Prajapati Divya P, Shahrvini Bita, MacDonald Bridget V, Crawford Kayva L, Lechner Matt, DeConde Adam S, Yan Carol H
Department of Surgery, Division of Otolaryngology-Head and Neck Surgery, University of California San Diego School of Medicine, San Diego, CA.
University of California San Diego School of Medicine, San Diego, CA.
Int Forum Allergy Rhinol. 2020 Sep 10. doi: 10.1002/alr.22688.
Acute loss of smell and taste are well-recognized symptoms of coronavirus disease 2019 (COVID-19), yet the correlation between self-reported and psychophysical olfactory function remains unclear. Understanding the reliability of self-reported smell loss in ambulatory cases can assess the utility of this screening measure.
A prospective, longitudinal study evaluating patient-reported and measured olfactory function using the validated 12-item Brief Smell Identification Test (BSIT) was conducted on adult outpatients with COVID-19. Patient-reported olfaction scores using a visual analog scale (VAS) were obtained at baseline, time of COVID-19 testing, and time of BSIT completion. Linear associations between VAS and BSIT were evaluated using Spearman's correlation coefficient and the sensitivity, specificity, and accuracy of VAS scores were calculated. Logistic regression identified characteristics associated with accurate assessment of olfactory function.
A total of 81 polymerase chain reaction (PCR)-confirmed COVID-19 positive subjects, of whom 54 self-reported smell loss, were prospectively recruited ≤5 days from diagnosis date between May 8, 2020, and July 8, 2020. Self-reported smell loss had good discriminative ability in identifying abnormal BSIT (area under receiver operating curve [AUC] 0.82, 95% confidence interval [CI], 0.71 to 0.92). A VAS <5 demonstrated sensitivity of 0.62 and specificity of 0.94 for predicting hyposmia (BSIT ≤8) with accuracy of 82.7%, whereas a VAS <9 had highest sensitivity at 0.86. Moderate bivariate linear associations were found between VAS and BSIT scores (r = 0.59, p < 0.001).
Self-reported olfactory loss associated with COVID-19 has a strong ability to predict abnormal olfactory function though the 2 measures are moderately correlated. Subjective olfactory assessment is useful in screening olfactory dysfunction at early disease time points when psychophysical testing cannot be conducted.
嗅觉和味觉急性丧失是2019冠状病毒病（COVID-19）的公认症状，但自我报告的嗅觉功能与心理物理学嗅觉功能之间的相关性仍不清楚。了解门诊病例中自我报告的嗅觉丧失的可靠性可以评估这种筛查措施的效用。
对成年COVID-19门诊患者进行了一项前瞻性纵向研究，使用经过验证的12项简易嗅觉识别测试（BSIT）评估患者报告的和测量的嗅觉功能。在基线、COVID-19检测时和BSIT完成时，使用视觉模拟量表（VAS）获得患者报告的嗅觉评分。使用Spearman相关系数评估VAS与BSIT之间的线性关联，并计算VAS评分的敏感性、特异性和准确性。逻辑回归确定与嗅觉功能准确评估相关的特征。
在2020年5月8日至2020年7月8日期间，从诊断日期起≤5天内前瞻性招募了总共81名经聚合酶链反应（PCR）确诊的COVID-19阳性受试者，其中54人自我报告有嗅觉丧失。自我报告的嗅觉丧失在识别异常BSIT方面具有良好的判别能力（受试者操作曲线下面积[AUC]为0.82，95%置信区间[CI]为0.71至0.92）。VAS<5对预测嗅觉减退（BSIT≤8）的敏感性为0.62，特异性为0.94，准确性为82.7%，而VAS<9的敏感性最高，为0.86。在VAS和BSIT评分之间发现了中度双变量线性关联（r = 0.59，p < 0.001）。
与COVID-19相关的自我报告的嗅觉丧失具有很强的能力来预测异常嗅觉功能，尽管这两种测量方法中度相关。当无法进行心理物理学测试时，主观嗅觉评估在疾病早期筛查嗅觉功能障碍方面很有用。
