Okada Masahiko, Ishida Noriyuki, Kanzaki Sho, Kawada Ichiro, Nagashima Kengo, Terai Hideki, Hiruma Gaku, Namkoong Ho, Asakura Takanori, Masaki Katsunori, Ohgino Keiko, Miyata Jun, Chubachi Shotaro, Kodama Nobuhiro, Maeda Shunsuke, Sakamoto Satoshi, Okamoto Masaki, Nagasaki Yoji, Umeda Akira, Miyagawa Kazuya, Shimada Hisato, Minami Kazuhiro, Hagiwara Rie, Ishii Makoto, Sato Yasunori, Fukunaga Koichi
Department of Medicine, Division of Pulmonary Medicine Keio University School of Medicine Tokyo Japan.
Biostatistics Unit, Clinical and Translational Research Center Keio University Hospital Tokyo Japan.
OTO Open. 2024 Mar 3;8(1):e120. doi: 10.1002/oto2.120. eCollection 2024 Jan-Mar.
This study aimed to investigate the clinical features of long COVID cases presenting with upper respiratory symptoms, a topic not yet fully elucidated.
Prospective cohort study.
A multicenter study involving 26 medical facilities in Japan.
Inclusion criteria were patients aged ≥18 years old with a confirmed COVID-19 diagnosis via severe acute respiratory syndrome coronavirus 2 polymerase chain reaction or antigen testing, who were hospitalized at the participating medical facilities. Analyzing clinical information and patient-reported outcomes from 1009 patients were analyzed. The outcome measured the degree of initial symptoms for taste or olfactory disorders and assessed the likelihood of these symptoms persisting as long COVID, as well as the impact on quality of life if the upper respiratory symptoms persisted as long COVID.
Patients with high albumin, low C-reactive protein, and low lactate dehydrogenase in laboratory tests tended to experience taste or olfactory disorders as part of long COVID. Those with severe initial symptoms had a higher risk of experiencing residual symptoms at 3 months, with an odds ratio of 2.933 (95% confidence interval [CI], 1.282-6.526) for taste disorders and 3.534 (95% CI, 1.382-9.009) for olfactory disorders. Presence of upper respiratory symptoms consistently resulted in lower quality of life scores.
The findings from this cohort study suggest that severe taste or olfactory disorders as early COVID-19 symptoms correlate with an increased likelihood of persistent symptoms in those disorders as long COVID.
本研究旨在调查出现上呼吸道症状的新冠后综合征病例的临床特征，这一主题尚未完全阐明。
前瞻性队列研究。
一项涉及日本26家医疗机构的多中心研究。
纳入标准为年龄≥18岁、通过严重急性呼吸综合征冠状病毒2聚合酶链反应或抗原检测确诊为新冠病毒病且在参与研究的医疗机构住院的患者。分析了1009例患者的临床信息和患者报告的结果。该结果测量了味觉或嗅觉障碍的初始症状程度，并评估了这些症状作为新冠后综合征持续存在的可能性，以及如果上呼吸道症状作为新冠后综合征持续存在对生活质量的影响。
实验室检查中白蛋白水平高、C反应蛋白水平低和乳酸脱氢酶水平低的患者，作为新冠后综合征的一部分，往往会出现味觉或嗅觉障碍。初始症状严重的患者在3个月时出现残留症状的风险更高，味觉障碍的优势比为2.933（95%置信区间[CI]，1.282 - 6.526），嗅觉障碍的优势比为3.534（95%CI，1.382 - 9.009）。上呼吸道症状的存在始终导致生活质量得分较低。
这项队列研究的结果表明，新冠早期症状中严重的味觉或嗅觉障碍与这些障碍作为新冠后综合征持续存在的可能性增加相关。
