2019冠状病毒疾病相关嗅觉障碍

2019冠状病毒疾病(COVID-19)的致病病毒为新型冠状病毒SARS-CoV-2,其主要临床表现为发热、干咳、乏力等上呼吸道感染症状,严重者可快速进展为急性呼吸窘迫综合征、脓毒症休克、难以纠正代谢性酸中毒和出凝血功能障碍及多器官功能衰竭等.多国流行病学研究调查表明嗅觉障碍是COVID-19的临床症状之一,甚至是部分...     

The diagnostic value of detecting sudden smell loss among asymptomatic COVID-19 patients in early stage: The possible early sign of COVID-19

ImportanceThe newly emerged coronavirus disease 19 (COVID-19), is threatening the world. Olfactory or gustatory dysfunction is reported as one of the symptoms worldwide. As reported so far, different clinical features have been reported according to outbreak sites and gender; most of the patients, who complained of anosmia or hyposmia, were Europeans. We had a fast review for novel articles about COVID-19 infection and olfactory function.ObservationsRapid reviews for COVID-19 or other viral infection and olfactory and/or gustatory dysfunctions were done in this review. Up to date, a lot of reports have shown that olfactory dysfunction is related to viral infections but no exact mechanism, clinical course, and definite treatment have been discovered, which is also same in COVID-19. In general, intranasal steroid (INS) and oral steroid for short time help improve the recovery of the olfactory function in case of olfactory dysfunction after virus infection. Considering severe respiratory complications and immunocompromised state of COVID-19, the use of steroid should be limited and cautious because we do not have enough data to support the usage of steroid to treat olfactory dysfunction in the clinical course of COVID-19.Conclusions and relevanceIn the days of pandemic COVID-19, we should keep in mind that olfactory dysfunctions, even without other upper respiratory infection or otolaryngologic symptoms, might be the early signs of COVID-19.     

Alteraciones del olfato en la COVID-19, revisión de la evidencia e implicaciones en el manejo de la pandemia

There is debate as to whether olfactory dysfunction should be considered a symptom of COVID-19 infection. We undertook a systematic literature review of the articles indexed in PubMed on olfactory disorders in viral respiratory tract conditions, with special emphasis on COVID-19. The main objective was to find evidence of clinical interest to support the relationship between anosmia and COVID-19. Olfactory disorders in upper respiratory tract infections are frequent, most caused by obstruction due to oedema of the nasal mucosa. Occasionally, post-viral sensorineural olfactory dysfunction occurs, with a variable prognosis. The evidence on anosmia in COVID-19 patients is extremely limited, corresponding to a level 5 or D of the Centre for Evidence-Based Medicine. According to the available evidence, it seems reasonable to apply isolation, hygiene and social distancing measures in patients with recent olfactory disorders as the only symptom, although the usefulness of diagnostic tests for this type of patient should be studied.     

Objective evaluation and predictive value of olfactory dysfunction among patients hospitalized with COVID-19

ObjectivesOlfactory dysfunction is a frequent feature of COVID-19. Despite the growing evidence, current knowledge on the subject remains insufficient, so that data obtained with different tools, from multiple centers and in distinct scenarios are welcome. Yet, the predictive value of olfactory dysfunction in terms of the overall prognosis of COVID-19 is unknown. This study aims to evaluate the olfactory function of hospitalized patients with COVID-19 and the impact of the results on their clinical outcomes.MethodsPatients with severe acute respiratory distress syndrome (ARDS) admitted to a university tertiary hospital were recruited and divided into those with ARDS due to COVID-19, and those with ARDS of any other cause. Sociodemographic and clinical data were collected at baseline and the patients had their objective olfactory function evaluated by the Alcohol Sniff Test on admission and during hospital stay. The participants were then followed up until reaching an endpoint: hospital discharge, endotracheal intubation, transfer to the intensive care unit, or death. Patients with COVID-19 were also subgrouped and compared according to their olfactory thresholds and to their overall clinical outcomes. The obtained data was analyzed using R software. Level of significance was set at 0.05.ResultsEighty-two patients were included (of which 58 had COVID-19). 87.93% of the patients with COVID-19 had diminished olfactory dysfunction on admission. The mean length of hospital stay among patients with olfactory dysfunction was greater (7.84 vs 6.14 days) and nine individuals in this subgroup had poor overall outcomes. None of those with normal olfactory function developed critical COVID-19. The mean olfactory function was significantly worse among patients with COVID-19 and poor outcomes (3.97 vs 7.90 cm, P = .023).ConclusionObjective olfactory dysfunction is frequent in ARDS caused by SARS-CoV-2 infection. Patients with longitudinal poorer outcomes present worse olfactory thresholds on admission.     

Incomplete and late recovery of sudden olfactory dysfunction in COVID-19

IntroductionSudden olfactory dysfunction is a new symptom related to COVID-19, with little data on its duration or recovery rate.ObjectiveTo characterize patients with sudden olfactory dysfunction during the COVID-19 pandemic, especially their recovery data.MethodsAn online survey was conducted by the Brazilian Society of Otorhinolaryngology and Cervico-Facial Surgery, and Brazilian Academy of Rhinology, including doctors who assessed sudden olfactory dysfunction patients starting after February 1st, 2020. Participants were posteriorly asked by e-mail to verify data on the recovery of sudden olfactory loss and test for COVID-19 at the end of the data collection period.Results253 sudden olfactory dysfunction patients were included, of which 59.1% were females with median age of 36 years, with a median follow-up period of 31 days. 183 patients (72.3%) had been tested for COVID-19, and of those 145 (79.2%) tested positive. Patients that tested positive for COVID-19 more frequently showed non-specific inflammatory symptoms (89.7% vs. 73.7%; p = 0.02), a lower rate of total recovery of sudden olfactory dysfunction (52.6% vs. 70.3%; p = 0.05) and a longer duration to achieve total recovery (15 days vs. 10 days; p = 0.0006) than the ones who tested negative for COVID-19. Considering only positive-COVID-19 patients, individuals with sudden hyposmia completely recovered more often than the ones with sudden anosmia (68.4% vs. 50.0%; p = 0.04).ConclusionPositive-COVID-19 patients with sudden olfactory dysfunction showed lower total recovery rate and longer duration than negative-COVID-19 patients. Additionally, total recovery was seen more frequently in positive-COVID-19 patients with sudden hyposmia than the ones with sudden anosmia.     

Patterns and clinical outcomes of olfactory and gustatory disorders in six months: Prospective study of 1031 COVID-19 patients

ObjectiveThis study aims to comprehensively evaluate olfactory and gustatory dysfunctions during the COVID-19 pandemic regarding onset, course, associated symptoms, prognosis and relation to patients' demographics, treatment received and other symptoms.Patients& methodsThis is a prospective study conducted on patients proven to be infected with COVID-19 and with olfactory/gustatory dysfunction symptoms. Detailed history was taken from each patient about the onset of this dysfunction, associated symptoms. Then follow-up survey was done after 6 months to evaluate the prognosis.Results1031 patients were included in the study, aged 18 to 69 years old, with 31.8% were male. Olfactory/gustatory dysfunctions occurred after other COVID-19 symptoms in 43.5% of cases, occurred suddenly in 80.4% and gradually in 19.6%. These dysfunctions were anosmia & ageusia in 50.2%, hyposmia & hypogeusia in 23.3%, anosmia alone in 17.7%, phantosmia in 18%, Parosmia in 28.4%. In terms of recovery 6-month follow up, 680 patients (66%) recovered completely, 22.1% recovered partially while 11.9% did not recover. Most improvement occurred in the first two weeks. Headache, malaise, nasal obstruction and rhinorrhea were the commonest COVID-19 symptoms associated.ConclusionMost recovery of olfactory/gustatory dysfunction in COVID-19 infection occurs at the first two weeks and is unrelated to patient demographics, treatment or olfactory training. Parosmia is an independent predictor for complete recovery, while phantosmia is significantly associated with lower probability of complete recovery.     

Patients with COVID-19-associated olfactory impairment also show impaired trigeminal function

ObjectiveNext to olfactory function, the nose can also perceive chemestetic sensations mediated by the trigeminal nerve. While olfactory dysfunction as a symptom of COVID-19 is well described, there has been little research on the limitation of other nasal sensory inputs due to SARS-CoV-2 infection. The aim of this study was to determine possible limitations of nasal chemesthesis after COVID-19 infection by a psychophysiological diagnostic tool.MethodsIn 65 patients with a PCR-confirmed, former COVID-19 disease, olfaction was tested by means of a sniffin' sticks test, tasting by taste sprays and chemesthesis with a menthol dilution series. The subjective self-assessment of the patients was recorded via a questionnaire.ResultsWe found a restriction of nasal chemesthesis and the extent correlated with the loss of smell, as well as with the values of the taste score, but not with subjective self-assessment.ConclusionNot only the ability to smell and taste, but also nasal chemesthesis is affected by COVID-19.     

The prevalence of olfactory and gustatory dysfunction in covid-19 - A systematic review

ObjectivesLoss of smell or taste are early symptoms of COVID-19. Given the high asymptomatic rate of COVID-19, as well as unreliable temperature checking and contact history taking, it is important to understand the role of olfactory and gustatory dysfunction (OGD) in the diagnosis of COVID-19. The aim of this study is to determine how initial symptoms of OGD can be used to screen patients for COVID-19 laboratory testing.MethodsWe followed recommendations from the Preferred Reporting Items for Systemic Reviews and Meta-analysis (PRISMA) statement to conduct this systematic review study. We used OGD-related key words to search for literature published between January 1, 2020 and September 30, 2020 on Pubmed, Ovid Medline databases. We estimated the prevalence of OGD and compared it with that of other OGD-related symptoms. The weighted summary proportion under the fixed and random effects model was assessed using MedCalc statistical software. Whenever there was heterogeneity, a random effects model was selected. Publication bias was assessed by funnel plot asymmetry and Egger's regression test.ResultsA total of 25 articles (evidence level III:5; IV:20) were identified and reviewed. Data synthesis of 19 articles revealed that the pooled prevalence of olfactory dysfunction in COVID-19 is 53.56% (range 5.6-100%, 95% CI 40.25-66.61%). The pooled prevalence of gustatory dysfunction in COVID-19 is 43.93% (range 1.5-85.18%, 95% CI 28.72-59.74%), just behind fever (62.22%, range 18.18-95.83%, 95% CI 54.82-69.33%), cough (64.74%, range 38.89-87.5%, 95% CI 57.97-71.22%), and fatigue (56.74%, range 6.25-93.62%, 95% CI 32.53-79.35%). The prevalence of gustatory dysfunction in subgroup with objective evaluation is lower than those without (9.91% vs. 49.21%, relive risk 2.82, p<0.001).ConclusionOur updated systematic review attests that OGD is an important early symptom of COVID-19 infection. Screening for OGD should be further emphasized to prioritize patients for laboratory test.     

Paranasal sinuses computed tomography findings in anosmia of COVID-19

ObjectiveOlfactory dysfunction in coronavirus disease-2019 (COVID-19) is poorly understood. Thus, mechanistic data are needed to elucidate the pathophysiological drivers of anosmia of COVID-19.MethodsWe performed the current study in patients who presented with anosmia and COVID-19 as documented by the polymerase chain reaction (PCR) assay between April 1st and May 15st, 2020. We assessed for the conductive causes of anosmia with computed tomography (CT) of paranasal sinuses.Results49 patients who presented with anosmia and positive PCR assay for COVID-19 were included. The average age was 45 ± 12.2 years. Complete anosmia was present in 85.7% of patients and 91.8% of patients reported sudden onset of olfactory dysfunction. Taste disturbance was common (75.5%). There were no significant pathological changes in the paranasal sinuses on CT scans. Olfactory cleft and ethmoid sinuses appeared normal while in other sinuses, partial opacification was detected only in some cases.ConclusionWe did not find significant mucosal changes or olfactory cleft abnormality on CT imaging in patients with anosmia of COVID-19. Conductive causes of anosmia (i.e., mucosal disease) do not seem play a significant role in anosmia of COVID-19.     

Non-sinonasal-related olfactory dysfunction: A cohort of 496 patients

Introduction and aimThere is a high prevalence of olfactory dysfunction in the general population. Several causes of olfactory dysfunction have been reported and this disorder is classically divided into sinonasal and non-sinonasal-related olfactory dysfunction. The aims of this study were firstly, to evaluate the frequency of the various aetiologies of olfactory dysfunction in a population of patients with non-sinonasal-related olfactory dysfunction and secondly, to evaluate the degree of olfactory impairment associated with these various aetiologies.Material and methodsWe retrospectively reviewed a cohort of 496 patients with non-sinonasal-related olfactory dysfunction. The aetiology of the olfactory dysfunction was recorded for each patient. The aetiology was determined by a complete clinical assessment, including medical history, complete otorhinolaryngological examination, psychophysical testing of olfactory function, recording of olfactory event-related potentials and brain magnetic resonance imaging. Six groups of patients were defined on the basis of the aetiology of the disease and orthonasal and retronasal psychophysical olfactory performances were evaluated in each group.ResultsPost-infectious and post-traumatic aetiologies were the most common causes, representing 37.9% and 33.1% of patients, respectively, followed by idiopathic (16.3%), congenital (5.9%), toxic (3.4%) and neurological (3.4%) olfactory dysfunction. Anosmia was significantly more frequent in congenital (93.1%) and post-traumatic (62.8%) olfactory dysfunction, whereas hyposmia was more frequent in the post-infectious group (59.6%). Orthonasal and retronasal olfactory function tests were significantly correlated in all groups except for the congenital group.ConclusionsThe data of this study confirm that the most common causes of non-sinonasal-related olfactory dysfunction are post-infectious and post-traumatic. Post-infectious olfactory dysfunction is mainly observed in middle-aged women and is mainly associated with hyposmia, whereas post-traumatic olfactory dysfunction is mainly observed in young men and is associated with a high rate of anosmia.     

Olfactory dysfunction in COVID-19: a marker of good prognosis?

IntroductionIn May 2020, the World Health Organization recognized olfactory dysfunction as a COVID-19 symptom. The presence of hyposmia/anosmia may be a marker of good prognosis in COVID-19.ObjectiveTo associate the presence of olfaction disorder to the clinical condition severity in patients with COVID-19.MethodsIndividuals with the flu syndrome caused by SARS-CoV-2, diagnosed from March to June 2020, were recruited. They were divided into three groups: mild flu syndrome, severe flu syndrome (admitted to hospital wards) and critical illness (admitted to the ICU). Inpatients were interviewed by telephone contact after hospital discharge and their medical records were also evaluated regarding complementary test results. Outpatients answered an electronic questionnaire containing only clinical information.ResultsA total of 261 patients participated in the study: 23.75% with mild flu syndrome, 57.85% with severe flu syndrome and 18.40% with critical illness. A total of 66.28% patients with COVID-19 had olfaction disorders. In approximately 56.58% of the individuals the smell alterations lasted between 9 days and 2 months. There was a significantly higher proportion of individuals with olfactory dysfunction in the group with mild flu syndrome than in the severe flu syndrome group (mild × severe – p < 0.001; Odds Ratio = 4.63; 95% CI [1.87–10.86]). This relationship was also maintained between patients with mild flu syndrome and critically-ill patients (mild × critical – p < 0.001; Odds Ratio = 9.28; 95% CI [3.52–25.53]).ConclusionOlfaction dysfunction was significantly more prevalent in patients with mild flu syndrome in COVID-19. It may be a predictor of a good prognosis for this infection. New population-based studies must be carried out to corroborate these findings.     

Pathophysiological relationship between COVID-19 and olfactory dysfunction: A systematic review

IntroductionSARS-CoV-2 is the pathogen of COVID-19. The virus is composed of the spike, membrane and envelope. On physiological smell, odoriferous substances bind to proteins secreted by sustentacular cells in order to be processed by olfactory receptor neurons. Olfactory disorder is one of the main manifestations of COVID-19, however, research is still required to clarify the mechanism involved in SARS-CoV-2 induced anosmia.ObjectiveThis article aims to analyze current scientific evidence intended to elucidate the pathophysiological relationship between COVID-19 and the cause of olfactory disorders.MethodsPubmed, Embase, Scopus and ScienceDirect were used to compose this article. The research was conducted on November 24th, 2020. Original articles with experimental studies in human, animal and in vitro, short communications, viewpoint, published in the English language and between 2019 and 2020 were included, all related to the pathophysiological relationship between olfactory disorders and COVID-19 infection.ResultsBoth human cell receptors ACE2 and TMPRSS2 are essential for the SARS-CoV-2 entrance. These receptors are mostly present in the olfactory epithelium cells, therefore, the main hypothesis is that anosmia is caused due to damage to non-neuronal cells which, thereafter, affects the normal olfactory metabolism. Furthermore, magnetic resonance imaging studies exhibit a relationship between a reduction on the neuronal epithelium and the olfactory bulb atrophy. Damage to non-neuronal cells explains the average recovery lasting a few weeks. This injury can be exacerbated by an aggressive immune response, which leads to damage to neuronal cells and stem cells inducing a persistent anosmia. Conductive anosmia is not sufficient to explain most cases of COVID-19 induced anosmia.ConclusionOlfactory disorders such as anosmia and hyposmia can be caused by COVID-19, the main mechanism is associated with olfactory epithelium damage, targeting predominantly non-neuronal cells. However, neuronal cells can also be affected, worsening the condition of olfactory loss.     

Olfactory and gustatory dysfunctions of COVID‐19 patients in China: A multicenter study

IntroductionWith the spread of the epidemic worldwide, an increasing number of doctors abroad have observed the following atypical symptoms of coronavirus disease 2019 (COVID‐19): olfactory or taste disorders. Therefore, clarifying the incidence and clinical characteristics of olfactory and taste disorders in Chinese COVID‐19 patients is of great significance and urgency.Materials and MethodsA retrospective study was conducted, which included 229 severe acute respiratory syndrome coronavirus 2 confirmed patients, through face‐to‐face interviews and telephone follow‐up. Following the completion of questionnaires, the patients participating in the study, were categorized according to the degree of olfactory and taste disorders experienced, and the proportion of each clinical type of patient with olfactory and taste disorders and the time when symptoms appeared were recorded.ResultsAmong the 229 patients, 31 (13.54%) had olfactory dysfunction, and 44 (19.21%) had gustatory dysfunction. For the patients with olfactory dysfunction, 6 (19.35%) developed severe disease and became critically ill. Olfactory dysfunction appeared before the other symptoms in 21.43% of cases. The proportion of females with olfactory and gustatory dysfunction was higher than that of males (P < 0.001).ConclusionsThe incidence of olfactory and gustatory dysfunction was much lower than that reported abroad; the prognosis of patients with olfactory dysfunction is relatively favorable; olfactory and gustatory dysfunction can be used as a sign for early screening; females are more prone to olfactory and gustatory dysfunction.     

Olfactory and taste disorders in COVID-19: a systematic review

IntroductionThe SARS-CoV-2 virus causes COVID-19, and it is responsible for the largest pandemic since the 1918 H1N1 influenza outbreak. The classic symptoms of the disease have been well defined by the World Health Organization; however, olfactory/gustatory disorders have been reported in some studies, but there are still several missing points in the understanding and in the consensus about the clinical management of these cases.ObjectiveTo identify evidence in the scientific literature about olfactory/gustatory disorders, their clinical presentation, prevalence and possible specific treatments associated with COVID-19.MethodsA systematic review of articles published up to April 25, 2020 was performed in Medline, Cochrane Clinical Trials, ScienceDirect, Lilacs, Scopus and Google Schoolar, OpenGrey.eu, DissOnline, The New York Academy of Medicine and Reasearch Gate. Inclusion criteria: (1) Studies on patients with COVID-19; (2) Records of COVID-19 signs/symptoms, and olfactory/gustatory functions. Exclusion criteria: (1) Studies on non-human coronavirus; (2) Review articles; (3) Experimental studies (in animals or in vitro); (4) Olfactory/gustatory disorders initiated prior to SARS-CoV-2 infection. The risk assessment of bias of the selected studies was performed using the Newcastle-Ottawa scale.ResultsSix articles from the 1788 records met the inclusion criteria and were analyzed. A total of 1457 patients of different ethnicities were assessed; of them, 885 (60.7%) and 822 (56.4%) had smell and taste disorders, respectively, with women being most often affected. There were olfactory/gustatory disorders even without nasal obstruction/rhinorrhea and beginning even before the signs/symptoms of COVID-19; the recovery of smell/taste, when it occurs, usually happened in the first two weeks after COVID-19 resolution. There is evidence that olfactory/gustatory disorders are strong predictors of infection by SARS-CoV-2, and it is possible to recommend patient isolation, as early as of the medical consultation, preventing the spread of the virus. No scientific evidence has been identified for effective treatments for any of the disorders.ConclusionOlfactory/gustatory disorders may occur at varying intensities and prior to the general symptoms of COVID-19 and should be considered as part of the clinical features of COVID-19, even in mild cases. There is still no scientific evidence of specific treatments for such disorders in COVID-19 disease.     

国内嗅觉障碍相关研究——基于Citespace的可视化分析

目的 对国内“嗅觉障碍”研究进行可视化分析及合理推测,尝试为学者提供该领域的研究现状及预测未来热点方向。方法 以“嗅觉障碍”为主题词,检索建库至2020年10月20日中国知网(CNKI)的学术论文并按纳入标准进行筛选,使用Citespace软件对该研究领域所筛选文献的作者、期刊/单位及主题词进行绘制图谱及可视化分析。结果 整体来讲,“嗅觉障碍”研究的文献发表量呈快速上升趋势。出现频次排名靠前的作者为魏永祥、倪道凤、刘钢、杭伟、姚淋尹、韩德民及刘剑锋,“嗅觉障碍”研究发文排名第1～3例的期刊为：《临床耳鼻咽喉头颈外科杂志》《国际耳鼻咽喉头颈外科杂志》《中华耳鼻咽喉头颈外科杂志》,合作高产单位并具有一定影响力的机构为首都医科大学附属北京安贞医院、中国医学科学院北京协和医院等。主题词聚类分析呈现出7个聚类：慢性鼻-鼻窦炎、帕金森病、kallmann、鼻炎、新型冠状病毒肺炎、超微结构和针刺。结论 在“嗅觉障碍”领域,早期韩德民、李志春等国内作者对“嗅觉障碍”的研究较深长,而近年来魏永祥、倪道凤等国内作者对“嗅觉障碍”的检测方法、病因、发病机制等进行基础研究及归纳分类,是近年来嗅觉障碍研究的主力...     

嗅裂疾病三例

目的报道一种新的嗅觉障碍疾病——嗅裂疾病，总结其临床特征、影像学特点以及治疗尝试。方法本组3例，均以完全失嗅为主诉。详细采集病史，行耳鼻咽喉科常规体检、鼻内镜检查。主观嗅功能测试使用T＆T标准嗅觉计行嗅觉察觉阈和识别阈测试。以醋酸异戊酯为刺激剂行嗅觉事件相关电位测试，刺激量为2ml。行鼻窦冠状位和轴位CT扫描。治疗方案：①抗生素治疗半个月；②糖皮质激素治疗半个月。结果鼻内镜检查患者双侧嗅裂处黏膜肿胀，嗅裂消失。T＆T主观嗅觉测试均为完全失嗅，最大嗅刺激未引出嗅觉事件相关电位。鼻窦CT提示局限于双侧嗅裂的软组织影。抗生素治疗嗅觉无改善。局部和全身糖皮质激素治疗，1例嗅觉改善，但停药后嗅觉又消失，再次使用糖皮质激素治疗无效。另2例嗅觉无改善。结论嗅裂疾病是一种以嗅觉障碍为主诉，病变局限于嗅裂的疾病，鼻窦CT有助于确诊，抗生素和糖皮质激素治疗效果不理想。     

Drug-induced olfactory and gustatory dysfunction: Analysis of FDA adverse events reporting system

ObjectivesWith the COVID-19 pandemic, there is growing interest and research in olfactory and gustatory dysfunction (OGD). Drug-induced dysfunction is an often overlooked etiology. While several medications include smell or taste disturbance as a side effect, there are no publications describing which medications are most frequently implicated. We aim to describe the patterns of these adverse drug reactions (ADRs) using the FDA Adverse Events Reporting System (FAERS).MethodsThe FAERS database was queried from 2011 to 2021 for terms describing ADRs related to OGD. Terms included anosmia, hyposmia, olfactory test abnormal, olfactory nerve disorder, hallucination olfactory, parosmia, ageusia, hypogeusia, dysgeusia, and taste disorder. We identified the top reported medications associated with general smell dysfunction, general taste dysfunction, reduced smell, and altered smell.ResultsFrom 2011 to 2021, 16,091 ADRs were reported with OGD, of which13,641 (84.8%) and 2,450 (15.2%) were associated with gustatory and olfactory reactions, respectively. Zinc products (370 reports) and fluticasone propionate (214) were most commonly associated with olfactory dysfunction, specifically reduced olfaction. Varenicline (24) and fluticasone propionate (23) were most commonly associated with altered smell. Lenalidomide (490) and sunitinib (468) were most commonly associated with gustatory dysfunction. Antineoplastic and immunomodulating medications accounted for 21.6% and 36.3% of olfactory and gustatory ADRs, respectively. Among this category, immunoglobulin drugs were the most commonly associated with OGD ADRs.ConclusionGustatory dysfunction is more commonly reported ADR compared with olfactory dysfunction. Immunologic/rheumatologic medications are the leading culprit of reported OGD. With increasing numbers of patients presenting to otolaryngologists for OGD, it is important to consider drug-induced etiology.Level of evidenceIII.     

新型冠状病毒肺炎相关突发性感音神经性耳聋的研究进展

新型冠状病毒肺炎(COVID-19)是一种传染性极强、严重危害全球公共卫生的疾病。临床表现主要包括发热、咳嗽、乏力等,随着疫情的发展,COVID-19患者病程中出现的突发性感音神经性耳聋(SSNHL)越来越多。SSNHL可以是COVID-19患者的后遗症,也有部分患者以SSNHL为首发和唯一的症状。该文对COVID-19相关SSNHL的最新研究进展作一总结,希望有助于后续的相关研究和临床诊治。