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新型冠状病毒肺炎康复后及长期新冠症状在耳鼻咽喉科的叙述性综述

Post COVID-19 and Long COVID Symptoms in Otorhinolaryngology-A Narrative Review.

作者信息

Guntinas-Lichius Orlando, Bitter Thomas, Takes Robert, Lee Victor H F, Saba Nabil F, Mäkitie Antti A, Kowalski Luiz P, Nixon Iain J, Ferlito Alfio

机构信息

Department of Otorhinolaryngology, Jena University Hospital, 07747 Jena, Germany.

Department of Otolaryngology-Head and Neck Surgery, Radboud University Medical Center, 6525 GA Nijmegen, The Netherlands.

出版信息

J Clin Med. 2025 Jan 14;14(2):506. doi: 10.3390/jcm14020506.

Abstract

Post/Long COVID (syndrome) is defined as a condition with symptoms persisting for more than 12 weeks after the onset of SARS-CoV-2 infection that cannot be explained otherwise. The prevalence of self-reported otorhinolaryngological Post/Long COVID symptoms is high. The aim of this review was to analyze the current literature regarding the actual prevalence, knowledge of the etiopathology, and evidence-based treatment recommendations of otorhinolaryngology-related Post/Long COVID symptoms. A systematic literature search of articles published since 2019 in PubMed and ScienceDirect was performed and resulted in 108 articles. These were the basis for this review and formed a comprehensive series of consented therapy statements on the most important of otorhinolaryngology-related Post/Long COVID symptoms. Otorhinolaryngological symptoms did not appear isolated but as part of a multi-organ syndrome. Self-reported otorhinolaryngology-related Post/Long COVID symptoms were often not confirmed by objective testing. The confirmed prevalence estimated for anosmia, dysgeusia, cough, facial palsy, hoarseness/dysphonia, acute hearing loss, tinnitus, and vertigo/dizziness was about 4%, 2%, 4-19%, 0%, 17-20%, 8%, 20%, and 5-26%, respectively. There are manifold theoretical concepts of the etiopathology of different symptoms, but there is no clear evidence-based proof. This certainly contributes to the fact that there is no effective specific treatment option for any of the symptoms mentioned. Healthcare pathways must be established so that otorhinolaryngological Post/Long COVID symptoms can be recognized and evaluated and otorhinolaryngologists can provide counseling. This would also help to establish and selectively include patients in clinical trials investigating specific therapeutic concepts.

摘要

新冠后/长期新冠(综合征)被定义为在新型冠状病毒感染发病后症状持续超过12周且无法以其他方式解释的一种病症。自我报告的耳鼻咽喉科新冠后/长期新冠症状的患病率很高。本综述的目的是分析当前关于耳鼻咽喉科相关新冠后/长期新冠症状的实际患病率、病因病理学知识以及循证治疗建议的文献。对2019年以来在PubMed和ScienceDirect上发表的文章进行了系统的文献检索,共检索到108篇文章。这些文章是本综述的基础,并形成了一系列关于最重要的耳鼻咽喉科相关新冠后/长期新冠症状的一致治疗声明。耳鼻咽喉科症状并非孤立出现,而是多器官综合征的一部分。自我报告的耳鼻咽喉科相关新冠后/长期新冠症状往往未得到客观测试的证实。嗅觉减退、味觉障碍、咳嗽、面瘫、声音嘶哑/发音障碍、急性听力损失、耳鸣以及眩晕/头晕的确诊患病率估计分别约为4%、2%、4 - 19%、0%、17 - 20%、8%、20%以及5 - 26%。对于不同症状的病因病理学有多种理论概念,但尚无明确的循证依据。这无疑导致了上述任何症状都没有有效的特异性治疗方案这一事实。必须建立医疗途径,以便能够识别和评估耳鼻咽喉科新冠后/长期新冠症状,并且耳鼻咽喉科医生能够提供咨询。这也将有助于在研究特定治疗概念的临床试验中纳入并选择性地纳入患者。

https://cdn.ncbi.nlm.nih.gov/pmc/blobs/c3dc/11765628/0fd6e727655e/jcm-14-00506-g001.jpg

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