Hospital Clínico San Carlos, Madrid, Spain.
Universidad Complutense de Madrid, Madrid, Spain.
Infection. 2021 Aug;49(4):677-684. doi: 10.1007/s15010-021-01587-9. Epub 2021 Mar 1.
Olfactory and gustatory dysfunctions (OGD) are a frequent symptom of coronavirus disease 2019 (COVID-19). It has been proposed that the neuroinvasive potential of the novel SARS-CoV-2 could be due to olfactory bulb invasion, conversely studies suggest it could be a good prognostic factor. The aim of the current study was to investigate the prognosis value of OGD in COVID-19. These symptoms were recorded on admission from a cohort study of 5868 patients with confirmed or highly suspected COVID-19 infection included in the multicenter international HOPE Registry (NCT04334291). There was statistical relation in multivariate analysis for OGD in gender, more frequent in female 12.41% vs 8.67% in male, related to age, more frequent under 65 years, presence of hypertension, dyslipidemia, diabetes, smoke, renal insufficiency, lung, heart, cancer and neurological disease. We did not find statistical differences in pregnant (p = 0.505), patient suffering cognitive (p = 0.484), liver (p = 0.1) or immune disease (p = 0.32). There was inverse relation (protective) between OGD and prone positioning (0.005) and death (< 0.0001), but no with ICU (0.165) or mechanical ventilation (0.292). On univariable logistic regression, OGD was found to be inversely related to death in COVID-19 patients. The odds ratio was 0.26 (0.15-0.44) (p < 0.001) and Z was - 5.05. The presence of anosmia is fundamental in the diagnosis of SARS.CoV-2 infection, but also could be important in classifying patients and in therapeutic decisions. Even more knowing that it is an early symptom of the disease. Knowing that other situations as being Afro-American or Latino-American, hypertension, renal insufficiency, or increase of C-reactive protein (CRP) imply a worse prognosis we can make a clinical score to estimate the vital prognosis of the patient. The exact pathogenesis of SARS-CoV-2 that causes olfactory and gustative disorders remains unknown but seems related to the prognosis. This point is fundamental, insomuch as could be a plausible way to find a treatment.
嗅觉和味觉障碍（OGD）是 2019 年冠状病毒病（COVID-19）的常见症状。有人提出，新型 SARS-CoV-2 的神经侵袭潜力可能是由于嗅球入侵，相反，研究表明它可能是一个良好的预后因素。本研究的目的是探讨 COVID-19 中 OGD 的预后价值。这些症状是从 HOPE 注册中心（NCT04334291）纳入的 5868 例确诊或高度疑似 COVID-19 感染患者的队列研究中入院时记录的。在多变量分析中，OGD 与性别有关，女性中更为常见（12.41%比男性 8.67%），与年龄有关，65 岁以下更为常见，与高血压、血脂异常、糖尿病、吸烟、肾功能不全、肺部、心脏、癌症和神经系统疾病有关。我们没有发现孕妇（p=0.505）、认知障碍（p=0.484）、肝脏（p=0.1）或免疫疾病（p=0.32）患者的统计学差异。OGD 与俯卧位（0.005）和死亡（<0.0001）呈负相关（保护性），但与 ICU（0.165）或机械通气（0.292）无关。在单变量逻辑回归中，发现 OGD 与 COVID-19 患者的死亡呈负相关。比值比为 0.26（0.15-0.44）（p<0.001），Z 值为-5.05。嗅觉丧失是 SARS-CoV-2 感染诊断的基础，但在对患者进行分类和治疗决策时也可能很重要。甚至更多地了解到它是疾病的早期症状。了解到非裔美国人或拉丁裔美国人、高血压、肾功能不全或 C 反应蛋白（CRP）升高等其他情况意味着预后更差，我们可以制定一个临床评分来估计患者的生命预后。导致嗅觉和味觉障碍的 SARS-CoV-2 的确切发病机制尚不清楚，但似乎与预后有关。这一点至关重要，因为它可能是找到治疗方法的合理途径。
