Zarachi Athina, Lianou Aikaterini D, Pezoulas Vasileios, Komnos Ioannis, Milionis Orestis, Fotiadis Dimitrios, Milionis Haralampos, Kastanioudakis Ioannis G, Liontos Angelos
Department of Otorhinolaryngology, Head and Neck Surgery, School of Health Sciences, University Hospital of Ioannina, University of Ioannina, Ioannina, GRC.
Department of Otolaryngology, Head and Neck Surgery, General Hospital of Filiates, Ioannina, GRC.
Cureus. 2023 Mar 20;15(3):e36413. doi: 10.7759/cureus.36413. eCollection 2023 Mar.
Background The visual analogue scale (VAS) has been used as a diagnostic tool for the evaluation of the severity of olfactory and gustatory dysfunction (OGD) caused by SARS-CoV2 infection. The main objective of the present study was the evaluation of OGD with VAS in COVID-19-positive patients in Northwestern Greece and its possible association with the patients' self-reported symptoms of olfactory and gustatory dysfunction. Methods The presence of olfactory and gustatory symptoms and their severity were assessed by questionnaire along with the use of specific odorants and tastant ingredients, in three time periods: prior to COVID-19, during COVID-19 (initial diagnosis) and post-COVID-19 disease (at four weeks from disease onset). Three hundred COVID-19-positive patients (home-quarantined and hospitalized) tested with RT-PCR test in the University Hospital of Ioannina Greece were included in this study. Statistical analysis was performed on SPSS Statistics 26.0 (IBM Corp., Armonk, NY) Results Out of a total of 300 patients, 146 and 190 patients had mild hyposmia and hypogeusia respectively, followed by patients with severe hyposmia or hypogeusia (118 and 88 respectively), at the time of COVID-19 onset (initial diagnosis). An increase in the number of patients with recovery of symptoms was observed during the follow-up period, during which only eight patients had non-resolving severe symptoms (six patients with hyposmia and two with hypogeusia). On further analysis, a statistically significant association was found between the severity of symptoms (assessed by VAS score) and the self-reported symptoms of sensory dysfunction by the patients. There was a significant association between the groups of patients with mild hyposmia and patients that reported no loss of smell; between the patients with moderate hyposmia and the patients who reported "loss of smell"; and between the patients with severe hyposmia and the group of patients who reported a loss of smell, at the COVID-19 onset period. Similarly, patients with mild hyposmia were associated with those that reported a loss of smell at the same time. The severity of hyposmia was also associated with the reported symptom of "loss of taste" at the time of COVID-19 diagnosis. Similar findings were observed regarding the severity of hypogeusia and the reported symptom of "loss of taste" among the groups of patients. Finally, the severity of hypogeusia was associated with smell loss at the time of initial diagnosis of the infection. Conclusion Similar to the literature data, our findings indicate that hyposmia and hypogeusia are common symptoms of COVID-19 disease with varying severity. In our study, most of the patients exerted a complete recovery of these OGD symptoms. In addition, we found an association between olfactory dysfunction and self-reported sensory of taste as well as gustatory dysfunction and sensory of smell. Finally, we found that the VAS score was a reliable diagnostic tool in the estimation of OGD in this cohort of patients. However, our results need to be confirmed by larger-scale trials.
背景 视觉模拟评分法（VAS）已被用作评估由SARS-CoV2感染引起的嗅觉和味觉功能障碍（OGD）严重程度的诊断工具。本研究的主要目的是用VAS评估希腊西北部新冠病毒检测呈阳性患者的OGD情况及其与患者自我报告的嗅觉和味觉功能障碍症状的可能关联。方法 通过问卷并结合使用特定气味剂和味觉成分，在三个时间段评估嗅觉和味觉症状的存在及其严重程度：新冠病毒感染前、新冠病毒感染期间（初次诊断）和新冠病毒感染后疾病期（发病四周后）。本研究纳入了在希腊约阿尼纳大学医院接受逆转录聚合酶链反应（RT-PCR）检测的300例新冠病毒检测呈阳性患者（居家隔离和住院患者）。使用SPSS Statistics 26.0（IBM公司，纽约州阿蒙克）进行统计分析。结果 在总共300例患者中，新冠病毒感染发病时（初次诊断），分别有146例和190例患者存在轻度嗅觉减退和味觉减退，其次是重度嗅觉减退或味觉减退患者（分别为118例和88例）。在随访期间观察到症状恢复的患者数量增加，在此期间只有8例患者有未缓解严重症状（6例嗅觉减退患者和2例味觉减退患者）。进一步分析发现，症状严重程度（通过VAS评分评估）与患者自我报告的感觉功能障碍症状之间存在统计学显著关联。在新冠病毒感染发病期，轻度嗅觉减退患者组与报告无嗅觉丧失的患者之间；中度嗅觉减退患者与报告“嗅觉丧失”的患者之间；重度嗅觉减退患者与报告嗅觉丧失的患者组之间存在显著关联。同样，轻度嗅觉减退患者与同时报告嗅觉丧失的患者相关。嗅觉减退的严重程度在新冠病毒诊断时也与报告的“味觉丧失”症状相关。在患者组中，关于味觉减退的严重程度和报告的“味觉丧失”症状也观察到类似发现。最后，味觉减退的严重程度在感染初次诊断时与嗅觉丧失相关。结论 与文献数据相似，我们的研究结果表明，嗅觉减退和味觉减退是新冠病毒疾病的常见症状，严重程度各不相同。在我们的研究中，大多数患者这些OGD症状完全恢复。此外，我们发现嗅觉功能障碍与自我报告的味觉感觉以及味觉功能障碍与嗅觉感觉之间存在关联。最后，我们发现VAS评分是评估该队列患者OGD的可靠诊断工具。然而，我们的结果需要通过更大规模的试验来证实。
