SARS-CoV-2感染嗅觉丧失的临床病程及诊断相关性

M. Bauwens, S. Claeys
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摘要

背景:急性发作的嗅觉和/或味觉功能障碍是COVID-19大流行期间常见的主诉。在感染的早期阶段,主要由无症状至轻度疾病严重程度的受试者报告。嗅觉缺失/嗅觉障碍和/或听觉障碍/嗅觉障碍的高流行率与SARSCoV-2感染有很强的相关性,因此这些症状可被视为重要的前驱症状。本研究的目的是概述(疑似)COVID-19病例嗅觉和/或味觉障碍的发生、流行病学和临床病程,并分析这些神经感觉功能障碍的诊断意义。方法:对500名在2019冠状病毒病大流行期间新发嗅觉和/或味觉障碍的参与者进行在线问卷调查。结果:急性嗅觉和味觉丧失分别为487例(97.4%)和464例(92.8%)。据报道,女性和更年轻的人患神经感觉疾病的比例明显更高。最常见的并发症状是疲劳、头痛、鼻塞、干咳、流涕和打喷嚏。8周后,嗅觉损伤患者恢复41.9%,味觉损伤患者恢复53.7%。93例受试者中,82例(88.2%)SARSCoV-2阳性。结论:嗅觉和/或味觉障碍是新冠肺炎大流行期间常见的临床表现。孤立的或与其他轻微症状相关的神经感觉障碍需要作为SARS-CoV-2感染的潜在症状加以处理,并应作为临床标志加以实施。
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The clinical course and diagnostic relevance of olfactory loss in a SARS-CoV-2 infection
Background: The acute onset of olfactory and/or gustatory dysfunction is a frequent complaint during the COVID-19 pandemic. It is predominantly reported by subjects with asymptomatic to mild disease severity during the early stage of the infection. The high prevalence of anosmia/dysosmia and/or ageusia/dysgeusia in this current era implements a strong correlation with a SARSCoV-2 infection and these symptoms could therefore be seen as important prodromes. The purpose of this study was to outline the occurrence, epidemiology and clinical course of olfactory and/or gustatory disorders in (suspected) COVID-19 cases and to analyse the diagnostic significance of these neurosensory dysfunctions. Methods: An online questionnaire was carried out which addressed 500 participants with new onset olfactory and/or gustatory impairment during the COVID-19 pandemic. Results: Acute olfactory and gustatory loss was reported by 487 (97.4%) and 464 (92.8%), respectively. A significant higher prevalence of neurosensory complaints was reported by women and people of younger age. The most prevalent concurrent symptoms were fatigue, headaches, nasal congestion, dry cough, rhinorrhoea and sneezing. The recovery rate after 8 weeks was 41.9% for olfactory impairment and 53.7% for gustatory impairment. Among the 93 subjects tested, 82 (88.2%) tested positive for SARSCoV-2. Conclusion: Olfactory and/or gustatory disorders are prevalent clinical findings during the COVID-19 pandemic. Neurosensory impairments, isolated or in association with other mild complaints, need to be addressed as potential symptoms of a SARS-CoV-2 infection and should be implemented as clinical markers.
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