. Lantos </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>a</span>Department of RadiologyWeill Cornell MedicineNew York, New York</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=J.E.%2BLantos%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Lantos%20J&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link"><a href="/search/author1%3AJ.E.%2BLantos%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li><li class="author-orcid-link last"><a href="https://orcid.org/0000-0003-4323-7828" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for J.E. Lantos</a></li></ul></div><div class="author-tooltip-2"><div class="author-tooltip-name">C.D. Phillips </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>a</span>Department of RadiologyWeill Cornell MedicineNew York, New York</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=C.D.%2BPhillips%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Phillips%20C&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link"><a href="/search/author1%3AC.D.%2BPhillips%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li><li class="author-orcid-link last"><a href="https://orcid.org/0000-0003-1773-8899" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for C.D. Phillips</a></li></ul></div><div class="author-tooltip-3"><div class="author-tooltip-name">A. Gupta </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>b</span>Department of RadiologyWeill Cornell MedicineNew York, New YorkClinical and Translational Neuroscience UnitFeil Family Brain and Mind Research Institute and Department of NeurologyWeill Cornell MedicineNew York, New York</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=A.%2BGupta%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Gupta%20A&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link"><a href="/search/author1%3AA.%2BGupta%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li><li class="author-orcid-link last"><a href="https://orcid.org/0000-0003-2816-0340" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for A. Gupta</a></li></ul></div><div class="author-tooltip-4"><div class="author-tooltip-name">E. Lin </div><div class="author-tooltip-affiliation"><span class="author-tooltip-text"><div class='author-affiliation'><span class='nlm-sup'>d</span>Department of RadiologyWeill Cornell MedicineNew York, New York</div></span></div><ul class="author-tooltip-find-more"><li class="author-tooltip-gs-link first"><a href="/lookup/google-scholar?link_type=googlescholar&amp;gs_type=author&amp;author%5B0%5D=E.%2BLin%2B" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on Google Scholar</a></li><li class="author-tooltip-pubmed-link"><a href="/lookup/external-ref?access_num=Lin%20E&amp;link_type=AUTHORSEARCH" target="_blank" class="" data-icon-position="" data-hide-link-title="0">Find this author on PubMed</a></li><li class="author-site-search-link"><a href="/search/author1%3AE.%2BLin%2B" rel="nofollow" class="" data-icon-position="" data-hide-link-title="0">Search for this author on this site</a></li><li class="author-orcid-link last"><a href="https://orcid.org/0000-0003-1860-4059" target="_blank" class="" data-icon-position="" data-hide-link-title="0">ORCID record for E. Lin</a></li></ul></div></div></div>  </div>

  
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    <div class="highwire-markup"><div xmlns="http://www.w3.org/1999/xhtml" data-highwire-cite-ref-tooltip-instance="highwire_reflinks_tooltip" class="content-block-markup" xmlns:xhtml="http://www.w3.org/1999/xhtml"><div class="article fulltext-view "><span class="highwire-journal-article-marker-start"></span><p id="p-2">We read the letter written by Shor et al with great interest, and we appreciate the data that they shared from their institution. We concur that subjective perception of olfactory bulb (OB) hyperintensity in isolation should not be interpreted as definitive evidence of coronavirus disease 2019 (COVID-19) infection but wish to note that quantitative assessment of OB signal intensity was additionally performed in the patient sample reported in Lin et al,<sup><a id="xref-ref-1-1" class="xref-bibr" href="#ref-1">1</a></sup> as detailed in a subsequently published article by Strauss et al.<sup><a id="xref-ref-2-1" class="xref-bibr" href="#ref-2">2</a></sup> Normalized OB T2 FLAIR signal intensity values were computed to account for technical differences in scan acquisitions among patients. There was a significant difference in a normalized OB T2 FLAIR signal intensity between the patients with COVID-19 (mean normalized signal intensity, 1.85; range, 0.74–1.85) and the controls with anosmia (mean normalized signal intensity, 1.27; range, 0.99–3.13) (<em>P </em>= .003). These preliminary findings have important implications for our understanding of potential neurotropism or, at the very least, neuroinflammatory changes associated with Severe Acute Respiratory Syndrome coronavirus 2 infection and pose an avenue for future prospective investigation.</p><div class="license" id="license-1"><p id="p-1">Indicates open access to non-subscribers at <a href="http://www.ajnr.org" rel="license">www.ajnr.org</a></p></div><div class="section ref-list" id="ref-list-1"><h2 class="">References</h2><ol class="cit-list ref-use-labels"><li><span class="ref-label">1.</span><a class="rev-xref-ref" href="#xref-ref-1-1" title="View reference 1. in text" id="ref-1">↵</a><div class="cit ref-cit ref-journal" id="cit-ajnr.A6932v1.1" data-doi="10.3174/ajnr.A6793"><div class="cit-metadata"><ol class="cit-auth-list"><li><span class="cit-auth"><span class="cit-name-surname">Lin</span>  <span class="cit-name-given-names">E</span></span>, </li><li><span class="cit-auth"><span class="cit-name-surname">Lantos</span>  <span class="cit-name-given-names">JE</span></span>, </li><li><span class="cit-auth"><span class="cit-name-surname">Strauss</span>  <span class="cit-name-given-names">SB</span></span>, <span class="cit-etal">et al</span></li></ol><cite>. <span class="cit-article-title">Brain imaging of patients with COVID-19: findings at an academic institution during the height of the outbreak in New York City</span>. <abbr class="cit-jnl-abbrev">AJNR Am J Neuroradiol</abbr> <span class="cit-pub-date">2020</span> <span class="cit-month">Aug</span> <span class="cit-day">20</span>. [<span class="cit-comment">Epub ahead of print</span>]<span class="cit-pub-id-sep cit-pub-id-doi-sep"> </span><span class="cit-pub-id cit-pub-id-doi"><span class="cit-pub-id-scheme-doi">doi:</span>10.3174/ajnr.A6793</span><span class="cit-pub-id-sep cit-pub-id-pmid-sep"> </span><span class="cit-pub-id cit-pub-id-pmid"><span class="cit-pub-id-scheme-pmid">pmid:</span>32819899</span></cite></div><div class="cit-extra"><a href="/lookup/ijlink/YTozOntzOjQ6InBhdGgiO3M6MTQ6Ii9sb29rdXAvaWpsaW5rIjtzOjU6InF1ZXJ5IjthOjQ6e3M6ODoibGlua1R5cGUiO3M6NDoiQUJTVCI7czoxMToiam91cm5hbENvZGUiO3M6NDoiYWpuciI7czo1OiJyZXNpZCI7czoxMjoiYWpuci5BNjc5M3YxIjtzOjQ6ImF0b20iO3M6Mzg6Ii9ham5yL2Vhcmx5LzIwMjAvMTAvMjkvYWpuci5BNjkzMi5hdG9tIjt9czo4OiJmcmFnbWVudCI7czowOiIiO30=" class="cit-ref-sprinkles cit-ref-sprinkles-ijlink"><span><span class="cit-reflinks-abstract">Abstract</span><span class="cit-sep cit-reflinks-variant-name-sep">/</span><span class="cit-reflinks-full-text"><span class="free-full-text">FREE </span>Full Text</span></span></a></div></div></li><li><span class="ref-label">2.</span><a class="rev-xref-ref" href="#xref-ref-2-1" title="View reference 2. in text" id="ref-2">↵</a><div class="cit ref-cit ref-journal" id="cit-ajnr.A6932v1.2" data-doi="10.3174/ajnr.A6751"><div class="cit-metadata"><ol class="cit-auth-list"><li><span class="cit-auth"><span class="cit-name-surname">Straus</span>  <span class="cit-name-given-names">SB</span></span>, </li><li><span class="cit-auth"><span class="cit-name-surname">Lantos</span>  <span class="cit-name-given-names">JE</span></span>, </li><li><span class="cit-auth"><span class="cit-name-surname">Heier</span>  <span class="cit-name-given-names">LA</span></span>, <span class="cit-etal">et al</span></li></ol><cite>. <span class="cit-article-title">Olfactory bulb signal abnormality in patients with COVID-19 who present with neurologic symptoms</span>. <abbr class="cit-jnl-abbrev">AJNR Am J Neuroradiol</abbr> <span class="cit-pub-date">2020</span>;<span class="cit-vol">41</span>:<span class="cit-fpage">1882</span>–<span class="cit-lpage">87</span><span class="cit-pub-id-sep cit-pub-id-doi-sep"> </span><span class="cit-pub-id cit-pub-id-doi"><span class="cit-pub-id-scheme-doi">doi:</span>10.3174/ajnr.A6751</span><span class="cit-pub-id-sep cit-pub-id-pmid-sep"> </span><span class="cit-pub-id cit-pub-id-pmid"><span class="cit-pub-id-scheme-pmid">pmid:</span>32855190</span></cite></div><div class="cit-extra"><a href="/lookup/ijlink/YTozOntzOjQ6InBhdGgiO3M6MTQ6Ii9sb29rdXAvaWpsaW5rIjtzOjU6InF1ZXJ5IjthOjQ6e3M6ODoibGlua1R5cGUiO3M6NDoiQUJTVCI7czoxMToiam91cm5hbENvZGUiO3M6NDoiYWpuciI7czo1OiJyZXNpZCI7czoxMDoiNDEvMTAvMTg4MiI7czo0OiJhdG9tIjtzOjM4OiIvYWpuci9lYXJseS8yMDIwLzEwLzI5L2FqbnIuQTY5MzIuYXRvbSI7fXM6ODoiZnJhZ21lbnQiO3M6MDoiIjt9" class="cit-ref-sprinkles cit-ref-sprinkles-ijlink"><span><span class="cit-reflinks-abstract">Abstract</span><span class="cit-sep cit-reflinks-variant-name-sep">/</span><span class="cit-reflinks-full-text"><span class="free-full-text">FREE </span>Full Text</span></span></a></div></div></li></ol></div><ul class="copyright-statement"><li class="fn" id="copyright-statement-1">© 2020 by American Journal of Neuroradiology</li></ul><span class="highwire-journal-article-marker-end"></span></div><span class="related-urls"></span></div></div>  </div>

  
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