Hospital do Servidor Público Estadual Francisco Morato de Oliveira, Departamento de Otorrinolaringologia, São Paulo, SP, Brazil.
Hospital do Servidor Público Estadual Francisco Morato de Oliveira, Departamento de Otorrinolaringologia, São Paulo, SP, Brazil.
Braz J Otorhinolaryngol. 2022 May-Jun;88(3):439-444. doi: 10.1016/j.bjorl.2020.12.002. Epub 2021 Jan 1.
In May 2020, the World Health Organization recognized olfactory dysfunction as a COVID-19 symptom. The presence of hyposmia/anosmia may be a marker of good prognosis in COVID-19.
To associate the presence of olfaction disorder to the clinical condition severity in patients with COVID-19.
Individuals with the flu syndrome caused by SARS-CoV-2, diagnosed from March to June 2020, were recruited. They were divided into three groups: mild flu syndrome, severe flu syndrome (admitted to hospital wards) and critical illness (admitted to the ICU). Inpatients were interviewed by telephone contact after hospital discharge and their medical records were also evaluated regarding complementary test results. Outpatients answered an electronic questionnaire containing only clinical information.
A total of 261 patients participated in the study: 23.75% with mild flu syndrome, 57.85% with severe flu syndrome and 18.40% with critical illness. A total of 66.28% patients with COVID-19 had olfaction disorders. In approximately 56.58% of the individuals the smell alterations lasted between 9 days and 2 months. There was a significantly higher proportion of individuals with olfactory dysfunction in the group with mild flu syndrome than in the severe flu syndrome group (mild × severe - p < 0.001; Odds Ratio = 4.63; 95% CI [1.87-10.86]). This relationship was also maintained between patients with mild flu syndrome and critically-ill patients (mild × critical - p < 0.001; Odds Ratio = 9.28; 95% CI [3.52-25.53]).
Olfaction dysfunction was significantly more prevalent in patients with mild flu syndrome in COVID-19. It may be a predictor of a good prognosis for this infection. New population-based studies must be carried out to corroborate these findings.
2020 年 5 月，世界卫生组织将嗅觉功能障碍认定为 COVID-19 的症状之一。出现嗅觉减退/丧失可能是 COVID-19 预后良好的标志。
探讨 COVID-19 患者嗅觉障碍与临床严重程度的相关性。
纳入 2020 年 3 月至 6 月期间被诊断为 SARS-CoV-2 引起的流感综合征的个体。将他们分为三组：轻度流感综合征、重度流感综合征（住院病房）和危重症（入住 ICU）。住院患者在出院后通过电话联系进行访谈，并对其病历进行评估以获得补充检查结果。门诊患者则回答了一份仅包含临床信息的电子问卷。
共有 261 例患者参与了研究：轻度流感综合征患者占 23.75%，重度流感综合征患者占 57.85%，危重症患者占 18.40%。共有 66.28%的 COVID-19 患者存在嗅觉障碍。约 56.58%的患者嗅觉改变持续 9 天至 2 个月。在轻度流感综合征组中，嗅觉障碍患者的比例明显高于重度流感综合征组（轻度×重度，p<0.001；比值比=4.63；95%置信区间[1.87-10.86]）。这种关系在轻度流感综合征患者和危重症患者之间也存在（轻度×危重症，p<0.001；比值比=9.28；95%置信区间[3.52-25.53]）。
COVID-19 患者中，轻度流感综合征患者的嗅觉障碍更为常见。它可能是这种感染预后良好的预测指标。必须开展新的基于人群的研究来证实这些发现。
