Graf Christiana, Wagener Inken, Grikscheit Katharina, Hoehl Sebastian, Berger Annemarie, Wetzstein Nils, Dietz Julia, Dultz Georg, Michael Florian, Filmann Natalie, Herrmann Eva, Tinnemann Peter, Goetsch Udo, Ciesek Sandra
Institute of Medical Virology, University Hospital Frankfurt, 60306 Frankfurt am Main, Germany.
Department of Internal Medicine I, University Hospital Frankfurt, 60306 Frankfurt am Main, Germany.
J Clin Med. 2023 Apr 27;12(9):3162. doi: 10.3390/jcm12093162.
Genesis and the prognostic value of olfactory dysfunction (OD) in COVID-19 remain partially described. The objective of our study was to characterize OD during SARS-CoV-2 infection and to examine whether testing of OD may be a useful tool in clinical practice in order to early identify patients with SARS-CoV-2 infection.
Olfactory function assessment was objectively carried out using the u-Smell-it test. In a cross-sectional study part, we evaluated this test in a control cohort of SARS-CoV-2 negative tested patients, who attended the University Hospital Frankfurt between May 2021 and March 2022. In a second longitudinal study part, sensitivity and specificity of OD was evaluated as a diagnostic marker of a SARS-CoV-2 infection in Frankfurt am Main, Germany in SARS-CoV-2 infected patients and their close contacts.
Among 494 SARS-CoV-2 negative tested patients, OD was detected in 45.7% and was found to be significantly associated with the male gender ( < 0.001), higher age ( < 0.001), cardiovascular and pulmonary comorbidities ( < 0.001; = 0.03). Among 90 COVID-19 positive patients, OD was found in 65.6% and was significantly associated with male gender and positive smoking status ( = 0.04 each). Prevalence and severity of OD were significantly increased in infections with the Delta variant (B.1.617.2) compared to those with the Omicron variant (BA.1.1.529). Diagnostic sensitivity and specificity of OD for diagnosis of SARS-CoV-2 infection were 69% and 64%, respectively.
OD is common in COVID-19 negative and positive tested patients with significantly different prevalence rates observed between different variants. Diagnostic accuracy of OD is not high enough to implement olfactory testing as a tool in diagnostic routine to early identify patients with a SARS-CoV-2 infection.
新型冠状病毒肺炎（COVID-19）中嗅觉功能障碍（OD）的发生机制及其预后价值仍未完全阐明。本研究的目的是描述严重急性呼吸综合征冠状病毒2（SARS-CoV-2）感染期间的OD情况，并探讨OD检测是否可作为临床实践中的一种有用工具，以便早期识别SARS-CoV-2感染患者。
使用u-Smell-it测试客观地进行嗅觉功能评估。在横断面研究部分，我们在2021年5月至2022年3月期间到法兰克福大学医院就诊的SARS-CoV-2检测阴性患者的对照队列中评估了该测试。在第二个纵向研究部分，在德国美因河畔法兰克福，对SARS-CoV-2感染患者及其密切接触者中，将OD的敏感性和特异性评估为SARS-CoV-2感染的诊断标志物。
在494例SARS-CoV-2检测阴性的患者中，45.7%检测出OD，且发现其与男性（P<0.001）、高龄（P<0.001）、心血管和肺部合并症（P<0.001；P = 0.03）显著相关。在90例COVID-19阳性患者中，65.6%检测出OD，且与男性和吸烟阳性状态显著相关（均为P = 0.04）。与感染奥密克戎变种（BA.1.1.529）相比，感染德尔塔变种（B.1.617.2）时OD的患病率和严重程度显著增加。OD诊断SARS-CoV-2感染的诊断敏感性和特异性分别为69%和64%。
OD在COVID-19检测阴性和阳性患者中均很常见，不同变种之间观察到的患病率有显著差异。OD的诊断准确性不足以将嗅觉测试作为一种工具用于诊断常规，以早期识别SARS-CoV-2感染患者。
