Self-reported olfactory loss associates with outpatient clinical course in COVID-19
Self-reported olfactory loss associates with outpatient clinical course in COVID-19
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DOI：
10.1002/alr.22592
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发表时间：
2020-06-07
影响因子：
6.4
通讯作者：
DeConde, Adam S.
中科院分区：
文献类型：
--
作者：
Yan, Carol H.;Faraji, Farhoud;DeConde, Adam S.
背景严重急性呼吸综合征-冠状病毒2(SARS-CoV-2)病毒的快速传播使世界各地的许多卫生系统不堪重负，迫使稀缺的医疗资源分流。在病程早期确定2019年冠状病毒病(新冠肺炎)患者入院指标有助于有效分配医疗干预措施。自我报告的嗅觉障碍最近被认为是新冠肺炎的一个特征，并可能是临床转归的重要预测指标。方法回顾所有到圣地亚哥医院系统就诊的经实验室确认为新冠肺炎阳性的患者，评估嗅觉和味觉功能以及临床病程。结果2020年3月3日至4月8日，共检出新冠肺炎阳性患者169例。169名受试者中128人(75.7%)获得嗅觉和味觉数据，其中26人(20.1%)需要住院治疗。入院接受新冠肺炎治疗与嗅觉和味觉完整、年龄增加、糖尿病以及与呼吸衰竭相关的主观和客观参数有关。经校正分析，嗅觉障碍与门诊治疗显著相关(调整后优势比0.0 9；95%CI，0.0 1~0.74)，而胸片肺浸润性和/或胸腔积液阳性发现与入院密切相关(调整后优势比8.01；95%CI 1.12~5 7.49)。结论低体温是新冠肺炎患者入院的独立预测因素。新冠肺炎中的嗅觉丧失可能与较温和的临床病程有关。
Background Rapid spread of the severe acute respiratory syndrome-coronavirus-2 (SARS-CoV-2) virus has left many health systems around the world overwhelmed, forcing triaging of scarce medical resources. Identifying indicators of hospital admission for coronavirus disease 2019 (COVID-19) patients early in the disease course could aid the efficient allocation of medical interventions. Self-reported olfactory impairment has recently been recognized as a hallmark of COVID-19 and may be an important predictor of clinical outcome.Methods A retrospective review of all patients presenting to a San Diego Hospital system with laboratory-confirmed positive COVID-19 infection was conducted with evaluation of olfactory and gustatory function and clinical disease course. Univariable and multivariable logistic regression were performed to identify risk factors for hospital admission and anosmia.Results A total of 169 patients tested positive for COVID-19 disease between March 3 and April 8, 2020. Olfactory and gustatory data were obtained for 128 (75.7%) of 169 subjects, of which 26 (20.1%) of 128 required hospitalization. Admission for COVID-19 was associated with intact sense of smell and taste, increased age, diabetes, and subjective and objective parameters associated with respiratory failure. On adjusted analysis, anosmia was strongly and independently associated with outpatient care (adjusted odds ratio [aOR] 0.09; 95% CI, 0.01-0.74), whereas positive findings of pulmonary infiltrates and/or pleural effusion on chest radiograph (aOR 8.01; 95% CI, 1.12-57.49) was strongly and independently associated with admission.Conclusion Normosmia is an independent predictor of admission in COVID-19 cases. Smell loss in COVID-19 may be associated with a milder clinical course.