Ribeiro Preto Medical School, University of Sao Paulo, Ribeiro Preto, SP, Brazil and Santa Casa de Sao Paulo School of Medical Sciences, Sao Paulo, SP, Brazil.
Ribeiro Preto Medical School, University of Sao Paulo, Ribeiro Preto, SP, Brazil.
Rhinology. 2024 Feb 1;62(1):55-62. doi: 10.4193/Rhin23.116.
Although the COVID-19 pandemic has increased the prevalence of cases with olfactory loss, other respiratory viruses can also cause this condition. We aimed to compare the prevalence of acute SARS-CoV-2 infection and other respiratory viruses in patients with sudden smell loss, and to assess the impact of SARS-CoV-2 viral load and co-infection on olfactory symptoms.
Patients with sudden smell loss were recruited in a multicenter prospective cohort study in 15 hospitals in Brazil. Clinical questionnaire, Connecticut Chemosensory Clinical Research Center (CCCRC) olfactory test and nasopharyngeal swab to perform a PCR-based respiratory viral panel were collected at first visit (day 0) and 30 and 60 days after recruitment.
188 of 213 patients presented positive test result for SARS-CoV-2, among which 65 were co-infected with other respiratory viruses (e.g., rhinovirus, enterovirus, and parainfluenza). 25 had negative test results for SARS-CoV-2. Patients in both SARSCoV-2 and non-SARS-CoV-2 groups had objective anosmia (less than 2 points according to the psychophysical olfactory CCCRC) at day 0, with no significant difference between them. Both groups had significant smell scores improvement after 30 and 60 days, with no difference between them. Co-infection with other respiratory viruses, and SARS-CoV-2 viral load did not impact olfactory scores.
Patients with sudden smell loss associated with SARS-CoV-2 and other respiratory viruses had similar presentation, with most participants initiating with anosmia, and total or near total recovery after 60 days. SARS-CoV-2 viral load and co-infections with other respiratory viruses were not associated with poorer olfactory outcomes.
尽管 COVID-19 大流行增加了嗅觉丧失病例的发病率，但其他呼吸道病毒也可能导致这种情况。我们旨在比较急性 SARS-CoV-2 感染和其他呼吸道病毒在突发性嗅觉丧失患者中的流行率，并评估 SARS-CoV-2 病毒载量和合并感染对嗅觉症状的影响。
在巴西 15 家医院的一项多中心前瞻性队列研究中招募了突发性嗅觉丧失的患者。在首次就诊（第 0 天）和招募后 30 天和 60 天，收集临床问卷、康涅狄格州化学感觉临床研究中心（CCCRC）嗅觉测试和鼻咽拭子，以进行基于 PCR 的呼吸道病毒面板检测。
213 名患者中有 188 名 SARS-CoV-2 检测结果呈阳性，其中 65 名患者合并感染了其他呼吸道病毒（例如鼻病毒、肠道病毒和副流感病毒）。25 名患者 SARS-CoV-2 检测结果为阴性。SARS-CoV-2 和非 SARS-CoV-2 组的患者在第 0 天均有客观的嗅觉障碍（根据 CCCRC 心理物理学嗅觉得分为 2 分以下），两组之间无显著差异。两组在 30 天和 60 天后嗅觉评分均有显著改善，两组之间无差异。合并其他呼吸道病毒感染和 SARS-CoV-2 病毒载量对嗅觉评分无影响。
与 SARS-CoV-2 和其他呼吸道病毒相关的突发性嗅觉丧失患者的表现相似，大多数患者最初表现为嗅觉丧失，60 天后可完全或几乎完全恢复。SARS-CoV-2 病毒载量和合并感染其他呼吸道病毒与较差的嗅觉预后无关。
