Department of Otolaryngology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.
Endoscopic Nasal and Sinus Surgery Excellent Center, King Chulalongkorn Memorial Hospital, Bangkok, Thailand.
Int Forum Allergy Rhinol. 2022 May;12(5):744-756. doi: 10.1002/alr.22923. Epub 2021 Dec 6.
A substantial proportion of coronavirus disease-2019 (COVID-19) patients demonstrate olfactory and gustatory dysfunction (OGD). Self-reporting for OGD is widely used as a predictor of COVID-19. Although psychophysical assessment is currently under investigation in this role, the sensitivity of these screening tests for COVID-19 remains unclear. In this systematic review we assess the sensitivity of self-reporting and psychophysical tests for OGD.
A systematic search was performed on PubMed, EMBASE, and ClinicalTrials.gov from inception until February 16, 2021. Studies of suspected COVID-19 patients with reported smell or taste alterations were included. Data were pooled for meta-analysis. Sensitivity, specificity, and diagnostic odds ratio (DOR) were reported in the outcomes.
In the 50 included studies (42,902 patients), self-reported olfactory dysfunction showed a sensitivity of 43.9% (95% confidence interval [CI], 37.8%-50.2%), a specificity of 91.8% (95% CI, 89.0%-93.9%), and a DOR of 8.74 (95% CI, 6.67-11.46) for predicting COVID-19 infection. Self-reported gustatory dysfunction yielded a sensitivity of 44.9% (95% CI, 36.4%-53.8%), a specificity of 91.5% (95% CI, 87.7%-94.3%), and a DOR of 8.83 (95% CI, 6.48-12.01). Olfactory psychophysical tests analysis revealed a sensitivity of 52.8% (95% CI, 25.5%-78.6%), a specificity of 88.0% (95% CI, 53.7%-97.9%), and a DOR of 8.18 (95% CI, 3.65-18.36). One study used an identification test for gustatory sensations assessment.
Although demonstrating high specificity and DOR values, neither self-reported OGD nor unvalidated and limited psychophysical tests were sufficiently sensitive in screening for COVID-19. They were not suitable adjuncts in ruling out the disease.
相当一部分 2019 冠状病毒病（COVID-19）患者表现出嗅觉和味觉功能障碍（OGD）。自我报告的 OGD 是 COVID-19 的一种广泛应用的预测指标。虽然目前正在研究心理物理学评估在这方面的作用，但这些筛查测试对 COVID-19 的敏感性仍不清楚。在这项系统评价中，我们评估了自我报告和心理物理学测试对 OGD 的敏感性。
对 PubMed、EMBASE 和 ClinicalTrials.gov 进行了系统检索，检索时间从建库至 2021 年 2 月 16 日。纳入报告有嗅觉或味觉改变的疑似 COVID-19 患者的研究。对数据进行汇总进行荟萃分析。报告了结局的敏感性、特异性和诊断比值比（DOR）。
在纳入的 50 项研究（42902 例患者）中，自我报告的嗅觉功能障碍对 COVID-19 感染的预测敏感性为 43.9%（95%CI，37.8%-50.2%），特异性为 91.8%（95%CI，89.0%-93.9%），DOR 为 8.74（95%CI，6.67-11.46）。自我报告的味觉功能障碍的敏感性为 44.9%（95%CI，36.4%-53.8%），特异性为 91.5%（95%CI，87.7%-94.3%），DOR 为 8.83（95%CI，6.48-12.01）。嗅觉心理物理学测试分析显示敏感性为 52.8%（95%CI，25.5%-78.6%），特异性为 88.0%（95%CI，53.7%-97.9%），DOR 为 8.18（95%CI，3.65-18.36）。一项研究使用了味觉感知评估的识别测试。
尽管自我报告的 OGD 和未经验证且有限的心理物理学测试具有高特异性和 DOR 值，但在筛查 COVID-19 时，它们的敏感性都不够高。它们不适合用于排除该疾病。
