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[新型冠状病毒肺炎中的嗅觉功能障碍:证据综述及其对大流行管理的意义]

[Olfactory dysfunction in COVID-19, a review of the evidence and implications for pandemic management].

作者信息

Lop Gros Joan, Iglesias Coma Mar, González Farré Mónica, Serra Pujadas Consol

机构信息

Servicio de Anatomía Patológica, Hospital del Mar, Parc de Salut Mar, Barcelona, España.

Servicio de Anatomía Patológica, Hospital del Mar, Parc de Salut Mar, Barcelona, España.

出版信息

Acta Otorrinolaringol Esp (Engl Ed). 2020 Nov-Dec;71(6):379-385. doi: 10.1016/j.otorri.2020.04.003. Epub 2020 May 11.

Abstract

There is debate as to whether olfactory dysfunction should be considered a symptom of COVID-19 infection, given the implications for managing the symptom itself, for diagnostic testing, and for implementing isolation measures. We undertook a systematic literature review of the articles indexed in PubMed on olfactory disorders in viral respiratory tract conditions, with special emphasis on COVID-19. The main objective was to find evidence of clinical interest to support the relationship between anosmia and COVID-19. Olfactory disorders in upper respiratory tract infections are frequent, most caused by obstruction due to oedema of the nasal mucosa. Occasionally, post-viral sensorineural olfactory dysfunction occurs, with a variable prognosis. The evidence on anosmia in COVID-19 patients is extremely limited, corresponding to a level 5 or D of the Centre for Evidence-Based Medicine. According to the various medical societies that have issued reports on the subject, it seems reasonable to apply isolation, hygiene and social distancing measures in patients with recent olfactory disorders as the only symptom, although the usefulness of diagnostic tests for this type of patient should be studied.

摘要

鉴于嗅觉功能障碍对症状本身的管理、诊断测试以及隔离措施的实施都有影响,关于它是否应被视为新冠病毒感染的症状存在争议。我们对PubMed中索引的关于病毒性呼吸道疾病嗅觉障碍的文章进行了系统的文献综述,特别关注了新冠病毒。主要目的是找到具有临床意义的证据来支持嗅觉丧失与新冠病毒之间的关系。上呼吸道感染中的嗅觉障碍很常见,大多数是由鼻黏膜水肿导致的阻塞引起的。偶尔会出现病毒感染后感觉神经性嗅觉功能障碍,预后不一。关于新冠病毒患者嗅觉丧失的证据极其有限,相当于循证医学中心的5级或D级。根据发布了关于该主题报告的各个医学协会的说法,对于仅有近期嗅觉障碍这一症状的患者采取隔离、卫生和社交距离措施似乎是合理的,不过这类患者诊断测试的效用还有待研究。

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引用本文的文献

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Do young women with COVID-19 have a higher risk of presenting olfactory dysfunction?感染新冠病毒的年轻女性出现嗅觉功能障碍的风险更高吗?
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本文引用的文献

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Features of anosmia in COVID-19.新冠病毒感染嗅觉丧失的特征。
Med Mal Infect. 2020 Aug;50(5):436-439. doi: 10.1016/j.medmal.2020.04.006. Epub 2020 Apr 17.
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Screening performance of abbreviated versions of the UPSIT smell test.UPSIT 嗅觉测试简编版本的筛查性能。
J Neurol. 2019 Aug;266(8):1897-1906. doi: 10.1007/s00415-019-09340-x. Epub 2019 May 3.
10
Investigation of chemosensitivity during and after an acute cold.急性感冒期间及之后的化学敏感性研究。
Int Forum Allergy Rhinol. 2017 Feb;7(2):185-191. doi: 10.1002/alr.21869. Epub 2016 Nov 7.

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