Tracking Smell Loss to Identify Healthcare Workers with SARS-CoV-2 Infection.
Tracking Smell Loss to Identify Healthcare Workers with SARS-CoV-2 Infection.
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追踪嗅觉丧失以识别感染 SARS-CoV-2 的医护人员。
DOI：
10.1101/2020.09.07.20188813
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发表时间：
2020
期刊：
影响因子：
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通讯作者：
Iw
中科院分区：
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作者：
Weiss,JulianJ;Attuquayefio,TukiN;White,ElizabethB;Li,Fangyong;Herz,RachelS;White,TheresaL;Campbell,Melissa;Geng,Bertie;Datta,Rupak;Wyllie,AnneL;Grubaugh,NathanD;Casanovas-Massana,Arnau;Muenker,MCatherine;Handoko,Ryan;Iw
治疗COVID-19患者的医护人员（HCW）感染风险很高，也可能通过与脆弱患者接触传播感染。嗅觉丧失与SARS-CoV-2感染有关，但尚不清楚嗅觉丧失监测是否可用于识别高风险个体中的无症状感染。在这项研究中，我们试图确定是否跟踪嗅觉敏感性和损失，使用在家里的评估可以识别SARS-CoV-2感染HCW.Methods和findingsWe进行了一项前瞻性队列研究，跟踪473 HCW在三个月内，以确定嗅觉损失是否可以预测SARS-CoV-2感染在这个高风险组。HCW受试者完成了对家庭物品嗅觉的纵向行为在家评估，以及详细的症状调查，包括嗅觉异常筛查问卷和实时定量聚合酶链反应检测，以确定SARS-CoV-2感染。我们的主要指标是SARS-CoV-2阳性HCW与SARS-CoV-2阴性HCW的嗅觉丧失的患病率，以及嗅觉丧失相对于SARS-CoV-2检测阳性的时间。在473例HCW中，17例（3.6%）检出SARS-CoV-2。在家庭评估和筛查问卷中，SARS-CoV-2感染HCW比SARS-CoV-2阴性HCW更容易报告嗅觉丧失（9/17，53%vs105/456，23%，P <0.01）。6/9（67%）报告嗅觉丧失的SARS-CoV-2阳性HCW在SARS-CoV-2检测呈阳性之前报告了嗅觉丧失，并且在检测呈阳性前两天报告了嗅觉丧失的中位数。SARS-CoV-2阳性HCW中嗅觉丧失者的神经症状发生率高于无嗅觉丧失者（9/9，100%vs 38，38%，P <0.01）。嗅觉丧失通常发生在阳性检测之前，并且与神经系统症状有关。
IntroductionHealthcare workers (HCW) treating COVID-19 patients are at high risk for infection and may also spread infection through their contact with vulnerable patients. Smell loss has been associated with SARS-CoV-2 infection, but it is unknown whether monitoring for smell loss can be used to identify asymptomatic infection among high risk individuals. In this study we sought to determine if tracking smell sensitivity and loss using an at-home assessment could identify SARS-CoV-2 infection in HCW.Methods and findingsWe performed a prospective cohort study tracking 473 HCW across three months to determine if smell loss could predict SARS-CoV-2 infection in this high-risk group. HCW subjects completed a longitudinal, behavioral at-home assessment of olfaction with household items, as well as detailed symptom surveys that included a parosmia screening questionnaire, and real-time quantitative polymerase chain reaction testing to identify SARS-CoV-2 infection. Our main measures were the prevalence of smell loss in SARS-CoV-2-positive HCW versus SARS-CoV-2-negative HCW, and timing of smell loss relative to SARS-CoV-2 test positivity. SARS-CoV-2 was identified in 17 (3.6%) of 473 HCW. HCW with SARS-CoV-2 infection were more likely to report smell loss than SARS-CoV-2-negative HCW on both the at-home assessment and the screening questionnaire (9/17, 53% vs 105/456, 23%,P< .01). 6/9 (67%) of SARS-CoV-2-positive HCW reporting smell loss reported smell loss prior to having a positive SARS-CoV-2 test, and smell loss was reported a median of two days before testing positive. Neurological symptoms were reported more frequently among SARS-CoV-2-positive HCW who reported smell loss compared to those without smell loss (9/9, 100% vs 3/8, 38%,P< .01).ConclusionsIn this prospective study of HCW, self-reported changes in smell using two different measures were predictive of SARS-CoV-2 infection. Smell loss frequently preceded a positive test and was associated with neurological symptoms.