Details

Autor(en) / Beteiligte

• Chung, Tom Wai-Hin
• Sridhar, Siddharth
• Zhang, Anna Jinxia
• Chan, Kwok-Hung
• Li, Hang-Long
• Wong, Fergus Kai-Chuen
• Ng, Ming-Yen
• Tsang, Raymond King-Yin
• Lee, Andrew Chak-Yiu
• Fan, Zhimeng
• Ho, Ronnie Siu-Lun
• Luk, Shiobhon Yiu
• Kan, Wai-Kuen
• Lam, Sonia Hiu-Yin
• Wu, Alan Ka-Lun
• Leung, Sau-Man
• Chan, Wai-Ming
• Ng, Pauline Yeung
• To, Kelvin Kai-Wang
• Cheng, Vincent Chi-Chung
• Lung, Kwok-Cheung
• Hung, Ivan Fan-Ngai
• Yuen, Kwok-Yung

Titel

Olfactory Dysfunction in Coronavirus Disease 2019 Patients: Observational Cohort Study and Systematic Review

Ist Teil von

• Open forum infectious diseases, 2020-06, Vol.7 (6), p.ofaa199

Ort / Verlag

US: Oxford University Press

Erscheinungsjahr

2020

Quelle

EZB-FREE-00999 freely available EZB journals

Beschreibungen/Notizen

• Abstract Background Olfactory dysfunction (OD) has been reported in coronavirus disease 2019 (COVID-19). However, there are knowledge gaps about the severity, prevalence, etiology, and duration of OD in COVID-19 patients. Methods Olfactory function was assessed in all participants using questionnaires and the butanol threshold test (BTT). Patients with COVID-19 and abnormal olfaction were further evaluated using the smell identification test (SIT), sinus imaging, and nasoendoscopy. Selected patients received nasal biopsies. Systematic review was performed according to PRISMA guidelines. PubMed items from January 1, 2020 to April 23, 2020 were searched. Studies that reported clinical data on olfactory disturbances in COVID-19 patients were analyzed. Results We included 18 COVID-19 patients and 18 controls. Among COVID-19 patients, 12 of 18 (67%) reported olfactory symptoms and OD was confirmed in 6 patients by BTT and SIT. Olfactory dysfunction was the only symptom in 2 patients. Mean BTT score of patients was worse than controls (P = .004, difference in means = 1.8; 95% confidence interval, 0.6–2.9). Sinusitis and olfactory cleft obstruction were absent in most patients. Immunohistochemical analysis of nasal biopsy revealed the presence of infiltrative CD68+ macrophages harboring severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) antigen in the stroma. Olfactory dysfunction persisted in 2 patients despite clinical recovery. Systematic review showed that the prevalence of olfactory disturbances in COVID-19 ranged from 5% to 98%. Most studies did not assess olfaction quantitatively. Conclusions Olfactory dysfunction is common in COVID-19 and may be the only symptom. Coronavirus disease 2019-related OD can be severe and prolonged. Mucosal infiltration by CD68+ macrophages expressing SARS-CoV-2 viral antigen may contribute to COVID-19-related OD. COVID-19-related olfactory dysfunction is common (67%, 12/18 patients). Recovery can be slow (>3 weeks). Sinusitis and olfactory cleft obstruction were absent in most patients. Immunohistochemical analysis of nasal biopsy specimens demonstrated infiltrative CD68+ macrophages expressing SARS-CoV-2 antigen in the stroma.