Chelsea and Westminster NHS Foundation Trust, 369 Fulham Road, London, SW10 9NH, UK.
Imperial College London, NIHR Health Protection Research Unit in Healthcare Associated Infections and Antimicrobial Resistance, Hammersmith Campus, Du Cane Road, London, W12 0NN, UK.
Clin Microbiol Infect. 2020 Sep;26(9):1236-1241. doi: 10.1016/j.cmi.2020.05.026. Epub 2020 Jun 2.
We investigated the prevalence of anosmia and ageusia in adult patients with a laboratory-confirmed diagnosis of infection with severe acute respiratory distress syndrome coronavirus-2 (SARS-CoV-2).
This was a retrospective observational analysis of patients infected with SARS-CoV-2 admitted to hospital or managed in the community and their household contacts across a London population during the period March 1st to April 1st, 2020. Symptomatology and duration were extracted from routinely collected clinical data and follow-up telephone consultations. Descriptive statistics were used.
Of 386 patients, 141 (92 community patients, 49 discharged inpatients) were included for analysis; 77/141 (55%) reported anosmia and ageusia, nine reported only ageusia and three only anosmia. The median onset of anosmia in relation to onset of SARS-CoV-2 disease (COVID-19) symptoms (as defined by the Public Health England case definition) was 4 days (interquartile range (IQR) 5). Median duration of anosmia was 8 days (IQR 16). Median duration of COVID-19 symptoms in community patients was 10 days (IQR 8) versus 18 days (IQR 13.5) in admitted patients. As of April 1, 45 patients had ongoing COVID-19 symptoms and/or anosmia; 107/141 (76%) patients had household contacts, and of 185 non-tested household contacts 79 (43%) had COVID-19 symptoms with 46/79 (58%) reporting anosmia. Six household contacts had anosmia only.
Over half of the positive patients reported anosmia and ageusia, suggesting that these should be added to the case definition and used to guide self-isolation protocols. This adaptation may be integral to case findings in the absence of population-level testing. Until we have successful population-level vaccination coverage, these steps remain critical in the current and future waves of this pandemic.
我们调查了经实验室确诊为感染严重急性呼吸窘迫综合征冠状病毒 2 型(SARS-CoV-2)的成年患者中嗅觉丧失和味觉丧失的患病率。
这是一项回顾性观察性分析,纳入了 2020 年 3 月 1 日至 4 月 1 日期间在伦敦人群中因 SARS-CoV-2 感染住院或在社区管理的患者及其家庭接触者。症状和持续时间从常规收集的临床数据和随访电话咨询中提取。使用描述性统计。
在 386 名患者中,有 141 名(92 名社区患者,49 名出院住院患者)被纳入分析;77/141(55%)报告嗅觉丧失和味觉丧失,9 名仅报告味觉丧失,3 名仅报告嗅觉丧失。嗅觉丧失与 SARS-CoV-2 疾病(COVID-19)症状(按英国公共卫生病例定义定义)发作的中位时间为 4 天(四分位距(IQR)5)。嗅觉丧失的中位持续时间为 8 天(IQR 16)。社区患者 COVID-19 症状的中位持续时间为 10 天(IQR 8),而住院患者为 18 天(IQR 13.5)。截至 4 月 1 日,45 名患者仍有 COVID-19 症状和/或嗅觉丧失;141 名患者中有 107 名(76%)有家庭接触者,在 185 名未接受检测的家庭接触者中,79 名(43%)有 COVID-19 症状,其中 46/79 名(58%)报告嗅觉丧失。有 6 名家庭接触者仅嗅觉丧失。
超过一半的阳性患者报告嗅觉丧失和味觉丧失,这表明应将这些症状添加到病例定义中,并用于指导自我隔离方案。在没有人群水平检测的情况下,这种适应可能是病例发现的关键。在我们成功实现人群水平疫苗接种覆盖率之前,这些步骤在当前和未来的大流行浪潮中仍然至关重要。