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[新冠病毒感染患者味觉和嗅觉的功能及形态学紊乱]

[Functional and morphological disorders of taste and olfaction in COVID-19 patients].

作者信息

Pavlidis Pavlos, Schittek Gregor Alexander, Fouka Evangelia, Spyridonidis Efstathios, Gouveris Haralampos

机构信息

HNO-Klinik, Universitätsklinikikum, Mainz, Deutschland.

, Badralexistr. 3, 59132, Veria, Griechenland.

出版信息

HNO. 2022 Nov;70(11):828-836. doi: 10.1007/s00106-022-01218-1. Epub 2022 Aug 30.

Abstract

OBJECTIVE

This study aimed to test the prevalence and evolution of acute olfactory and gustatory functional impairment and their morphologic correlates in COVID-19 patients who require hospitalization due to COVID-19-related respiratory conditions.

METHODS

Included were 53 consecutive hospitalized patients (23 males, 30 females; age 42.54 ± 10.95 years) with an RT-PCR-confirmed COVID-19 diagnosis. Patients were examined twice: just after hospital discharge and 4-6 weeks later. Electrogustometric (EGM) thresholds at the tongue area supplied by the chorda tympani, at the soft palate, and in the region of the vallate papillae were recorded bilaterally. Olfaction was examined by Sniffin' sticks (Burghardt GmbH, Wedel, Germany). The patients' nasal and oral mucosa (fungiform papillae, fpap) were examined by contact endoscopy. Findings were compared to those of 53 healthy individuals matched for sex and age (23 males, 30 females; age 42.90 ± 10.64 years).

RESULTS

EGM thresholds in patients were significantly higher than those of healthy subjects at both timepoints. EGM thresholds at the second measurement were significantly lower than those at the first measurement. Accordingly, patient-reported gustatory outcomes were improved at the second measurement. The same pattern was found using Sniffin' sticks. Significant alterations in form and vascularization of fPap were detected in patients, especially at the first instance. Interestingly we did not observe any significant changes in the morphology and vascularization of nasal mucosa.

CONCLUSION

COVID-19 affects both gustatory and olfactory functions. In parallel, it also affects the structure and vascularization of both nasal and oral mucosa, albeit the nasal mucosa to a much lesser, non-significant extent. Our findings suggest that COVID-19 may cause a mild to profound neuropathy of multiple cranial nerves.

摘要

目的

本研究旨在检测因新型冠状病毒肺炎(COVID-19)相关呼吸道疾病而需住院治疗的COVID-19患者急性嗅觉和味觉功能障碍的患病率及演变情况,以及它们与形态学的相关性。

方法

纳入53例经逆转录聚合酶链反应(RT-PCR)确诊为COVID-19的连续住院患者(23例男性,30例女性;年龄42.54±10.95岁)。患者接受两次检查:出院后即刻以及4至6周后。双侧记录鼓索神经支配的舌区、软腭及轮廓乳头区域的电味觉阈值(EGM)。采用Sniffin' sticks(德国韦德尔市的Burghardt GmbH公司)检测嗅觉。通过接触式内镜检查患者的鼻黏膜和口腔黏膜(菌状乳头,fpap)。将结果与53例年龄和性别匹配的健康个体(23例男性,30例女性;年龄42.90±10.64岁)的结果进行比较。

结果

在两个时间点,患者的EGM阈值均显著高于健康受试者。第二次测量时的EGM阈值显著低于第一次测量时的阈值。相应地,患者报告的味觉结果在第二次测量时有所改善。使用Sniffin' sticks检测时也发现了相同的模式。在患者中检测到fpap的形态和血管化有显著改变,尤其是在首次检查时。有趣的是,我们未观察到鼻黏膜的形态和血管化有任何显著变化。

结论

COVID-19会影响味觉和嗅觉功能。同时,它也会影响鼻黏膜和口腔黏膜的结构及血管化,尽管鼻黏膜受影响的程度要小得多,且无统计学意义。我们的研究结果表明,COVID-19可能会导致多根颅神经出现轻度至重度的神经病变。

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