Transient loss and recovery of oral chemesthesis, taste and smell with COVID-19: a small case-control series.
Transient loss and recovery of oral chemesthesis, taste and smell with COVID-19: a small case-control series.
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COVID-19 导致口腔化学感觉、味觉和嗅觉的短暂丧失和恢复：一个小型病例对照系列。
DOI：
10.1101/2023.03.27.23287763
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发表时间：
2023
期刊：
影响因子：
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通讯作者：
Hayes,JohnE
中科院分区：
文献类型：
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作者：
Weir,ElisabethM;Exten,Cara;Gerkin,RichardC;Munger,StevenD;Hayes,JohnE
短暂的嗅觉丧失是流感和其他上呼吸道感染的常见症状。味觉丧失是可能的，但在这些疾病中很少见，患者报告的“味觉丧失”通常是由于味觉/风味混淆引起的。因此，COVID-19 患者味觉和化学感觉丧失（即化学体感，如变暖或变冷）的最初报告遭到了怀疑，直到多项研究证实 SARS-CoV-2 感染可能会破坏这些感觉。许多研究都是基于自我报告或急性疾病结束后的单一时间点评估。在这里，我们描述了 2021 年初（即 Delta 和 Omicron SARS-CoV-2 浪潮之前）招募的 18-45 岁成年人在 28 天内的密集纵向数据。 2021 年上半年，这些人要么是 COVID-19 阳性，要么是密切接触者（根据研究时的美国 CDC 标准）。入组后，所有参与者都获得了鼻夹、商业软心豆粒糖（酸樱桃和肉桂）的盲样样本以及刮擦嗅气味识别测试卡 (ScentCheckPro)，用于日常评估。在感染第 10 天或之前入组的 COVID-19 病例中，高斯过程回归显示两种不同的功能指标（气味识别和气味强度）相对于对照（从未患过 COVID-19 的暴露个体）有所下降。由于招募是在暴露后开始的，一些参与者仅在招募后才生病，这使我们能够捕获基线评级、损失发生和恢复情况。将这 4 个病例和 4 个年龄和性别匹配的对照的数据在 28 天内绘制成面板图。变量包括四种气味的平均鼻嗅强度 (ScentCheckPro)、感知到的鼻塞、口腔灼烧感（肉桂软心豆粒糖）以及酸味和甜味（酸樱桃软心豆粒糖）。随着时间的推移，对照表现出稳定的评级。相比之下，随着时间的推移，COVID-19 病例表现出明显的偏差。气味强度或气味识别的变化不能用鼻塞来解释。没有明显的味道损失或恢复的单一模式，这意味着不同的味道质量可能以不同的速度恢复。一些人的口腔烧伤在迅速恢复之前暂时减少，这表明仅在疾病结束后收集的数据集中可能会遗漏急性损失。总体而言，密集的日常测试表明，急性 SARS-CoV-2 感染会改变口鼻嗅觉、口腔化学感觉和味觉。对于不同的模式来说，这种破坏是不同步的，不同模式和个人的损失率和恢复率各不相同。
Transient loss of smell is a common symptom of influenza and other upper respiratory infections. Loss of taste is possible but rare with these illnesses, and patient reports of ‘taste loss’ typically arise from a taste / flavor confusion. Thus, initial reports from COVID-19 patients of loss of taste and chemesthesis (i.e., chemical somatosensation like warming or cooling) were met with skepticism until multiple studies confirmed SARS-CoV-2 infections could disrupt these senses. Many studies have been based on self-report or on single time point assessments after acute illness was ended. Here, we describe intensive longitudinal data over 28 days from adults aged 18–45 years recruited in early 2021 (i.e., prior to the Delta and Omicron SARS-CoV-2 waves). These individuals were either COVID-19 positive or close contacts (per U.S. CDC criteria at the time of the study) in the first half of 2021. Upon enrollment, all participants were given nose clips, blinded samples of commercial jellybeans (Sour Cherry and Cinnamon), and scratch-n-sniff odor identification test cards (ScentCheckPro), which they used for daily assessments. In COVID-19 cases who enrolled on or before Day 10 of infection, Gaussian Process Regression showed two distinct measures of function – odor identification and odor intensity – declined relative to controls (exposed individuals who never developed COVID-19). Because enrollment began upon exposure, some participants became ill only after enrollment, which allowed us to capture baseline ratings, onset of loss, and recovery. Data from these four cases and four age- and sex- matched controls were plotted over 28 days to create panel plots. Variables included mean orthonasal intensity of four odors (ScentCheckPro), perceived nasal blockage, oral burn (Cinnamon jellybeans), and sourness and sweetness (Sour Cherry jellybeans). Controls exhibited stable ratings over time. By contrast, COVID-19 cases showed sharp deviations over time. Changes in odor intensity or odor identification were not explained by nasal blockage. No single pattern of taste loss or recovery was apparent, implying different taste qualities might recover at different rates. Oral burn was transiently reduced for some before recovering quickly, suggesting acute loss may be missed in datasets collected only after illness ends. Collectively, intensive daily testing shows orthonasal smell, oral chemesthesis and taste were each altered by acute SARS-CoV-2 infection. This disruption was dyssynchronous for different modalities, with variable loss and recovery rates across both modalities and individuals.