Otolaryngology Unit, ASST Santi Paolo e Carlo, Department of Health Sciences, Università Degli Studi di Milano, Milan, Italy.
Radiology and Interventional Radiology Unit, ASST Santi Paolo e Carlo, Department of Health Sciences, Università Degli Studi di Milano, Milan, Italy.
Eur Arch Otorhinolaryngol. 2021 Feb;278(2):557-560. doi: 10.1007/s00405-020-06165-7. Epub 2020 Jun 23.
Smell alterations are a symptom of COVID-19 and have been associated with olfactory cleft mucosal thickening (OCMT). Although their pathogenesis is unclear, evidences link them to viral neuroinvasive potential. This study aims at estimating the prevalence of OCMT in CT scans of COVID-19 patients and investigating its clinical correlates.
In a single-institution retrospective cross-sectional study, we included all patients hospitalized for COVID-19 undergoing head CT scan for any reason. Exclusion criteria were history of recent head trauma or chronic rhinosinusitis; opacification > 2 mm in any sinonasal space other than the olfactory cleft; CT performed during/after invasive ventilation or feeding via nasogastric tube. We recorded the prevalence of OCMT and related it to age, sex, need for invasive ventilation during hospital stay, outcome, length of hospital stay, diffusion of lung SARS-CoV-19 lesions and outcome.
63 eligible patients were identified (39 male, 24 female; median age 77.82 ± 17.77 years). OCMT was identified in 16 patients (25.4%; 95% CI 15.3-37.9%). Patients with OCMT had longer hospital stays (median 16 ± 4 vs. 9 ± 14.5 days, p = .009, Mann-Whitney U test) and required invasive ventilation more frequently than patients without mucosal thickening (OR 4.89, 95% CI 0.96-24.89, p = .063, Fisher's test). No other difference was observed.
OCMT affects nearly one in four patients hospitalized for COVID-19. It is associated with a worse disease course irrespective of age, sex and diffusion of lung lesions, although with no direct effect on survival.
嗅觉改变是 COVID-19 的症状之一，与嗅裂黏膜增厚（OCMT）有关。虽然其发病机制尚不清楚，但有证据表明它与病毒的神经侵袭潜能有关。本研究旨在评估 COVID-19 患者 CT 扫描中 OCMT 的患病率，并调查其临床相关性。
在一项单中心回顾性横断面研究中，我们纳入了所有因任何原因住院接受 COVID-19 头部 CT 扫描的患者。排除标准为近期头部外伤或慢性鼻-鼻窦炎病史；嗅裂以外任何鼻窦空间的混浊程度>2mm；在有创通气或经鼻胃管喂养期间或之后进行 CT 检查。我们记录了 OCMT 的患病率，并将其与年龄、性别、住院期间是否需要有创通气、结局、住院时间、肺部 SARS-CoV-19 病变的扩散以及结局相关联。
共纳入 63 例符合条件的患者（39 名男性，24 名女性；中位年龄 77.82±17.77 岁）。16 例（25.4%；95%CI 15.3-37.9%）患者发现 OCMT。有 OCMT 的患者住院时间更长（中位数 16±4 天 vs. 9±14.5 天，p=0.009，Mann-Whitney U 检验），且比无黏膜增厚的患者更频繁地需要有创通气（OR 4.89，95%CI 0.96-24.89，p=0.063，Fisher 检验）。未观察到其他差异。
COVID-19 住院患者中近四分之一存在 OCMT。无论年龄、性别和肺部病变的扩散情况如何，它都与更差的疾病进程相关，但对生存率没有直接影响。
