新冠疫情期间嗅觉和味觉功能障碍的客观筛查:一项针对医护人员的前瞻性自我管理测试研究

Objective screening for olfactory and gustatory dysfunction during the COVID-19 pandemic: a prospective study in healthcare workers using self-administered testing.

作者信息

Cao Austin C, Nimmo Zachary M, Mirza Natasha, Cohen Noam A, Brody Robert M, Doty Richard L

机构信息

Perelman School of Medicine, University of Pennsylvania, Philadelphia, PA, USA.

Department of Otorhinolaryngology-Head and Neck Surgery, University of Pennsylvania, Philadelphia, PA, USA.

出版信息

World J Otorhinolaryngol Head Neck Surg. 2021 Feb 12;8(3):249-56. doi: 10.1016/j.wjorl.2021.02.001.

Abstract

BACKGROUND

Smell and taste loss are highly prevalent symptoms in coronavirus disease 2019 (COVID-19), although few studies have employed objective measures to quantify these symptoms, especially dysgeusia. Reports of unrecognized anosmia in COVID-19 patients suggests that self-reported measures are insufficient for capturing patients with chemosensory dysfunction.

OBJECTIVES

The purpose of this study was to quantify the impact of recent COVID-19 infection on chemosensory function and demonstrate the use of at-home objective smell and taste testing in an at-risk population of healthcare workers.

METHODS

Two hundred and fifty healthcare workers were screened for possible loss of smell and taste using online surveys. Self-administered smell and taste tests were mailed to respondents meeting criteria for elevated risk of infection, and one-month follow-up surveys were completed.

RESULTS

Among subjects with prior SARS-CoV-2 infection, 73% reported symptoms of olfactory and/or gustatory dysfunction. Self-reported smell and taste loss were both strong predictors of COVID-19 positivity. Subjects with evidence of recent SARS-CoV-2 infection (<45 days) had significantly lower olfactory scores but equivalent gustatory scores compared to other subjects. There was a time-dependent increase in smell scores but not in taste scores among subjects with prior infection and chemosensory symptoms. The overall infection rate was 4.4%, with 2.5% reported by PCR swab.

CONCLUSION

Healthcare workers with recent SARS-CoV-2 infection had reduced olfaction and normal gustation on self-administered objective testing compared to those without infection. Rates of infection and chemosensory symptoms in our cohort of healthcare workers reflect those of the general public.

摘要

背景

嗅觉和味觉丧失是2019冠状病毒病(COVID-19)中非常普遍的症状,尽管很少有研究采用客观测量方法来量化这些症状,尤其是味觉障碍。COVID-19患者中未被识别的嗅觉丧失报告表明,自我报告的测量方法不足以捕捉有化学感觉功能障碍的患者。

目的

本研究的目的是量化近期COVID-19感染对化学感觉功能的影响,并展示在家中对高危医护人员群体进行客观嗅觉和味觉测试的应用。

方法

通过在线调查对250名医护人员进行嗅觉和味觉可能丧失的筛查。将自我管理的嗅觉和味觉测试邮寄给符合感染风险升高标准的受访者,并完成为期一个月的随访调查。

结果

在既往感染过严重急性呼吸综合征冠状病毒2(SARS-CoV-2)的受试者中,73%报告有嗅觉和/或味觉功能障碍症状。自我报告的嗅觉和味觉丧失都是COVID-19阳性的有力预测指标。与其他受试者相比,近期有SARS-CoV-2感染证据(<45天)的受试者嗅觉评分显著较低,但味觉评分相当。在既往感染且有化学感觉症状的受试者中,嗅觉评分随时间增加,而味觉评分没有。总体感染率为4.4%,PCR拭子检测报告的感染率为2.5%。

结论

与未感染的医护人员相比,近期感染SARS-CoV-2的医护人员在自我管理的客观测试中嗅觉减退,味觉正常。我们医护人员队列中的感染率和化学感觉症状反映了普通公众的情况。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/4aab/9479476/06b6fb1fa757/WJO2-8-249-g003.jpg

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