感染 COVID-19 后的恢复率和长期嗅觉功能障碍

Melanie Dias, Z. Shaida, N. Haloob, Claire Hopkins
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引用次数: 0

摘要

嗅觉功能障碍是 COVID-19 最公认的症状之一,严重影响生活质量,尤其是在恢复期较长的病例中。本综述旨在探讨感染 COVID-19 后嗅觉恢复的模式,尤其关注延迟恢复的情况。作者在嗅觉领域资深专家的指导下对文献进行了全面综述。然而,心理物理测试发现持续性嗅觉功能障碍的比例更高。研究发现,患者在感染后至少两年内仍可恢复嗅觉功能;预后不良的指标包括急性期嗅觉功能严重减退、女性和高龄。长期病例在数量和质量上的紊乱差异可能反映了外周和中枢的病理生理机制。许多综述研究的局限性在于缺乏心理物理测试和基线嗅觉评估。新出现的证据提高了临床医生的认识和知识水平,从而更好地支持患者进行嗅觉康复,并有望在数月或数年后恢复。为了更好地了解延迟康复的潜在发病机制、在病程早期识别高危人群并开发治疗目标,还需要开展进一步的研究。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Recovery rates and long‐term olfactory dysfunction following COVID‐19 infection
Olfactory dysfunction is one of the most recognized symptoms of COVID‐19, significantly impacting quality of life, particularly in cases where recovery is prolonged. This review aims to explore patterns of olfactory recovery post‐COVID‐19 infection, with particular focus on delayed recovery.Published literature in the English language, including senior author's own work, online and social media platforms, and patients' anecdotal reports.A comprehensive review of the literature was undertaken by the authors with guidance from the senior author with expertise in the field of olfaction.Based on self‐report, an estimated 95% of patients recover their olfactory function within 6 months post‐COVID‐19 infection. However, psychophysical testing detects higher rates of persistent olfactory dysfunction. Recovery has been found to continue for at least 2 years postinfection; negative prognostic indicators include severe olfactory loss in the acute phase, female sex, and older age. Variability in quantitative and qualitative disturbance in prolonged cases likely reflects both peripheral and central pathophysiological mechanisms. Limitations of many of the reviewed studies reflect lack of psychophysical testing and baseline olfactory assessment.Post‐COVID‐19 olfactory dysfunction remains a significant health and psychosocial burden. Emerging evidence is improving awareness and knowledge among clinicians to better support patients through their olfactory rehabilitation, with hope of recovery after several months or years. Further research is needed to better understand the underlying pathogenesis of delayed recovery, identify at risk individuals earlier in the disease course, and develop therapeutic targets.
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