Abstract
3 min readObjective: 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 mainland China. 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 mainland China. 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 35 566 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(χ2=367.013, P<0.001) and young people(χ2=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% (4 391/9 840) of the patients who had not recovered their sense of smell and taste also suffered from nasal congestion, runny nose, and 32.62% (3 210/9 840) suffered from dry mouth and sore throat. The improvement of olfactory and taste functions was correlated with the persistence of accompanying symptoms(χ2=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 after SARS-CoV-2 infection, and recovered to 5.83and 6.55 respectively at the time of the survey. The median duration of olfactory and gustatory dysfunctions was 15 days and 12 days, respectively, with 0.5% (121/24 096) of patients experiencing these dysfunctions for more than 28 days. The overall self-reported improvement rate of smell and taste dysfunctions was 59.16% (14 256/24 096). Gender(OR=0.893, 95%CI: 0.839-0.951), SARS-CoV-2 vaccination status (OR=1.334, 95%CI: 1.164-1.530), history of head and facial trauma(OR=1.180, 95%CI: 1.036-1.344, P=0.013), nose (OR=1.104, 95%CI: 1.042-1.171, P=0.001) and oral (OR=1.162, 95%CI: 1.096-1.233) health status, smoking history(OR=0.765, 95%CI: 0.709-0.825), and the persistence of accompanying symptoms (OR=0.359, 95%CI: 0.332-0.388) were correlated with the recovery of olfactory and taste dysfunctions related to SARS-CoV-2 (above P<0.001 except for the indicated values). Conclusion: The incidence of olfactory and taste dysfunctions related to infection with the SARS-CoV-2 Omicron strain is high in mainland China, with females and young people more likely to develop these dysfunctions. Active and effective intervention measures may be required for cases that persist for a long time. The recovery of olfactory and taste functions is influenced by several factors, including gender, SARS-CoV-2 vaccination status, history of head and facial trauma, nasal and oral health status, smoking history, and persistence of accompanying symptoms.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χ2检验、Losgistic回归等对数据进行分析。 结果： ①获得35 566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%（24 096例）；其中女性为47.70%（16 966例），高于男性的20.05%（7 130例），差异有统计学意义（χ2=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（χ2=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%（4 391/9 840）伴鼻塞、流涕，32.62%（3 210/9 840）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（χ2=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%（121/24 096）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%（14 256/24 096）。性别（OR=0.893，95%CI为0.839~0.951）、新型冠状病毒疫苗接种情况（OR=1.334，95%CI为1.164~1.530）、头面部外伤史（OR=1.180，95%CI为1.036~1.344，P=0.013）、鼻腔健康状况（OR=1.104，95%CI为1.042~1.171，P=0.001）和口腔健康状况（OR=1.162，95%CI为1.096~1.233）、吸烟史（OR=0.765，95%CI为0.709~0.825）、伴随症状持续与否（OR=0.359，95%CI为0.332~0.388）对嗅觉味觉障碍的预后有影响（以上除标注外，P值均<0.001）。 结论： ①女性、有吸烟史的患者感染新型冠状病毒后更易发生嗅觉味觉障碍；②接种4针疫苗、有饮酒史的患者感染新型冠状病毒后更不容易发生嗅觉味觉障碍；③新型冠状病毒感染后嗅觉味觉功能多数在一定程度上自发改善，但短期内未能恢复至原有水平，少数可能长期存在；④男性、接种2针和3针疫苗、无吸烟史、无持续的伴随症状、既往有头面部外伤史以及有鼻腔口腔健康问题的患者更易恢复嗅觉味觉功能。.
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