PDF(Pubmed)
Abstract：
Transient loss of smell is a common symptom of influenza and other upper respiratory infections. Loss of taste is possible but rare with these illnesses, and patient reports of \'taste loss\' typically arise from a taste / flavor confusion. Thus, initial reports from COVID-19 patients of loss of taste and chemesthesis (i.e., chemical somatosensation like warming or cooling) were met with skepticism until multiple studies confirmed SARS-CoV-2 infections could disrupt these senses. Many studies have been based on self-report or on single time point assessments after acute illness was ended. Here, we describe intensive longitudinal data over 28 days from adults aged 18-45 years recruited in early 2021 (i.e., prior to the Delta and Omicron SARS-CoV-2 waves). These individuals were either COVID-19 positive or close contacts (per U.S. CDC criteria at the time of the study) in the first half of 2021. Upon enrollment, all participants were given nose clips, blinded samples of commercial jellybeans (Sour Cherry and Cinnamon), and scratch-n-sniff odor identification test cards (ScentCheckPro), which they used for daily assessments. In COVID-19 cases who enrolled on or before Day 10 of infection, Gaussian Process Regression showed two distinct measures of function - odor identification and odor intensity - declined relative to controls (exposed individuals who never developed COVID-19). Because enrollment began upon exposure, some participants became ill only after enrollment, which allowed us to capture baseline ratings, onset of loss, and recovery. Data from these four cases and four age- and sex- matched controls were plotted over 28 days to create panel plots. Variables included mean orthonasal intensity of four odors (ScentCheckPro), perceived nasal blockage, oral burn (Cinnamon jellybeans), and sourness and sweetness (Sour Cherry jellybeans). Controls exhibited stable ratings over time. By contrast, COVID-19 cases showed sharp deviations over time. Changes in odor intensity or odor identification were not explained by nasal blockage. No single pattern of taste loss or recovery was apparent, implying different taste qualities might recover at different rates. Oral burn was transiently reduced for some before recovering quickly, suggesting acute loss may be missed in datasets collected only after illness ends. Collectively, intensive daily testing shows orthonasal smell, oral chemesthesis and taste were each altered by acute SARS-CoV-2 infection. This disruption was dyssynchronous for different modalities, with variable loss and recovery rates across both modalities and individuals.
摘要：
短暂的嗅觉丧失是流感和其他上呼吸道感染的常见症状。味觉丧失是可能的，但这些疾病很少见，和患者报告的“味觉丧失”通常是由味道/味道混淆引起的。因此，COVID-19患者味觉丧失和化学丧失的初步报告(即，化学躯体感觉，如变暖或降温）受到怀疑，直到多项研究证实SARS-CoV-2感染可以破坏这些感觉。许多研究都是基于自我报告或急性疾病结束后的单个时间点评估。这里,我们描述了2021年初招募的18-45岁成年人在28天内的密集纵向数据(即，在Delta和OmicronSARS-CoV-2波之前)。在2021年上半年，这些人要么是COVID-19阳性，要么是密切接触者（根据研究时的美国CDC标准）。注册后，所有参与者都被给予鼻夹，商品软糖（酸樱桃和肉桂）的盲样品，和划痕-n-嗅气味识别测试卡(ScentCheckPro)，他们用于日常评估。在感染第10天或之前登记的COVID-19病例中，高斯过程回归显示了两种不同的功能指标-气味识别和气味强度-相对于对照组（从未患COVID-19的暴露个体）下降。因为入学是在暴露后开始的，一些参与者只有在入学后才生病，这让我们能够获得基线评级，损失的开始，和恢复。在28天内绘制来自这四个病例和四个年龄和性别匹配的对照的数据以创建面板图。变量包括四种气味的平均鼻前强度(ScentCheckPro)，感觉到鼻塞，口腔烧伤（肉桂软糖），酸味和甜味（酸樱桃软糖）。对照随时间表现出稳定的评级。相比之下,随着时间的推移，COVID-19病例显示出明显的偏差。气味强度或气味识别的变化不能通过鼻塞来解释。没有单一的模式的味道损失或恢复是明显的，暗示不同的味道品质可能会以不同的速度恢复。在快速恢复之前，口腔烧伤暂时减少了一些，提示仅在疾病结束后收集的数据集中可能会遗漏急性丢失。总的来说，每天密集的测试显示鼻前气味，急性SARS-CoV-2感染分别改变了口腔化学和味觉。这种中断对于不同的模式是不同步的，模式和个人的损失率和回收率都不同。
