Predictive Value of Sudden Olfactory Loss in the Diagnosis of COVID-19
Predictive Value of Sudden Olfactory Loss in the Diagnosis of COVID-19
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DOI：
10.1159/000509143
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发表时间：
2020-07-01
影响因子：
1.3
通讯作者：
Hummel, Thomas
中科院分区：
文献类型：
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作者：
Haehner, Antje;Draf, Julia;Hummel, Thomas
前言：最近的报道表明，突然的气味丧失可能是SARS-CoV-2感染的症状之一。本研究的目的是调查在两周内到冠状病毒检测中心就诊的门诊人群中嗅觉丧失的频率，并评价症状“突然气味丧失”在筛查过程中的诊断价值。方法：在这项横断面对照队列研究中，500名有普通感冒症状到冠状病毒检测中心且符合冠状病毒检测标准的患者完成了标准化诊断问卷，其中包括患者的主要症状、时间进程，以及对患者当前的气味、味觉功能和鼻呼吸与症状出现前水平的额外自我评估。结果：在500名患者中，69例出现嗅觉丧失。其中二十二人其后对SARS-CoV-2测试呈阳性反应。在无嗅觉丧失的患者中，仅有12例呈阳性反应，导致新冠肺炎患者中出现嗅觉突然丧失症状的频率为64.7%。与没有嗅觉丧失的新冠肺炎患者相比，他们明显更年轻，受影响也更轻。与SARS-CoV-2检测呈阳性的嗅觉丧失患者相比，有嗅觉主诉的SARS-CoV-2阴性患者鼻腔气流的变化明显更明显。排除鼻塞患者后，“突然嗅觉丧失”症状的特异性(97%)和敏感性(65%)较高，对COVID-19的阳性预测值和阴性预测值分别为63%和97%。结论：考虑到非住院新冠肺炎患者嗅觉丧失的频率较高，应将急性嗅觉障碍列为疾病的早期症状，并定期进行检测。与其他急性病毒性嗅觉障碍相比，新冠肺炎相关的嗅觉丧失似乎很少伴随严重的鼻塞。
Introduction:Recent reports suggest that sudden smell loss might be a symptom of SARS-CoV-2 infection. The aim of this study was to investigate the frequency of olfactory loss in an outpatient population who presented to a coronavirus testing center during a 2-week period and to evaluate the diagnostic value of the symptom "sudden smell loss" for screening procedures.Methods:In this cross-sectional controlled cohort study, 500 patients who presented with symptoms of a common cold to a corona testing center and fulfilled corona testing criteria completed a standardized diagnostic questionnaire which included the patients' main symptoms, time course, and an additional self-assessment of the patients' current smell, taste function, and nasal breathing compared to the level before the onset of symptoms.Results:Out of the 500 patients, 69 presented with olfactory loss. Twenty-two of them subsequently tested positive for SARS-CoV-2. Only 12 out of the patients without olfactory loss tested positive, resulting in a frequency of 64.7% for the symptom "sudden smell loss" in COVID-19 patients. Compared to COVID-19 patients without smell loss, they were significantly younger and less severely affected. Changes in nasal airflow were significantly more pronounced in SARS-CoV-2 negative patients with olfactory complaints compared to the patients with smell loss who tested positive for SARS-CoV-2. By excluding patients with a blocked nose, the symptom "sudden smell loss" can be attested a high specificity (97%) and a sensitivity of 65% with a positive predictive value of 63% and negative predictive value of 97% for COVID-19.Conclusion:Considering the high frequency of smell loss in non-hospitalized COVID-19 patients, acute olfactory impairment should be recognized as an early symptom of the disease and should be tested for on a regular basis. In contrast to other acute viral smell impairment, COVID-19-associated smell loss seems to be only rarely accompanied by a severely blocked nose.