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[新型冠状病毒奥密克戎毒株感染相关嗅觉和味觉功能障碍的发病率及预后:一项针对35566人的全国多中心调查]

[Incidence and prognosis of olfactory and gustatory dysfunctions related to infection of SARS-CoV-2 Omicron strain: a national multi-center survey of 35 566 population].

作者信息

Liu M F, Ma R X, Cao X B, Zhang H, Zhou S H, Jiang W H, Jiang Y, Sun J W, Yang Q T, Li X Z, Sun Y N, Shi L, Wang M, Song X C, Chen F Q, Zhang X S, Wei H Q, Yu S Q, Zhu D D, Ba L, Cao Z W, Xiao X P, Wei X, Lin Z H, Chen F H, Shan C G, Wang G K, Ye J, Qu S H, Zhao C Q, Wang Z L, Li H B, Liu F, Cui X B, Ye S N, Liu Z, Xu Y, Cai X, Hang W, Zhang R X, Zhao Y L, Yu G D, Shi G G, Lu M P, Shen Y, Zhao Y T, Pei J H, Xie S B, Yu L G, Liu Y H, Gu S S, Yang Y C, Cheng L, Liu J F

机构信息

Graduate School of Beijing University of Chinese Medicine, Beijing 100029, China Department of Otorhinolaryngology Head and Neck Surgery, China-Japan Friendship Hospital, Beijing 100029, China.

Department of Otorhinolaryngology Head and Neck Surgery, the First People's Hospital of Yinchuan, Yinchuan 750001, China.

出版信息

Zhonghua Er Bi Yan Hou Tou Jing Wai Ke Za Zhi. 2023 Jun 7;58(6):579-588. doi: 10.3760/cma.j.cn115330-20230316-00117.

Abstract

This cross-sectional investigation aimed to determine the incidence, clinical characteristics, prognosis, and related risk factors of olfactory and gustatory dysfunctions related to infection with the SARS-CoV-2 Omicron strain in mainland China. Data of patients with SARS-CoV-2 from December 28, 2022, to February 21, 2023, were collected through online and offline questionnaires from 45 tertiary hospitals and one center for disease control and prevention in mainland China. The questionnaire included demographic information, previous health history, smoking and alcohol drinking, SARS-CoV-2 vaccination, olfactory and gustatory function before and after infection, other symptoms after infection, as well as the duration and improvement of olfactory and gustatory dysfunction. The self-reported olfactory and gustatory functions of patients were evaluated using the Olfactory VAS scale and Gustatory VAS scale. A total of 35 566 valid questionnaires were obtained, revealing a high incidence of olfactory and taste dysfunctions related to infection with the SARS-CoV-2 Omicron strain (67.75%). Females(χ2=367.013, <0.001) and young people(χ2=120.210, <0.001) were more likely to develop these dysfunctions. Gender(=1.564, 95%: 1.487-1.645), SARS-CoV-2 vaccination status (=1.334, 95%: 1.164-1.530), oral health status (=0.881, 95%: 0.839-0.926), smoking history (=1.152, 95%=1.080-1.229), and drinking history (=0.854, 95%: 0.785-0.928) were correlated with the occurrence of olfactory and taste dysfunctions related to SARS-CoV-2(above <0.001). 44.62% (4 391/9 840) of the patients who had not recovered their sense of smell and taste also suffered from nasal congestion, runny nose, and 32.62% (3 210/9 840) suffered from dry mouth and sore throat. The improvement of olfactory and taste functions was correlated with the persistence of accompanying symptoms(χ2=10.873, =0.001). The average score of olfactory and taste VAS scale was 8.41 and 8.51 respectively before SARS-CoV-2 infection, but decreased to3.69 and 4.29 respectively after SARS-CoV-2 infection, and recovered to 5.83and 6.55 respectively at the time of the survey. The median duration of olfactory and gustatory dysfunctions was 15 days and 12 days, respectively, with 0.5% (121/24 096) of patients experiencing these dysfunctions for more than 28 days. The overall self-reported improvement rate of smell and taste dysfunctions was 59.16% (14 256/24 096). Gender(=0.893, 95%: 0.839-0.951), SARS-CoV-2 vaccination status (=1.334, 95%CI: 1.164-1.530), history of head and facial trauma(=1.180, 95%: 1.036-1.344, =0.013), nose (=1.104, 95%: 1.042-1.171, =0.001) and oral (=1.162, 95%: 1.096-1.233) health status, smoking history(=0.765, 95%: 0.709-0.825), and the persistence of accompanying symptoms (=0.359, 95%: 0.332-0.388) were correlated with the recovery of olfactory and taste dysfunctions related to SARS-CoV-2 (above <0.001 except for the indicated values). The incidence of olfactory and taste dysfunctions related to infection with the SARS-CoV-2 Omicron strain is high in mainland China, with females and young people more likely to develop these dysfunctions. Active and effective intervention measures may be required for cases that persist for a long time. The recovery of olfactory and taste functions is influenced by several factors, including gender, SARS-CoV-2 vaccination status, history of head and facial trauma, nasal and oral health status, smoking history, and persistence of accompanying symptoms.

摘要

这项横断面调查旨在确定中国大陆地区与感染严重急性呼吸综合征冠状病毒2(SARS-CoV-2)奥密克戎毒株相关的嗅觉和味觉功能障碍的发生率、临床特征、预后及相关危险因素。通过线上和线下问卷,收集了2022年12月28日至2023年2月21日期间来自中国大陆45家三级医院和1家疾病预防控制中心的SARS-CoV-2患者的数据。问卷内容包括人口统计学信息、既往健康史、吸烟和饮酒情况、SARS-CoV-2疫苗接种情况、感染前后的嗅觉和味觉功能、感染后的其他症状,以及嗅觉和味觉功能障碍的持续时间和改善情况。采用嗅觉视觉模拟评分量表(Olfactory VAS scale)和味觉视觉模拟评分量表(Gustatory VAS scale)对患者自我报告 的嗅觉和味觉功能进行评估。共获得35566份有效问卷,结果显示与感染SARS-CoV-2奥密克戎毒株相关的嗅觉和味觉功能障碍发生率较高(67.75%)。女性(χ2=367.013,P<0.001)和年轻人(χ2=120.210,P<0.001)更易出现这些功能障碍。性别(β=1.564,95%CI:1.487-1.645)、SARS-CoV-2疫苗接种状况(β=1.334,95%CI:1.164-1.530)、口腔健康状况(β=0.881,95%CI:0.839-0.926)、吸烟史(β=1.152,95%CI=1.080-1.229)和饮酒史(β=0.854,95%CI:0.785-0.928)与SARS-CoV-2相关的嗅觉和味觉功能障碍的发生相关(上述P均<0.001)。嗅觉和味觉未恢复的患者中,44.62%(4391/9840)还伴有鼻塞、流涕,32.62%(3210/9840)伴有口干、咽痛。嗅觉和味觉功能的改善与伴随症状的持续存在相关(χ2=10.873,P=0.001)。SARS-CoV-2感染前,嗅觉和味觉VAS量表的平均得分分别为8.41和8.51,但感染后分别降至3.69和4.29,调查时分别恢复至5.83和6.55。嗅觉和味觉功能障碍的中位持续时间分别为15天和12天,0.5%(121/24096)的患者功能障碍持续超过28天。嗅觉和味觉功能障碍的总体自我报告改善率为59.16%(14256/24096)。性别(β=0.893,95%CI:0.839-0.951)、SARS-CoV-2疫苗接种状况(β=1.334,95%CI:1.164-1.530)、头面部外伤史(β=1.180,95%CI:1.036-1.344;P=0.013)、鼻部(β=1.104,95%CI:1.042-1.171;P=0.001)和口腔(β=1.162,95%CI:1.096-1.233)健康状况、吸烟史(β=0.765,95%CI:0.709-)、825)和伴随症状的持续存在(β=0.359,95%CI:0.332-0.388)与SARS-CoV-2相关的嗅觉和味觉功能障碍的恢复相关(除注明值外,上述P均<0.001)。中国大陆地区与感染SARS-CoV-2奥密克戎毒株相关的嗅觉和味觉功能障碍发生率较高,女性和年轻人更易出现这些功能障碍。对于持续时间较长的病例,可能需要采取积极有效的干预措施。嗅觉和味觉功能的恢复受多种因素影响,包括性别、SARS-CoV-2疫苗接种状况、头面部外伤史、鼻部和口腔健康状况、吸烟史以及伴随症状的持续存在。

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