COVID-19 住院患者嗅觉和味觉变化及其与住院期间患者病情演变的关系。
Changes in olfaction and taste in patients hospitalized for COVID-19 and their relationship to patient evolution during hospitalization.
机构信息
Universidade Federal de Minas Gerais, Faculdade de Medicina, Belo Horizonte, MG, Brazil.
Universidade Federal de Minas Gerais, Faculdade de Medicina, Belo Horizonte, MG, Brazil.
出版信息
Braz J Otorhinolaryngol. 2022 Nov-Dec;88 Suppl 5(Suppl 5):S75-S82. doi: 10.1016/j.bjorl.2021.11.002. Epub 2021 Nov 24.
OBJECTIVES
During the COVID-19 pandemic, several cases of changes in olfaction and taste associated with the infection have been reported. Therefore, otolaryngologists are frequently the first medical professionals sought by patients. The aim of this study was to evaluate the frequency of olfaction and taste disorders in patients hospitalized with COVID-19, and their association with other clinical manifestations and patient evolution during hospitalization.
METHODS
248 patients, admitted to three public hospitals in Belo Horizonte, Minas Gerais, Brazil, were prospectively included: Hospital das Clínicas da Universidade Federal de Minas Gerais (HC-UFMG), Hospital Júlia Kubitschek (HJK) and Hospital Eduardo de Menezes (HEM), who, upon admission to hospital, presented with Severe Acute Respiratory Syndrome due to COVID-19. Clinical and laboratory variables and outcomes during hospitalization were prospectively collected from the electronic medical records. The collection of sociodemographic and symptomatology data during the acute phase was carried out prospectively in electronic medical records and confirmed with the patients at a subsequent outpatient visit.
RESULTS
The most frequently reported symptoms were dyspnea (77.4%), cough (69.8%) and fever (55.2%). During the acute phase of the disease, 95 (38.3%) and 87 (35.1%) patients reported taste and olfaction disorders, respectively. There was a lower prevalence of dysosmia among patients with previous comorbidities (p < 0.05). Both symptoms were associated with less need for intensive care admission (p = 0.001 for dysgeusia and p = 0.021 for dysosmia) and a negative correlation with length of hospital stay (dysosmia: r = -0.175, p < 0.05; dysgeusia: r = -0.29, p < 0.001) and length of stay in the ICU (dysosmia: r = -0.136, p < 0.05; dysgeusia: r = -0.215, p < 0.05). The absence of taste disorders was also associated with a greater need for mechanical ventilation (p < 0.001).
CONCLUSION
Changes in taste and olfaction were reported by a large number of patients in the acute phase of COVID-19. In this study, both were markers of better clinical patient evolution.
LEVEL OF EVIDENCE
1B.
目的
在 COVID-19 大流行期间，有报道称与感染相关的嗅觉和味觉变化的病例很多。因此，耳鼻喉科医生经常是患者首先寻求的医疗专业人员。本研究旨在评估 COVID-19 住院患者嗅觉和味觉障碍的频率，及其与其他临床表现和住院期间患者演变的关系。
方法
前瞻性纳入巴西贝洛奥里藏特三家公立医院的 248 名患者：米纳斯吉拉斯联邦大学临床医院（HC-UFMG）、朱利亚·库比切克医院（HJK）和爱德华多·德梅内塞斯医院（HEM），他们因 COVID-19 导致严重急性呼吸综合征入院。前瞻性地从电子病历中收集住院期间的临床和实验室变量以及结局。在急性阶段，通过电子病历前瞻性地收集社会人口统计学和症状数据，并在随后的门诊就诊时与患者进行确认。
结果
报告的最常见症状为呼吸困难（77.4%）、咳嗽（69.8%）和发热（55.2%）。在疾病的急性期，95（38.3%）和 87（35.1%）名患者分别报告有味觉和嗅觉障碍。有既往合并症的患者中嗅觉障碍的发生率较低（p<0.05）。两种症状均与较少需要入住重症监护病房有关（味觉障碍：p=0.001；嗅觉障碍：p=0.021），与住院时间呈负相关（嗅觉障碍：r=-0.175，p<0.05；味觉障碍：r=-0.29，p<0.001）和入住 ICU 时间呈负相关（嗅觉障碍：r=-0.136，p<0.05；味觉障碍：r=-0.215，p<0.05）。味觉障碍的缺失也与更需要机械通气有关（p<0.001）。
结论
在 COVID-19 的急性期，大量患者报告味觉和嗅觉改变。在本研究中，这两种变化都是患者临床转归较好的标志物。
证据水平
1B。
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