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新冠病毒感染后患者长期嗅觉、味觉和化学感觉功能障碍的高发率:一项使用综合心理物理评估的为期一年的配对病例对照研究。

High prevalence of long-term olfactory, gustatory, and chemesthesis dysfunction in post-COVID-19 patients: a matched case-control study with one-year follow-up using a comprehensive psychophysical evaluation.

机构信息

Department of Medical, Surgical and Health Sciences, Section of Otolaryngology, University of Trieste, Trieste, Italy.

Smell and Taste Clinic, Department of Otorhinolaryngology, Technical University of Dresden, Dresden, Germany.

出版信息

Rhinology. 2021 Dec 1;59(6):517-527. doi: 10.4193/Rhin21.249.

Abstract

BACKGROUND

Using an age and gender matched-pair case-control study, we aimed to estimate the long-term prevalence of psychophysical olfactory, gustatory , and chemesthesis impairment at least one year after SARS-CoV-2 infection considering the background of chemosensory dysfunction in non-COVID-19 population.

METHODOLOGY

This case-controlled study included 100 patients who were home-isolated for mildly symptomatic COVID-19 between March and April 2020. One control regularly tested for SARS-CoV-2 infection and always tested negative was matched to each case according to gender and age. Chemosensory function was investigated by a comprehensive psychophysical evaluation including ortho- and retronasal olfaction and an extensive assessment of gustatory function. Differences in chemosensory parameters were evaluated through either Fisher’s exact test or Kruskal-Wallis test.

RESULTS

The psychophysical assessment of chemosensory function took place after a median of 401 days from the first SARS-CoV-2 positive swab. The evaluation of orthonasal smell identified 46% and 10% of cases and controls, respectively, having olfactory dysfunction, with 7% of COVID-19 cases being functionally anosmic. Testing of gustatory function revealed a 27% of cases versus 10% of controls showing a gustatory impairment. Nasal trigeminal sensitivity was significantly lower in cases compared to controls. Persistent chemosensory impairment was associated with emotional distress and depression.

CONCLUSION

More than one year after the onset of COVID-19, cases exhibited an excess of olfactory, gustatory , and chemesthesis disturbances compared to matched-pair controls with these symptoms being associated to emotional distress and depression.

摘要

背景

通过一项年龄和性别匹配的病例对照研究,我们旨在考虑非 COVID-19 人群中化学感觉功能障碍的背景,估计至少在 SARS-CoV-2 感染一年后,嗅觉、味觉和化学感觉的长期患病率。

方法

这项病例对照研究纳入了 100 名 2020 年 3 月至 4 月期间因 COVID-19 症状较轻而居家隔离的患者。根据性别和年龄,每个病例都匹配了一个定期接受 SARS-CoV-2 检测且始终呈阴性的对照。通过综合的心理物理学评估,包括嗅觉和味觉的正、逆行测试,对化学感觉功能进行了研究。通过 Fisher 精确检验或 Kruskal-Wallis 检验评估化学感觉参数的差异。

结果

在第一次 SARS-CoV-2 阳性拭子检测后中位数为 401 天进行了化学感觉功能的心理物理学评估。嗅觉的正鼻测试发现 46%的病例和 10%的对照存在嗅觉障碍,7%的 COVID-19 病例为功能性嗅觉丧失。味觉测试发现 27%的病例和 10%的对照存在味觉障碍。与对照相比,病例的鼻三叉神经敏感性明显较低。持续性化学感觉障碍与情绪困扰和抑郁有关。

结论

在 COVID-19 发病一年后,与配对对照组相比,病例表现出嗅觉、味觉和化学感觉障碍的发生率增加,这些症状与情绪困扰和抑郁有关。

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