Abstract：
Olfactory dysfunction (OD) is a common presenting symptom of COVID-19 infection. Radiological imaging of the olfactory structures in patients with COVID-19 and OD can potentially shed light on its pathogenesis, and guide clinicians in prognostication and intervention.
PubMed, Embase, Cochrane, SCOPUS were searched from inception to August 1, 2021. Three reviewers selected observational studies, case series, and case reports reporting radiological changes in the olfactory structures, detected on magnetic resonance imaging, computed tomography, or other imaging modalities, in patients aged ≥18 years with COVID-19 infection and OD, following preferred reporting items for systematic reviews and meta-analyses guidelines and a PROSPERO-registered protocol (CRD42021275211). We described the proportion of radiological outcomes, and used random-effects meta-analyses to pool the prevalence of olfactory cleft opacification, olfactory bulb signal abnormalities, and olfactory mucosa abnormalities in patients with and without COVID-19-associated OD.
We included 7 case-control studies (N = 353), 11 case series (N = 154), and 12 case reports (N = 12). The pooled prevalence of olfactory cleft opacification in patients with COVID-19 infection and OD (63%, 95% CI = 0.38-0.82) was significantly higher than that in controls (4%, 95% CI = 0.01-0.13). Conversely, similar proportions of cases and controls demonstrated olfactory bulb signal abnormalities (88% and 94%) and olfactory mucosa abnormalities (2% and 0%). Descriptive analysis found that 55.6% and 43.5% of patients with COVID-19 infection and OD had morphological abnormalities of the olfactory bulb and olfactory nerve, respectively, while 60.0% had abnormal olfactory bulb volumes.
Our findings implicate a conductive mechanism of OD, localized to the olfactory cleft, in approximately half of the affected COVID-19 patients. Laryngoscope, 132:1260-1274, 2022.
PubMed, Embase, Cochrane, SCOPUS were searched from inception to August 1, 2021. Three reviewers selected observational studies, case series, and case reports reporting radiological changes in the olfactory structures, detected on magnetic resonance imaging, computed tomography, or other imaging modalities, in patients aged ≥18 years with COVID-19 infection and OD, following preferred reporting items for systematic reviews and meta-analyses guidelines and a PROSPERO-registered protocol (CRD42021275211). We described the proportion of radiological outcomes, and used random-effects meta-analyses to pool the prevalence of olfactory cleft opacification, olfactory bulb signal abnormalities, and olfactory mucosa abnormalities in patients with and without COVID-19-associated OD.
We included 7 case-control studies (N = 353), 11 case series (N = 154), and 12 case reports (N = 12). The pooled prevalence of olfactory cleft opacification in patients with COVID-19 infection and OD (63%, 95% CI = 0.38-0.82) was significantly higher than that in controls (4%, 95% CI = 0.01-0.13). Conversely, similar proportions of cases and controls demonstrated olfactory bulb signal abnormalities (88% and 94%) and olfactory mucosa abnormalities (2% and 0%). Descriptive analysis found that 55.6% and 43.5% of patients with COVID-19 infection and OD had morphological abnormalities of the olfactory bulb and olfactory nerve, respectively, while 60.0% had abnormal olfactory bulb volumes.
Our findings implicate a conductive mechanism of OD, localized to the olfactory cleft, in approximately half of the affected COVID-19 patients. Laryngoscope, 132:1260-1274, 2022.
摘要：
嗅觉功能障碍（OD）是COVID-19感染的常见症状。COVID-19和OD患者嗅觉结构的放射学成像可能有助于阐明其发病机制，并指导临床医生的预后和干预。
PubMed,Embase,科克伦,SCOPUS从成立到2021年8月1日进行了搜索。三名审稿人选择了观察性研究，案例系列,和报告嗅觉结构放射学变化的病例报告，在磁共振成像上检测到，计算机断层扫描,或其他成像模式，年龄≥18岁的COVID-19感染和OD患者，遵循系统评价和荟萃分析指南的首选报告项目以及PROSPERO注册方案（CRD42021275211）。我们描述了放射学结果的比例，并使用随机效应荟萃分析来汇集嗅裂混浊的患病率，嗅球信号异常,有和没有COVID-19相关OD的患者的嗅觉粘膜异常。
我们纳入了7项病例对照研究(N=353)，11个案例系列(N=154)，和12例病例报告（N=12）。COVID-19感染和OD患者嗅裂混浊的合并患病率(63%，95%CI=0.38-0.82)显著高于对照组(4%,95%CI=0.01-0.13)。相反，相似比例的病例和对照显示嗅球信号异常(88%和94%)和嗅粘膜异常(2%和0%).描述性分析发现,55.6%和43.5%的COVID-19感染和OD患者存在嗅球和嗅神经形态异常,分别,而60.0%的嗅球体积异常。
我们的发现暗示了OD的传导机制，局限于嗅觉裂缝，大约一半的受影响的COVID-19患者。喉镜,132:1260-1274,2022。
PubMed,Embase,科克伦,SCOPUS从成立到2021年8月1日进行了搜索。三名审稿人选择了观察性研究，案例系列,和报告嗅觉结构放射学变化的病例报告，在磁共振成像上检测到，计算机断层扫描,或其他成像模式，年龄≥18岁的COVID-19感染和OD患者，遵循系统评价和荟萃分析指南的首选报告项目以及PROSPERO注册方案（CRD42021275211）。我们描述了放射学结果的比例，并使用随机效应荟萃分析来汇集嗅裂混浊的患病率，嗅球信号异常,有和没有COVID-19相关OD的患者的嗅觉粘膜异常。
我们纳入了7项病例对照研究(N=353)，11个案例系列(N=154)，和12例病例报告（N=12）。COVID-19感染和OD患者嗅裂混浊的合并患病率(63%，95%CI=0.38-0.82)显著高于对照组(4%,95%CI=0.01-0.13)。相反，相似比例的病例和对照显示嗅球信号异常(88%和94%)和嗅粘膜异常(2%和0%).描述性分析发现,55.6%和43.5%的COVID-19感染和OD患者存在嗅球和嗅神经形态异常,分别,而60.0%的嗅球体积异常。
我们的发现暗示了OD的传导机制，局限于嗅觉裂缝，大约一半的受影响的COVID-19患者。喉镜,132:1260-1274,2022。
