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嗅觉功能障碍对新型冠状病毒肺炎患者的预后价值:COVIDORA研究

The Prognostic Value of Olfactory Dysfunction in Patients with COVID-19: The COVIDORA Study.

作者信息

Hamel Anne-Laure, Delbos Léo, Natella Pierre-André, Radulesco Thomas, Alexandru Mihaela, Bartaire Emmanuel, Bartier Sophie, Benoite Gonda, Bequignon Emilie, Castillo Laurent, Canouï-Poitrine Florence, Carsuzaa Florent, Corré Alain, Coste André, Couloigner Vincent, Daveau Clémentine, De Boissieu Paul, De Bonnecaze Guillaume, De Gabory Ludovic, Debry Christian, Deraedt Simon, Dufour Xavier, El Bakkouri Wissame, Gilain Laurent, Hans Stéphane, Hautefort Charlotte, Hermann Ruben, Jankowski Roger, La Croix Candice, Lecanu Jean-Baptiste, Malard Olivier, Michel Justin, Nguyen Yann, Nevoux Jerome, Papon Jean-François, Patron Vincent, Prigent Marine, Pruliere-Escabasse Virginie, Renaud Marion, Rumeau Cécile, Salmon Dominique, Saroul Nicolas, Serrano Elie, Nhung Tran Khai Christine, Tringali Stéphane, Truy Eric, Vandersteen Clair, Verillaud Benjamin, Veil Raphaël, Fieux Maxime

机构信息

URC, Hôpital Henri Mondor, Assistance Publique des Hôpitaux de Paris, F-94010 Créteil, France.

Service de Santé Publique et d'Épidémiologie, Hôpital Bicêtre, Assistance Publique des Hôpitaux de Paris, F-94270 Paris, France.

出版信息

Life (Basel). 2024 Feb 22;14(3):293. doi: 10.3390/life14030293.

Abstract

BACKGROUND

Among all studies describing COVID-19 clinical features during the first wave of the pandemic, only a few retrospective studies have assessed the correlation between olfac-tory dysfunction (OD) and the evolution of disease severity. The main aim was to assess whether OD is a predictive factor of COVID-19 severity based on the patient's medical management (outpa-tient care, standard hospital admission, and ICU admission).

METHODS

A national, prospective, mul-ticenter cohort study was conducted in 20 public hospitals and a public center for COVID-19 screen-ing. During the first wave of the pandemic, from 6 April to 11 May 2020, all patients tested positive for COVID-19 confirmed by RT-PCR underwent two follow-up ENT consultations within 10 days of symptom onset. The main outcome measures were the evolution of medical management (out-patient care, standard hospital admission, and ICU admission) at diagnosis and along the clinical course of COVID-19 disease.

RESULTS

Among 481 patients included, the prevalence of OD was 60.7%, and it affected mostly female patients (74.3%) under 65 years old (92.5%), with fewer comor-bidities than patients with normal olfactory function. Here, 99.3% (290/292) of patients with OD presented with non-severe COVID-19 disease. Patients reporting OD were significantly less hospi-talized than the ones managed as outpatients, in either a standard medical unit or an ICU. Conclu-sions: As regards the clinical course of COVID-19 disease, OD could predict a decreased risk of hospitalization during the first wave of the pandemic.

摘要

背景

在所有描述新冠疫情第一波期间新冠病毒疾病(COVID-19)临床特征的研究中,只有少数回顾性研究评估了嗅觉功能障碍(OD)与疾病严重程度演变之间的相关性。主要目的是根据患者的医疗管理情况(门诊治疗、标准住院治疗和重症监护病房[ICU]收治)评估OD是否为COVID-19严重程度的预测因素。

方法

在20家公立医院和1家COVID-19筛查公共中心开展了一项全国性、前瞻性、多中心队列研究。在疫情第一波期间,即2020年4月6日至5月11日,所有经逆转录聚合酶链反应(RT-PCR)确诊为COVID-19阳性的患者在症状出现后10天内接受了两次耳鼻喉科随访会诊。主要结局指标为诊断时以及COVID-19疾病临床过程中的医疗管理演变情况(门诊治疗、标准住院治疗和ICU收治)。

结果

在纳入的481例患者中,OD的患病率为60.7%,主要影响65岁以下的女性患者(74.3%),且合并症比嗅觉功能正常的患者少。在此,99.3%(290/292)的OD患者表现为非重症COVID-19疾病。报告有OD的患者在标准医疗单元或ICU的住院率显著低于门诊治疗的患者。结论:就COVID-19疾病的临床过程而言,OD可预测疫情第一波期间住院风险降低。

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