新型冠状病毒Omicron株感染后嗅觉和味觉障碍的发病率和预后:35566份中国多中心大规模调查数据分析  

Incidence and prognosis of olfactory and gustatory dysfunctions related to infection of SARS-CoV-2 Omicron strain:a national multi-center survey of 35566 population

作　　者：刘梦帆 马瑞霞 曹现宝 张华[5] 周水洪[6] 蒋卫红[7] 姜彦[8] 孙敬武 杨钦泰[10] 李学忠[11] 孙亚男[12] 史丽[13] 王旻[14] 宋西成[15] 陈福权 张晓曙[17] 魏宏权[18] 余少卿[19] 朱冬冬[20] 巴罗[21] 曹志伟[22] 肖旭平[23] 魏欣[24] 林志宏[25] 陈枫虹[26] 单春光[27] 王广科[28] 叶菁[29] 瞿申红[30] 赵长青[31] 王振霖[32] 李华斌 刘锋[34] 崔晓波[35] 叶胜难[36] 刘争[37] 许昱[38] 蔡晓[39] 杭伟[40] 章如新 赵玉林[42] 喻国冻 时光刚[44] 陆美萍[45] 沈暘[46] 赵玉桐 裴嘉红[4] 谢邵兵[7] 于龙刚[8] 刘业海[47] 谷少尉[11] 杨玉成[46] 程雷[45] 刘剑锋[2] Liu Mengfan;Ma Ruixia;Cao Xianbao;Zhang Hua;Zhou Shuihong;Jiang Weihong;Jiang Yan;Sun Jingwu;Yang Qintai;Li Xuezhong;Sun Yanan;Shi Li;Wang Min;Song Xicheng;Chen Fuquan;Zhang Xiaoshu;Wei Hongquan;Yu Shaoqing;Zhu Dongdong;Ba Luo;Cao Zhiwei;Xiao Xuping;Wei Xin;Lin Zhihong;Chen Fenghong;Shan Chunguang;Wang Guangke;Ye Jing;Qu Shenhong;Zhao Changqing;Wang Zhenlin;Li Huabin;Liu Feng;Cui Xiaobo;Ye Shengnan;Liu Zheng;Xu Yu;Cai Xiao;Hang Wei;Zhang Ruxin;Zhao Yulin;Yu Guodong;Shi Guanggang;Lu Meiping;Shen Yang;Zhao Yutong;Pei Jiahong;Xie Shaobing;Yu Longgang;Liu Yehai;Gu Shaowei;Yang Yucheng;Cheng Lei;Liu Jianfeng(Graduate School of Bejing University of Chinese Medicine,Beijing 100029,China;Department of Otorhinolaryngology Head and Neck Surgery,China-Japan Friendship Hospital,Beijing 100029,China;Department of Otorhinolaryngology Head and Neck Surgery,the First People's Hospital of Yinchuan,Yinchuan 750001,China;Department of Otorhinolaryngology,the First People's Hospital of Yunnan Province,Kunming 650100,China;Department of Otorhinolaryngology Head and Neck Surgery,the First Affiliated Hospital of Xinjiang Medical University,Urumqi 830054,China;Department of Otorhinolaryngology Head and Neck Surgery,the First Affiliated Hospital of Zhejiang University School of Medicine,Hangzhou 310003,China;Department of Otorhinolaryngology Head and Neck Surgery,Xiangya Hospital Central South University,Changsha 410008,China;Department of Otorhinolaryngology Head and Neck Surgery,the Affiliated Hospital of Qingdao University,Qingdao 266000,China;Department of Otorhinolaryngology Head and Neck Surgery,the First Afiliated Hospital of USTC,Hefei 230001,China;Department of Otorhinolaryngology Head and Neck Surgery,the Third Affiliated Hospital of Sun Yat-sen University,Guangzhou 510630,China;Department of Otorhinolaryngology Head and Neck Surgery,Qilu Hospital of Shandong University,Jinan 250012,China;Department of Otorhinolaryngology Head and Neck Surgery,the Second Affiliated Hospital of Harbin Medical University,Harbin 150001,China;Depar

机构地区：[1]北京中医药大学研究生院,北京100029 [2]中日友好医院耳鼻咽喉头颈外科,北京100029 [3]宁夏银川市第一人民医院耳鼻咽喉头颈外科,银川750001 [4]云南省第一人民医院耳鼻咽喉科,昆明650100 [5]新疆医科大学第一附属医院耳鼻咽喉头颈外科,乌鲁木齐830054 [6]浙江大学医学院附属第一医院耳鼻咽喉头颈外科,杭州310003 [7]中南大学湘雅医院耳鼻咽喉头颈外科,长沙410008 [8]青岛大学附属医院耳鼻咽喉头颈外科,青岛266000 [9]中国科学技术大学附属第一医院(安徽省立医院)耳鼻咽喉头颈外科,合肥230001 [10]中山大学附属第三医院耳鼻咽喉头颈外科,广州510630 [11]山东大学齐鲁医院耳鼻咽喉头颈外科,济南250012 [12]哈尔滨医科大学第二附属医院耳鼻咽喉头颈外科,哈尔滨150001 [13]山东大学山东省耳鼻喉医院鼻科,济南250299 [14]北京大学人民医院耳鼻咽喉头颈外科,北京100032 [15]青岛大学附属烟台毓璜顶医院耳鼻咽喉头颈外科,烟台264000 [16]空军军医大学附属西京医院耳鼻咽喉头颈外科,西安710032 [17]甘肃省疾病预防控制中心,兰州730000 [18]中国医科大学附属第一医院耳鼻咽喉头颈外科,沈阳110001 [19]同济大学附属同济医院耳鼻咽喉头颈外科,上海200065 [20]吉林大学中日联谊医院耳鼻咽喉头颈外科,长春130033 [21]西藏自治区人民医院耳鼻咽喉头颈外科,拉萨850000 [22]中国医科大学附属盛京医院耳鼻咽喉头颈外科,沈阳110004 [23]湖南省人民医院耳鼻咽喉头颈外科,长沙410005 [24]海南省人民医院耳鼻咽喉头颈外科,海口570311 [25]浙江大学医学院附属第二医院耳鼻咽喉头颈外科,杭州310009 [26]中山大学附属第一医院耳鼻咽喉头颈外科医院,广州510080 [27]河北医科大学第二附属医院耳鼻咽喉头颈外科,石家庄050000 [28]河南省人民医院耳鼻咽喉头颈外科,郑州450003 [29]南昌大学第一附属医院耳鼻咽喉头颈�

出　　处：《中华耳鼻咽喉头颈外科杂志》2023年第6期579-588,共10页Chinese Journal of Otorhinolaryngology Head and Neck Surgery

基　　金：北京市自然科学基金面上项目(7212090);中央高水平医院临床科研业务项目(2022-NHLHCRF-YGJE-02)。

摘　　要：目的:明确新型冠状病毒Omicron株感染后嗅觉和味觉障碍发病率、发病特征、预后以及相关影响因素。方法:本研究为中国45家三级甲等医院及1家疾病预防控制中心参与的横断面研究。研究通过线上和线下问卷调查的方式收集2022年12月28日至2023年2月21日共8周时间新型冠状病毒感染患者的资料,包括基本信息、既往健康状况、吸烟饮酒史、疫苗接种史、感染前后的嗅觉和味觉功能、感染后的其他症状以及嗅觉味觉障碍的持续时间和改善情况等。采用视觉模拟量表(VAS)评估患者自报的嗅觉味觉功能。采用χ^(2)检验、Losgistic回归等对数据进行分析。结果:①获得35566份有效调查问卷,新型冠状病毒Omicron株感染后嗅觉味觉障碍的发病率为67.75%(24096例);其中女性为47.70%(16966例),高于男性的20.05%(7130例),差异有统计学意义(χ^(2)=367.013,P<0.001);18~40岁年龄组较其他年龄组更容易出现嗅觉味觉障碍(χ^(2)=120.210,P<0.001)。②性别(OR=1.564,95%CI为1.487~1.645)、新型冠状病毒疫苗接种情况(OR=0.601,95%CI为0.517~0.698)、口腔健康状况(OR=0.881,95%CI为0.839~0.926)、吸烟史(OR=1.152,95%CI为1.080~1.229)、饮酒史(OR=0.854,95%CI为0.785~0.928)与新型冠状病毒感染后嗅觉味觉障碍的发生相关(P值均<0.001)。③尚未恢复嗅觉味觉功能的患者中44.62%(4391/9840)伴鼻塞、流涕,32.62%(3210/9840)伴口干、咽痛。嗅觉味觉功能的改善情况与伴随症状的持续与否有相关性(χ^(2)=10.873,P=0.001)。④新型冠状病毒感染前嗅觉味觉VAS分别为8.41、8.51分,感染后分别降至3.69、4.29分,截至调查时可恢复至5.83、6.55分。嗅觉障碍持续的中位时间为15 d,味觉障碍持续的中位时间为12 d。0.50%(121/24096)的患者嗅觉味觉障碍持续时间超过28 d。⑤嗅觉、味觉障碍总体的自报改善率为59.16%(14256/24096)。性别(OR=0.893,95%CI为0.839~0.951)、新型冠状病毒疫苗接种情况(ORObjective This cross-sectional investigation aimed to determine the incidence,clinical characteristics,prognosis,and related risk factors of olfactory and gustatory dysfunctions related to infection with the SARS-CoV-2 Omicron strain in China's Mainland.Methods Data of patients with SARS-CoV-2 from December 28,2022,to February 21,2023,were collected through online and offline questionnaires from 45 tertiary hospitals and one center for disease control and prevention in China's Mainland.The questionnaire included demographic information,previous health history,smoking and alcohol drinking,SARS-CoV-2 vaccination,olfactory and gustatory function before and after infection,other symptoms after infection,as well as the duration and improvement of olfactory and gustatory dysfunction.The self-reported olfactory and gustatory functions of patients were evaluated using the Olfactory VAS scale and Gustatory VAS scale.Results A total of 35566 valid questionnaires were obtained,revealing a high incidence of olfactory and taste dysfunctions related to infection with the SARS-CoV-2 Omicron strain(67.75%).Females(χ^(2)=367.013,P<0.001)and young people(χ^(2)=120.210,P<0.001)were more likely to develop these dysfunctions.Gender(OR=1.564,95%CI:1.487-1.645),SARS-CoV-2 vaccination status(OR=1.334,95%CI:1.164-1.530),oral health status(OR=0.881,95%CI:0.839-0.926),smoking history(OR=1.152,95%CI=1.080-1.229),and drinking history(OR=0.854,95%CI:0.785-0.928)were correlated with the occurrence of olfactory and taste dysfunctions related to SARS-CoV-2(above P<0.001).44.62%(4391/9840)of the patients who had not recovered their sense of smell and taste also suffered from nasal congestion,runny nose,and 32.62%(3210/9840)suffered from dry mouth and sore throat.The improvement of olfactory and taste functions was correlated with the persistence of accompanying symptoms(χ^(2)=10.873,P=0.001).The average score of olfactory and taste VAS scale was 8.41 and 8.51 respectively before SARS-CoV-2 infection,but decreased to3.69 and 4.29 respectively a

关 键 词：嗅觉障碍 味觉障碍 流行病学研究 严重急性呼吸综合征冠状病毒2 发病率 预后 

分 类 号：R563.1[医药卫生—呼吸系统]