Diamond Bar High School, Diamond Bar, California, USA.
Case Western Reserve University School of Medicine, Cleveland, Ohio, USA.
Auris Nasus Larynx. 2022 Apr;49(2):165-175. doi: 10.1016/j.anl.2021.07.007. Epub 2021 Jul 15.
OBJECTIVES: Loss of smell or taste are early symptoms of COVID-19. Given the high asymptomatic rate of COVID-19, as well as unreliable temperature checking and contact history taking, it is important to understand the role of olfactory and gustatory dysfunction (OGD) in the diagnosis of COVID-19. The aim of this study is to determine how initial symptoms of OGD can be used to screen patients for COVID-19 laboratory testing. METHODS: We followed recommendations from the Preferred Reporting Items for Systemic Reviews and Meta-analysis (PRISMA) statement to conduct this systematic review study. We used OGD-related key words to search for literature published between January 1, 2020 and September 30, 2020 on Pubmed, Ovid Medline databases. We estimated the prevalence of OGD and compared it with that of other OGD-related symptoms. The weighted summary proportion under the fixed and random effects model was assessed using MedCalc statistical software. Whenever there was heterogeneity, a random effects model was selected. Publication bias was assessed by funnel plot asymmetry and Egger's regression test. RESULTS: A total of 25 articles (evidence level III:5; IV:20) were identified and reviewed. Data synthesis of 19 articles revealed that the pooled prevalence of olfactory dysfunction in COVID-19 is 53.56% (range 5.6-100%, 95% CI 40.25-66.61%). The pooled prevalence of gustatory dysfunction in COVID-19 is 43.93% (range 1.5-85.18%, 95% CI 28.72-59.74%), just behind fever (62.22%, range 18.18-95.83%, 95% CI 54.82-69.33%), cough (64.74%, range 38.89-87.5%, 95% CI 57.97-71.22%), and fatigue (56.74%, range 6.25-93.62%, 95% CI 32.53-79.35%). The prevalence of gustatory dysfunction in subgroup with objective evaluation is lower than those without (9.91% vs. 49.21%, relive risk 2.82, p<0.001). CONCLUSION: Our updated systematic review attests that OGD is an important early symptom of COVID-19 infection. Screening for OGD should be further emphasized to prioritize patients for laboratory test.
目的:嗅觉或味觉丧失是 COVID-19 的早期症状。鉴于 COVID-19 的无症状率很高,以及体温检测和接触史不可靠,了解嗅觉和味觉障碍(OGD)在 COVID-19 诊断中的作用非常重要。本研究的目的是确定初始 OGD 症状如何用于筛选接受 COVID-19 实验室检测的患者。
方法:我们遵循系统评价和荟萃分析的首选报告项目(PRISMA)声明的建议进行了这项系统综述研究。我们使用 OGD 相关关键词在 Pubmed、Ovid Medline 数据库中搜索 2020 年 1 月 1 日至 2020 年 9 月 30 日期间发表的文献。我们估计了 OGD 的患病率,并将其与其他 OGD 相关症状进行了比较。使用 MedCalc 统计软件评估固定和随机效应模型下的加权汇总比例。只要存在异质性,就选择随机效应模型。通过漏斗图不对称和 Egger 回归检验评估发表偏倚。
结果:共确定并审查了 25 篇文章(证据水平 III:5;IV:20)。对 19 篇文章的数据进行综合分析显示,COVID-19 嗅觉障碍的总患病率为 53.56%(范围为 5.6-100%,95%CI 40.25-66.61%)。COVID-19 味觉障碍的总患病率为 43.93%(范围为 1.5-85.18%,95%CI 28.72-59.74%),仅次于发热(62.22%,范围为 18.18-95.83%,95%CI 54.82-69.33%)、咳嗽(64.74%,范围为 38.89-87.5%,95%CI 57.97-71.22%)和疲劳(56.74%,范围为 6.25-93.62%,95%CI 32.53-79.35%)。有客观评估的亚组中味觉障碍的患病率低于无客观评估的亚组(9.91%比 49.21%,相对风险 2.82,p<0.001)。
结论:我们的最新系统综述证明,OGD 是 COVID-19 感染的重要早期症状。应进一步强调对 OGD 的筛查,以优先为患者进行实验室检测。
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