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COVID-19:化学感觉功能障碍的恢复。一项关于嗅觉和味觉的多中心研究。

COVID-19: Recovery from Chemosensory Dysfunction. A Multicentre study on Smell and Taste.

机构信息

Smell and Taste Clinic, Department of Otorhinolaryngology, Technical University Dresden, Dresden, Germany.

Flavour Institute, Department of Clinical Medicine, Aarhus University, Aarhus, Denmark.

出版信息

Laryngoscope. 2021 May;131(5):1095-1100. doi: 10.1002/lary.29383. Epub 2021 Jan 15.

Abstract

OBJECTIVE/HYPOTHESIS: With the COVID-19 pandemic, chemosensory dysfunction are among the most prevalent symptoms. Most reports are subjective evaluations, which have been suggested to be unreliable. The objective is to test chemosensory dysfunction and recovery based on extensive psychophysical tests in COVID-19 during the course of the disease.

STUDY DESIGN

Prospective cohort study.

METHODS

A total of 111 patients from four centers participated in the study. All tested positive for SARS-COV-2 with RT-PCR. They were tested within 3 days of diagnosis and 28 to 169 days after infection. Testing included extensive olfactory testing with the Sniffin' Sticks test for threshold, discrimination and identification abilities, and with the Taste Sprays and Taste Strips for gustatory function for quasi-threshold and taste identification abilities.

RESULTS

There was a significant difference in olfactory function during and after infection. During infection 21% were anosmic, 49% hyposmic, and 30% normosmic. After infection only 1% were anosmic, 26% hyposmic, and 73% normosmic. For gustatory function, there was a difference for all taste qualities, but significantly in sour, bitter, and total score. Twenty-six percent had gustatory dysfunction during infection and 6.5% had gustatory dysfunction after infection. Combining all tests 22% had combined olfactory and gustatory dysfunction during infection. After infection no patients had combined dysfunction.

CONCLUSIONS

Chemosensory dysfunction is very common in COVID-19, either as isolated smell or taste dysfunction or a combined dysfunction. Most people regain their chemosensory function within the first 28 days, but a quarter of the patients show persisting dysfunction, which should be referred to specialist smell and taste clinics for rehabilitation of chemosensory function.

LEVEL OF EVIDENCE

3 Laryngoscope, 131:1095-1100, 2021.

摘要

目的/假设:随着 COVID-19 大流行,化学感觉功能障碍是最常见的症状之一。大多数报告都是主观评估,这些评估被认为是不可靠的。本研究的目的是基于 COVID-19 患者疾病过程中的广泛心理物理学测试,来检测和评估化学感觉功能障碍及其恢复情况。

研究设计

前瞻性队列研究。

方法

来自四个中心的 111 名患者参与了这项研究。所有患者均通过 RT-PCR 检测 SARS-COV-2 呈阳性。他们在诊断后 3 天内以及感染后 28 至 169 天内接受了检测。检测包括使用 Sniffin' Sticks 测试进行广泛的嗅觉测试,以评估阈值、辨别和识别能力,以及使用 Taste Sprays 和 Taste Strips 进行味觉测试,以评估味觉的准阈值和味觉识别能力。

结果

在感染期间和之后,嗅觉功能存在显著差异。感染期间,21%的患者嗅觉丧失,49%的患者嗅觉减退,30%的患者嗅觉正常。感染后,只有 1%的患者嗅觉丧失,26%的患者嗅觉减退,73%的患者嗅觉正常。对于味觉功能,所有味觉质量都存在差异,但酸味、苦味和总评分差异显著。26%的患者在感染期间存在味觉功能障碍,6.5%的患者在感染后存在味觉功能障碍。综合所有测试,22%的患者在感染期间同时存在嗅觉和味觉功能障碍。感染后,没有患者同时存在功能障碍。

结论

在 COVID-19 中,化学感觉功能障碍非常常见,表现为孤立的嗅觉或味觉功能障碍,或同时存在两种功能障碍。大多数人在最初的 28 天内恢复了化学感觉功能,但四分之一的患者表现出持续的功能障碍,这些患者应转至嗅觉和味觉专科诊所进行化学感觉功能康复。

证据等级

3 级《喉镜》,131:1095-1100,2021 年。

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