Prevalence of Taste and Smell Dysfunction in Coronavirus Disease 2019
Prevalence of Taste and Smell Dysfunction in Coronavirus Disease 2019
复制标题
DOI：
10.1001/jamaoto.2020.1155
复制
发表时间：
2020-08-01
影响因子：
7.8
通讯作者：
Spriano, Giuseppe
中科院分区：
文献类型：
--
作者：
Mercante, Giuseppe;Ferreli, Fabio;Spriano, Giuseppe
2019年冠状病毒病患者的调查研究调查了疾病发作时是否存在鼻窦表现，以实现早期诊断。问题2019年冠状病毒病的发作是否与鼻窦表现相关？这项对2019年204名冠状病毒病患者的调查研究发现，55. 4%的患者出现味觉减退，而41. 7%的患者出现嗅觉减退。严重的鼻塞是罕见的，在发病（7.8%）。意义研究结果表明，当味觉和嗅觉严重下降而没有鼻塞时，应怀疑患有2019年冠状病毒病。重要性2019年冠状病毒病（COVID-19）的早期诊断可能有助于控制该疾病向人群的扩散。目的探讨新型冠状病毒病（COVID-19，COVID-19）发病时的鼻窦表现，以达到早期诊断的目的。设计、设置和参与者这项回顾性电话调查研究调查了2020年3月5日至3月23日期间确诊为COVID-19的患者，这些患者在单一转诊中心住院或出院。排除无法回答（插管、接受无创通气或死亡）或无法通过电话联系的患者。在359例连续患者中，204例符合入选标准; 76例无法回答，76例无法通过电话联系，3例拒绝。使用经过验证的问卷调查研究了COVID-19诊断前报告的鼻窦表现：意大利鼻窦结局测试22（I-SNOT-22）。如果I-SNOT-22的第5项记录了味觉和/或嗅觉的降低，则进行进一步调查，以在0至5的量表上分别对其进行评分，0表示没有问题，5表示问题非常严重。主要结局和指标COVID-19诊断前鼻窦表现的患病率。结果在入组的204例患者中（110例[53.9%]男性;平均[SD]年龄，52.6 [14.4]岁），中位I-SNOT-22总分为21（范围，0-73）。I-SNOT-22确定了116名患者（56.9%）味觉和/或嗅觉减退，113名（55.4%）味觉减退（中位数评分，5;范围，2-5），85名（41.7%）嗅觉减退（中位数评分，5;范围，1-5）。82例患者（40.2%）报告了这两种情况。81例患者（39.7%）出现味觉重度减退，72例患者（35.3%）出现嗅觉重度减退。只有12例（14.8%）味觉严重减退的患者和12例（16.7%）嗅觉严重减退的患者报告严重鼻塞。味觉和嗅觉严重减退在女性患者中比男性患者更普遍（比值比，3.16 [95% CI，1.76-5.67] vs 2.58 [95% CI，1.43-4.65]），中年患者比年轻患者更普遍（效应量，0.50 [95% CI，0.21-0.78] vs 0.85 [95% CI，0.55-1.15]）。吸烟习惯与味觉（比值比，0.95; 95%CI，0.53-1.71）和/或嗅觉（比值比，0.65; 95%CI，0.35-1.21）严重减退之间未观察到显著相关性。结论和相关性这项电话调查研究的结果表明，味觉和/或嗅觉下降可能是COVID-19的常见和早期症状。在这项研究中，鼻阻塞在疾病发作时并不常见。如果患者出现味觉和/或嗅觉改变，全科医生可能在早期识别潜在的COVID-19方面发挥关键作用，并在确认或排除诊断之前建议隔离。
This survey study of patients with coronavirus disease 2019 investigates the presence of sinonasal manifestations at the onset of the disease to achieve an earlier diagnosis.Question Are there relevant sinonasal manifestations associated with the onset of coronavirus disease 2019? Findings This survey study of 204 patients with coronavirus disease 2019 found that taste reduction was present in 55.4% of patients, whereas smell reduction was present in 41.7% of patients. Severe nasal obstruction was uncommon at the onset of the disease (7.8%). Meaning The findings suggest that coronavirus disease 2019 should be suspected when severe reduction of taste and smell are present in the absence of nasal obstruction.Importance Early diagnosis of coronavirus disease 2019 (COVID-19) may help control the diffusion of the disease into the population. Objective To investigate the presence of sinonasal manifestations at the onset of COVID-19 to achieve an earlier diagnosis. Design, Setting, and Participants This retrospective telephone survey study investigated patients diagnosed with COVID-19 from March 5 to March 23, 2020, who were hospitalized or discharged from a single referral center. Patients who were unable to answer (intubated, receiving noninvasive ventilation, or deceased) or unreachable by telephone were excluded. Of 359 consecutive patients, 204 fulfilled the inclusion criteria; 76 were unable to answer, 76 were unreachable by telephone, and 3 refused. Exposures Sinonasal manifestations reported before COVID-19 diagnosis were studied with a validated questionnaire: Italian Sino-Nasal Outcome Test 22 (I-SNOT-22). If reduction of taste and/or smell was documented by item 5 of the I-SNOT-22, further inquiries were made to score them separately on a scale from 0 to 5, with 0 indicating no problem and 5 indicating problem as bad as it can be. Main Outcomes and Measures The prevalence of sinonasal manifestations preceding COVID-19 diagnosis. Results Among the 204 patients enrolled (110 [53.9%] male; mean [SD] age, 52.6 [14.4] years), the median I-SNOT-22 total score was 21 (range, 0-73). I-SNOT-22 identified 116 patients (56.9%) with reduction of taste and/or smell, 113 (55.4%) with taste reduction (median score, 5; range, 2-5), and 85 (41.7%) with smell reduction (median score, 5; range, 1-5). Eighty-two patients (40.2%) reported both. Severe reduction of taste was present in 81 patients (39.7%), and severe reduction of smell was present in 72 patients (35.3%). Only 12 patients (14.8%) with severe taste reduction and 12 patients (16.7%) with severe smell reduction reported severe nasal obstruction. Severe reduction of taste and smell was more prevalent in female vs male patients (odds ratios, 3.16 [95% CI, 1.76-5.67] vs 2.58 [95% CI, 1.43-4.65]) and middle-aged vs younger patients (effect sizes, 0.50 [95% CI, 0.21-0.78] vs 0.85 [95% CI, 0.55-1.15]). No significant association was observed between smoking habits and severe reduction of taste (odds ratio, 0.95; 95% CI, 0.53-1.71) and/or smell (odds ratio, 0.65; 95% CI, 0.35-1.21). Conclusions and Relevance The findings of this telephone survey study suggest that reduction of taste and/or smell may be a frequent and early symptom of COVID-19. Nasal obstruction was not commonly present at the onset of the disease in this study. The general practitioner may play a pivotal role in identifying potential COVID-19 in patients at an early stage if taste and/or smell alterations manifest and in suggesting quarantine before confirmation or exclusion of the diagnosis.