Sbrana Mariana Ferreira, Fornazieri Marco Aurélio, Bruni-Cardoso Alexandre, Avelino-Silva Vivian I, Schechtman Deborah, Voegels Richard Louis, Malnic Bettina, Glezer Isaias, de Rezende Pinna Fabio
Department of Otorhinolaryngology, Faculdade de Medicina da Universidade de São Paulo, São Paulo, Brazil.
Department of Clinical Surgery, Universidade Estadual de Londrina and Pontifical Catholic University of Paraná, Londrina, Brazil.
Front Physiol. 2021 Mar 9;12:622987. doi: 10.3389/fphys.2021.622987. eCollection 2021.
Upper respiratory viral infections can decrease the sense of smell either by inflammatory restriction of nasal airflow that carries the odorant molecules or through interference in olfactory sensory neuron function. During the coronavirus disease 2019 (COVID-19) pandemic, triggered by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), worldwide reports of severe smell loss (anosmia/hyposmia) revealed a different type of olfactory dysfunction associated with respiratory virus infection. Since self-reported perception of smell is subjective and SARS-CoV-2 exposure is variable in the general population, we aimed to study a population that would be more homogeneously exposed to the virus. Here, we investigated the prevalence of olfactory loss in frontline health professionals diagnosed with COVID-19 in Brazil, one of the major epicenters of the disease. We also analyzed the rate of olfactory function recovery and the particular characteristics of olfactory deficit in this population. A widely disclosed cross-sectional online survey directed to health care workers was developed by a group of researchers to collect data concerning demographic information, general symptoms, otolaryngological symptoms, comorbidities, and COVID-19 test results. Of the 1,376 health professionals who completed the questionnaire, 795 (57.8%) were working directly with COVID-19 patients, either in intensive care units, emergency rooms, wards, outpatient clinics, or other areas. Five-hundred forty-one (39.3%) participants tested positive for SARS-CoV-2, and 509 (37%) were not tested. Prevalence of olfactory dysfunction in COVID-19-positive subjects was 83.9% (454 of 541) compared to 12.9% (42 of 326) of those who tested negative and to 14.9% (76 of 509) of those not tested. Olfactory dysfunction incidence was higher in those working in wards, emergency rooms, and intensive care units compared to professionals in outpatient clinics. In general, remission from olfactory symptoms was frequent by the time of responses. Taste disturbances were present in 74.1% of infected participants and were significantly associated with hyposmia. In conclusion, olfactory dysfunction is highly correlated with exposure to SARS-CoV-2 in health care professionals, and remission rates up to 2 weeks are high.
上呼吸道病毒感染可通过限制携带气味分子的鼻气流或干扰嗅觉感觉神经元功能来降低嗅觉。在由严重急性呼吸综合征冠状病毒2(SARS-CoV-2)引发的2019年冠状病毒病(COVID-19)大流行期间,全球范围内关于严重嗅觉丧失(嗅觉缺失/嗅觉减退)的报告揭示了一种与呼吸道病毒感染相关的不同类型的嗅觉功能障碍。由于自我报告的嗅觉感知是主观的,且普通人群中SARS-CoV-2暴露情况各不相同,我们旨在研究一个病毒暴露情况更为均匀的人群。在此,我们调查了巴西(该疾病的主要疫区之一)确诊感染COVID-19的一线医护人员中嗅觉丧失的患病率。我们还分析了该人群中嗅觉功能恢复的比率以及嗅觉缺陷的具体特征。一组研究人员开展了一项广泛公开的针对医护人员的横断面在线调查,以收集有关人口统计学信息、一般症状、耳鼻喉科症状、合并症以及COVID-19检测结果的数据。在完成问卷的1376名医护人员中,795名(57.8%)直接与COVID-19患者接触,他们工作于重症监护病房、急诊室、病房、门诊诊所或其他区域。541名(39.3%)参与者SARS-CoV-2检测呈阳性,509名(37%)未接受检测。COVID-19阳性受试者中嗅觉功能障碍的患病率为83.9%(541例中的454例),而阴性受试者中为12.9%(326例中的42例),未检测者中为14.9%(509例中的76例)。与门诊诊所的专业人员相比,在病房、急诊室和重症监护病房工作的人员嗅觉功能障碍发生率更高。总体而言,到回复时嗅觉症状缓解较为常见。74.1% 的感染参与者存在味觉障碍,且味觉障碍与嗅觉减退显著相关。总之,医护人员的嗅觉功能障碍与接触SARS-CoV-2高度相关,且两周内的缓解率较高。