Department of Infectious Diseases and Immunology, Hotel Dieu Hospital, Paris Public Hospitals (APHP), 1 Place du Parvis de Notre-Dame, Paris 75004, France; University of Paris, School of Medicine, Paris 75005, France.
Department of Oto-rhino-laryngology, Head and Neck Surgery, Intercommunal Hospital of Créteil, Créteil 94000, France; University Paris-Est Créteil (UPEC), School of Medicine, Créteil 94000, France; INSERM U955, IMRB- CEpiA team, 94000 Créteil, France Paris Public Hospitals Henri Mondor Hospital (APHP), Créteil 94000, France; Department of Oto-rhino-laryngology, Henri Mondor Hospital of Créteil, Paris Public Hospitals, Créteil 94000, France; Centre National de la Recherche Scientifique CNRS, ERL 7000, Créteil 94000, France.
J Infect. 2020 Oct;81(4):614-620. doi: 10.1016/j.jinf.2020.07.005. Epub 2020 Jul 7.
To determine the frequency of SARS-CoV-2 positive samples in a subset of patients consulting for primarily isolated acute (<7 days) loss of smell and to assess the diagnostic accuracy of olfactory/gustatory dysfunction for COVID-19 diagnosis in the overall population tested for COVID-19 in the same period.
Prospective multicentric cohort study in four olfactory ENT units and a screening center for COVID-19.
i) Among a subset of 55 patients consulting for primarily recent loss of smell, we found that 51 (92.7%) had a COVID-19 positive test (median viral load of 28.8 cycle threshold). Loss of smell was mostly total (anosmia), rarely associated with nasal obstruction but associated with a taste disorder in 80%. Olfactory dysfunction occurred suddenly, either as first complaint or preceded by mild symptoms occurring a median of 3 days. The majority of patients (72.9%) partially recovered the sense of smell within 15 days. ii) In a population of 1824 patients tested for COVID-19, the positive predictive value and the specificity of loss of smell and/or taste were 78.5% and 90.3% respectively (sensitivity (40.8%), negative predictive value (63.6%)).
Self-reported loss of smell had a high predictive positive value to identify COVID-19. Making this sign well known publicly could help to adopt isolation measures and inform potential contacts.
确定主要因急性（<7 天）嗅觉丧失就诊的患者亚组中 SARS-CoV-2 阳性样本的频率，并评估嗅觉/味觉障碍对同期 COVID-19 检测人群中 COVID-19 诊断的诊断准确性。
在四个嗅觉 ENT 单位和一个 COVID-19 筛查中心进行前瞻性多中心队列研究。
i）在主要因近期嗅觉丧失就诊的 55 例患者亚组中，我们发现 51 例（92.7%）COVID-19 检测阳性（中位病毒载量为 28.8 个循环阈值）。嗅觉丧失大多为完全丧失（嗅觉丧失），很少伴有鼻塞，但 80%伴有味觉障碍。嗅觉功能障碍突然发生，要么是首次出现的症状，要么是在出现中位 3 天的轻微症状之前发生。大多数患者（72.9%）在 15 天内部分恢复嗅觉。ii）在 1824 例 COVID-19 检测患者中，嗅觉丧失和/或味觉丧失的阳性预测值和特异性分别为 78.5%和 90.3%（敏感性（40.8%），阴性预测值（63.6%））。
自我报告的嗅觉丧失对识别 COVID-19 具有很高的阳性预测价值。广泛宣传这一征象有助于采取隔离措施并通知潜在接触者。
