Granvik Christoffer, Lind Alicia, Barros Guilherme W F, Ahlm Clas, Anderson Sara, Andersson Linus, Normark Johan
Department of Clinical Microbiology, Umeå University, Umeå, Sweden.
Department of Diagnostics and Intervention, Umeå University, Umeå, Sweden.
Brain Behav Immun Health. 2025 Jun 13;47:101032. doi: 10.1016/j.bbih.2025.101032. eCollection 2025 Aug.
BACKGROUND: Olfactory impairment has been associated with adverse health outcomes, particularly in older populations, including cognitive decline, malnutrition, and frailty. The COVID-19 pandemic highlighted olfactory impairment as a key symptom affecting individuals across all age groups, raising concerns about its long-term impacts. This study investigates the association between post-acute olfactory impairment and long-term physical capacity in COVID-19 patients, hypothesizing that impaired olfaction is linked to reduced physical performance. METHODS: This prospective cohort study included 63 hospitalized and non-hospitalized COVID-19 patients (38.1 % women; median age 51 years, IQR 47.0-60.0) who underwent olfactory testing 1-3 months post-infection. Olfactory assessments included threshold screening, supra-threshold intensity ratings, and an odour identification test. Physical capacity was assessed using the 1-min sit-to-stand test at follow-ups (3, 6, 12, and 24 months). Partial correlation analysis and linear mixed models were used to analyse the data, adjusting for covariates such as age, sex, BMI, comorbidities, smoking status, and severity of infection. RESULTS: In the early post-acute phase, 36.5 % of participants exhibited olfactory impairment. We identified a significant, negative correlation between objectively tested olfactory impairment and physical capacity at all follow-ups. In a linear mixed model adjusted for relevant covariates, olfactory impairment was associated with reduced physical capacity up to 24 months after infection. The association strengthened over time, reflected by the increasing beta values for the interaction term: 0.09 (p = 0.200) at 6 months, 0.13 (p = 0.053) at 12 months, and 0.23 (p = 0.001) at 24 months. CONCLUSION: Individuals with olfactory impairment in the early post-acute phase of COVID-19 infection were more likely to exhibit diminished physical capacity 24 months later. This study highlights the broader implications of olfactory impairment, previously noted mainly in older populations, demonstrating its relevance across age groups. The COVID-19 pandemic presented a unique opportunity to investigate this relationship, enhancing our understanding of how olfactory impairments relate to long-term physical performance. These findings emphasize the need for further research with larger, more diverse cohorts and objective longitudinal assessments to confirm and extend these observations.
背景:嗅觉障碍与不良健康后果相关,尤其是在老年人群中,包括认知能力下降、营养不良和身体虚弱。新冠疫情凸显了嗅觉障碍是影响所有年龄组人群的关键症状,引发了对其长期影响的担忧。本研究调查新冠患者急性感染后嗅觉障碍与长期身体能力之间的关联,假设嗅觉受损与身体机能下降有关。 方法:这项前瞻性队列研究纳入了63名住院和非住院的新冠患者(38.1%为女性;中位年龄51岁,四分位间距47.0 - 60.0),这些患者在感染后1 - 3个月接受了嗅觉测试。嗅觉评估包括阈值筛查、阈上强度评级和气味识别测试。在随访(3、6、12和24个月)时使用1分钟坐立试验评估身体能力。采用偏相关分析和线性混合模型分析数据,并对年龄、性别、体重指数、合并症、吸烟状况和感染严重程度等协变量进行调整。 结果:在急性感染后的早期阶段,36.5%的参与者存在嗅觉障碍。我们发现在所有随访中,客观测试的嗅觉障碍与身体能力之间存在显著的负相关。在调整了相关协变量的线性混合模型中,嗅觉障碍与感染后长达24个月的身体能力下降有关。这种关联随时间增强,交互项的β值增加反映了这一点:6个月时为0.09(p = 0.200),12个月时为0.13(p = 0.053),24个月时为0.23(p = 0.001)。 结论:新冠感染急性感染后早期有嗅觉障碍的个体在24个月后更有可能出现身体能力下降。本研究强调了嗅觉障碍更广泛的影响,此前主要在老年人群中被提及,表明其在各年龄组中的相关性。新冠疫情为研究这种关系提供了独特的机会,增进了我们对嗅觉障碍与长期身体机能之间关系的理解。这些发现强调需要进行更大规模、更多样化队列的进一步研究以及客观的纵向评估,以证实和扩展这些观察结果。
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