Shen Jun, Wu Li, Wang Ping, Shen Xiaolei, Jiang Yuhan, Liu Jianren, Chen Wei
Department of Neurology, Shanghai Ninth People's Hospital, Shanghai Jiao Tong University School of Medicine, Shanghai, China.
Front Med (Lausanne). 2022 Nov 7;9:1038938. doi: 10.3389/fmed.2022.1038938. eCollection 2022.
Olfactory dysfunction is a common neurological symptom of Corona Virus Disease 2019(COVID-19). Little is known about hyposmia after COVID-19 infection with Omicron variant in Chinese population.
To investigate the incidence, clinical characteristics and recovery of hyposmia in hospitalized non-severe COVID-19 patients with Omicron variant in Shanghai, China.
Three hundred and forty-nine Chinese non-severe COVID-19 patients with Omicron variant were consecutively enrolled in a designated hospital to investigate the incidence of hyposmia in hospitalization and the recovery rate 1 month later. The visual assessment scale (VAS) was used to evaluate the severity of hyposmia. We compared the demographic, clinical features and treatment outcomes, as well as laboratory parameters between patients with and without hyposmia.
The cross-sectional survey showed that 22 (6.3%) hospitalized patients with non-severe COVID-19 had hyposmia. Patients with hyposmia were younger (61.5 vs. 72.0, = 0.002), had more related clinical symptoms (sore throat, cough, poor appetite, diarrhea, myalgia and taste impairment, etc.), a higher proportion of moderate clinical type (31.8 vs. 13.5%, = 0.028) and longer duration of hospitalization (11 vs. 8 days, = 0.027) than those without hyposmia. Whereas, there were no significant differences regarding gender, comorbidity and nucleic acid conversion time between the two groups. Laboratory subgroup analyses demonstrated that patients with hyposmia had slightly low serum IL-6 and TNF-α levels. However, both of the levels were not associated with hyposmia occurrence in multivariate regression analyses. Further follow-up study disclosed that 16 of 22 (72.7%) hyposmia patients had recovered olfaction 1 month later. Serum IL-6 and TNF-α levels were similar between hyposmia recovered patients and those with persistent hyposmia.
Although the incidence of hyposmia after Omicron variant infection is relatively low and the short-term recovery rate is quite high, patients with hyposmia are prone to have a higher proportion of both upper and lower respiratory tract involvements, gastrointestinal and neurological symptoms, contributing to a longer duration of hospitalization.
嗅觉功能障碍是2019冠状病毒病(COVID-19)常见的神经症状。关于中国人群感染奥密克戎变异株后的嗅觉减退情况,人们知之甚少。
调查中国上海住院的非重症奥密克戎变异株COVID-19患者嗅觉减退的发生率、临床特征及恢复情况。
连续纳入一家定点医院的349例中国非重症奥密克戎变异株COVID-19患者,调查住院期间嗅觉减退的发生率及1个月后的恢复率。采用视觉评估量表(VAS)评估嗅觉减退的严重程度。比较有嗅觉减退和无嗅觉减退患者的人口统计学特征、临床特征、治疗结局以及实验室参数。
横断面调查显示,22例(6.3%)住院的非重症COVID-19患者存在嗅觉减退。嗅觉减退患者较年轻(61.5岁对72.0岁,P = 0.002),有更多相关临床症状(咽痛、咳嗽、食欲减退、腹泻、肌痛和味觉减退等),中度临床类型比例更高(31.8%对13.5%,P = 0.028),住院时间更长(11天对8天,P = 0.027)。而两组在性别、合并症及核酸转阴时间方面无显著差异。实验室亚组分析表明,嗅觉减退患者血清白细胞介素-6(IL-6)和肿瘤坏死因子-α(TNF-α)水平略低。然而,在多因素回归分析中,这两个水平均与嗅觉减退的发生无关。进一步的随访研究发现,22例嗅觉减退患者中有16例(72.7%)在1个月后嗅觉恢复。嗅觉恢复患者与持续嗅觉减退患者的血清IL-6和TNF-α水平相似。
尽管奥密克戎变异株感染后嗅觉减退的发生率相对较低且短期恢复率较高,但嗅觉减退患者上、下呼吸道受累、胃肠道和神经症状的比例较高,导致住院时间延长。