Mazzatenta Andrea, Neri Giampiero, D'Ardes Damiano, De Luca Carlo, Marinari Stefano, Porreca Ettore, Cipollone Francesco, Vecchiet Jacopo, Falcicchia Chiara, Panichi Vincenzo, Origlia Nicola, Di Giulio Camillo
Neurophysiology, Olfaction and Chemoreception Laboratory, Physiology and Physiopathology Section, Neuroscience, Imaging and Clinical Sciences Department, 'G. d'Annunzio' University of Chieti-Pescara, Chieti, Italy.
Medicine and Aging Sciences Department, 'G. d'Annunzio'University of Chieti-Pescara, Chieti, Italy.
Front Med (Lausanne). 2020 Dec 2;7:589409. doi: 10.3389/fmed.2020.589409. eCollection 2020.
One of the most striking reported symptoms in CoViD-19 is loss of smell and taste. The frequency of these impairments and their specificity as a potential central nervous system function biomarker are of great interest as a diagnostic clue for CoViD-19 infection as opposed to other similar symptomatologic diseases and because of their implication in viral pathogenesis. Here severe CoViD-19 was investigated by comparing self-report vs. testing of smell and taste, thus the objective severity of olfactory impairment and their possible correlation with other symptoms. Because a significant discrepancy between smell and taste testing vs. self-report results ( < 0.001) emerges in our result, we performed a statistical analysis highlighting disagreement among normosmia ( < 0.05), hyposmia, severe hyposmia, and anosmia ( < 0.001) and, in hypogeusia and severe hypogeusia, while no differences are observed in normogeusia and ageusia. Therefore, we analyzed the olfactory threshold by an objective test revealing the distribution of hyposmic (34%), severe hyposmic (48%), and anosmic (13%) patients in severe CoViD-19. In severe CoViD-19 patients, taste is lost in 4.3% of normosmic individuals, 31.9% of hyposmic individuals, 46.8% of severe hyposmic individuals, and 17% of anosmic individuals. Moreover, 95% of 100 CoViD-19 patients objectively tested were affected by smell dysfunction, while 47% were affected by taste dysfunction. Furthermore, analysis by objective testing also highlighted that the severity of smell dysfunction in CoViD-19 subjects did not correlate with age and sex. In conclusion, we report by objective testing that the majority of CoViD-19 patients report severe anosmia, that most of the subjects have olfactory impairment rather than taste impairment, and, finally, that the olfactory impairment correlate with symptom onset and hospitalization ( < 0.05). Patients who exhibit severe olfactory impairment had been hospitalized for about a week from symptom onset; double time has taken place in subjects with normosmia. Our results may be limited by the relatively small number of study participants, but these suggest by objective testing that hyposmia, severe hyposmia, and anosmia may relate directly to infection severity and neurological damage. The smell test assessment could be a potential screening symptom that might contribute to the decision to test suspected cases or guide quarantine instructions, further therapeutic approach, and evaluation of neurological damage.
新型冠状病毒肺炎（COVID-19）报告的最显著症状之一是嗅觉和味觉丧失。这些功能障碍的发生率及其作为潜在中枢神经系统功能生物标志物的特异性，作为COVID-19感染相对于其他类似症状性疾病的诊断线索，以及因其在病毒发病机制中的意义，备受关注。在此，通过比较自我报告与嗅觉和味觉测试，对重症COVID-19进行了研究，从而了解嗅觉障碍的客观严重程度及其与其他症状的可能相关性。由于我们的研究结果显示嗅觉和味觉测试与自我报告结果之间存在显著差异（<0.001），我们进行了一项统计分析，突出了嗅觉正常（<0.05）、嗅觉减退、严重嗅觉减退和嗅觉丧失（<0.001）之间的不一致，以及味觉减退和严重味觉减退的情况，而在味觉正常和味觉丧失方面未观察到差异。因此，我们通过客观测试分析了嗅觉阈值，揭示了重症COVID-19患者中嗅觉减退（34%）、严重嗅觉减退（48%）和嗅觉丧失（13%）的分布情况。在重症COVID-19患者中，嗅觉正常个体中有4.3%失去味觉，嗅觉减退个体中有31.9%失去味觉，严重嗅觉减退个体中有46.8%失去味觉，嗅觉丧失个体中有17%失去味觉。此外，在100例接受客观测试的COVID-19患者中，95%存在嗅觉功能障碍，47%存在味觉功能障碍。此外，客观测试分析还突出显示，COVID-19患者嗅觉功能障碍的严重程度与年龄和性别无关。总之，我们通过客观测试报告，大多数COVID-19患者存在严重嗅觉丧失，大多数受试者存在嗅觉障碍而非味觉障碍，最后，嗅觉障碍与症状发作和住院相关（<0.05）。出现严重嗅觉障碍的患者从症状发作开始已住院约一周；嗅觉正常的受试者住院时间为两倍。我们的结果可能受到研究参与者数量相对较少的限制，但这些结果通过客观测试表明，嗅觉减退、严重嗅觉减退和嗅觉丧失可能与感染严重程度和神经损伤直接相关。嗅觉测试评估可能是一种潜在的筛查症状，可能有助于决定对疑似病例进行检测或指导隔离指示、进一步的治疗方法以及神经损伤的评估。
