Department of Medical, Surgical and Health Sciences, Section of Otolaryngology, University of Trieste, Trieste, Italy.
Unit of Otolaryngology, AULSS 2 - Marca Trevigiana, Treviso, Italy.
Chem Senses. 2021 Jan 1;46. doi: 10.1093/chemse/bjab006.
This study prospectively assessed the 6-month prevalence of self-reported and psychophysically measured olfactory dysfunction in subjects with mild-to-moderate COVID-19. Self-reported smell or taste impairment was prospectively evaluated by SNOT-22 at diagnosis, 4-week, 8-week, and 6-month. At 6 months from the diagnosis, psychophysical evaluation of olfactory function was also performed using the 34-item culturally adapted University of Pennsylvania Smell Identification Test (CA-UPSIT). 145 completed both the 6-month subjective and psychophysical olfactory evaluation. According to CA-UPSIT, 87 subjects (60.0%) exhibited some smell dysfunction, with 10 patients being anosmic (6.9%) and seven being severely microsmic (4.8%). At the time CA-UPSIT was administered, a weak correlation was observed between the self-reported alteration of the sense of smell or taste and olfactory test scores (Spearman's r = -0.26). Among 112 patients who self-reported normal sense of smell at last follow-up, CA-UPSIT revealed normal smell in 46 (41.1%), mild microsmia in 46 (41.1%), moderate microsmia in 11 (9.8%), severe microsmia in 3 (2.3%), and anosmia in 6 (5.4%) patients; however, of those patients self-reporting normal smell but who were found to have hypofunction on testing, 62 out of 66 had a self-reported reduction in sense of smell or taste at an earlier time point. Despite most patients report a subjectively normal sense of smell, we observed a high percentage of persistent smell dysfunction at 6 months from the diagnosis of syndrome coronavirus 2 (SARS-CoV-2) infection, with 11.7% of patients being anosmic or severely microsmic. These data highlight a significant long-term rate of smell alteration in patients with previous SARS-COV-2 infection.
本研究前瞻性评估了轻症至中度 COVID-19 患者自我报告和心理生理测量的嗅觉障碍的 6 个月患病率。在诊断时、4 周、8 周和 6 个月时，通过 SNOT-22 前瞻性评估自我报告的嗅觉或味觉障碍。在诊断后 6 个月，使用经过文化调整的宾夕法尼亚大学嗅觉识别测试（CA-UPSIT）34 项评估嗅觉功能的心理生理评估。145 名患者完成了 6 个月的主观和心理物理嗅觉评估。根据 CA-UPSIT，87 名患者（60.0%）存在某种嗅觉障碍，其中 10 名患者无嗅觉（6.9%），7 名患者严重嗅觉减退（4.8%）。在进行 CA-UPSIT 时，自我报告嗅觉或味觉改变与嗅觉测试评分之间观察到弱相关（Spearman's r = -0.26）。在 112 名自我报告最后一次随访时嗅觉正常的患者中，CA-UPSIT 显示 46 名（41.1%）嗅觉正常，46 名（41.1%）轻度嗅觉减退，11 名（9.8%）中度嗅觉减退，3 名（2.3%）重度嗅觉减退，6 名（5.4%）无嗅觉；然而，在那些自我报告嗅觉正常但嗅觉功能测试异常的患者中，66 名中有 62 名在较早的时间点报告嗅觉或味觉主观减退。尽管大多数患者报告主观嗅觉正常，但我们观察到，在诊断为冠状病毒 2 型（SARS-CoV-2）感染后 6 个月，嗅觉障碍持续存在的比例较高，11.7%的患者无嗅觉或严重嗅觉减退。这些数据突出表明，既往 SARS-CoV-2 感染患者的嗅觉改变率较高。
