RESUMO
BackgroundWith increasing rates of SARS-CoV-2 infections and the intention to avoid a lock-down, the risks for the working population are of great interest. No large studies have been conducted which allow risk assessment for this population. MethodsDKMS is a non-profit donor center for stem cell donation and reaches out to registered volunteers between 18 and 61 years of age. To identify risk factors for severe COVID-19 courses in this population we performed a cross-sectional study. Self-reported data on oro- or nasopharyngeal swabs, risk factors, symptoms and treatment were collected with a health questionnaire and linked to existing genetic data. We fitted multivariable logistic regression models for the risk of contracting SARS-CoV-2, risk of severe respiratory infection and risk of hospitalization. FindingsOf 4,440,895 contacted volunteers 924,660 (20.8%) participated in the study. Among 157,544 participants tested, 7,948 reported SARS-CoV-2 detection. Of those, 947 participants (11.9%) reported an asymptomatic course, 5,014 (63.1%) mild/moderate respiratory infections, and 1,987 (25%) severe respiratory tract infections. In total, 286 participants (3.6%) were hospitalized for respiratory tract infections. The risk of hospitalization in comparison to a 20-year old person of normal weight was 2.1-fold higher (95%-CI, 1.2-3.69, p=0.01) for a person of same age with a BMI between 35-40 kg/m2, it was 5.33-fold higher (95%-CI, 2.92-9.70, p<0.001) for a 55-year old person with normal weight and 11.2-fold higher (95%-CI, 10.1-14.6, p<0.001) for a 55-year old person with a BMI between 35-40 kg/m2. Blood group A was associated with a 1.15-fold higher risk for contracting SARS-CoV-2 (95%-CI 1.08-1.22, p<0.001) than blood group O but did not impact COVID-19 severity. InterpretationIn this relatively healthy population, the risk for hospitalizations due to SARS-CoV-2 infections was moderate. Age and BMI were major risk factors. These data may help to tailor risk-stratified preventive measures. FundingDKMS initiated and conducted this study. The Federal Ministry of Education and Research (BMBF) supported the study by a research grant (COVID-19 call (202), reference number 01KI20177).
RESUMO
IntroductionRecent reports suggest that sudden smell loss might be a symptom of SARS-CoV-2 infection. The aim of this study was to investigate the frequency of olfactory loss in an out-patient population who presented to a coronavirus testing center during a 2-week period and to evaluate the diagnostic value of the symptom "sudden smell loss" for screening procedures. MethodsIn this cross-sectional controlled cohort study, 500 patients who presented with symptoms of a common cold to a corona testing center and fulfilled corona testing criteria, completed a standardized diagnostic questionnaire which included the patients main symptoms, time course and an additional self-assessment of the patients current smell, taste function and nasal breathing compared to the level before onset of symptoms. ResultsOut of the 500 patients, 69 presented with olfactory loss. Twenty-two of them subsequently tested positive for SARS-CoV-2. Only twelve out of the patients without olfactory loss tested positive, resulting in a frequency of 64.7% for the symptom "sudden smell loss" in COVID-19 patients. Compared to COVID-19 patients without smell loss, they were significantly younger and less severely affected. Changes in nasal airflow were significantly more pronounced in SARS-CoV-2 negative patients with olfactory complaints compared to the patients with smell loss who were tested positive for SARS-CoV-2. By excluding patients with a blocked nose, the symptom "sudden smell loss" can be attested a high specificity (97%) and a sensitivity of 65% with a PPV of 63% and NPV of 97% for COVID-19. ConclusionConsidering the high frequency of smell loss in non-hospitalized COVID-19 patients, acute olfactory impairment should be included in the WHO symptoms list and should be recognized as an early symptom of the disease. In contrast to other acute viral smell impairment, COVID-19 associated smell loss seems to be only rarely accompanied by a severely blocked nose.
RESUMO
ObjectiveEvaluate the prevalence and characteristics of olfactory or gustatory dysfunction in COVID-19 patients Study DesignMulticenter Case Series Setting5 tertiary care hospitals (3 in China, 1 in France, 1 in Germany) Subjects and Methods394 PCR confirmed COVID-19 positive patients were screened, and those with olfactory or gustatory dysfunction were included. Data including demographics, COVID-19 severity, patient outcome, and the incidence and degree of olfactory and/or gustatory dysfunction were collected and analyzed. The Questionnaire of Olfactory Disorders (QOD) and Visual Analogue Scale (VAS) were used to quantify olfactory and gustatory dysfunction respectively. All subjects at one hospital (Shanghai) without subjective olfactory complaints underwent objective testing. ResultsOf 394 screened subjects, 161 (41%) reported olfactory and/or gustatory dysfunction and were included. Incidence of olfactory and/or gustatory disorders in Chinese (n=239), German (n=39) and French (n=116) cohorts were 32%, 69%, and 49% respectively. The median age of included subjects was 39 years old, 92/161 (57%) were male, and 10/161 (6%) were children. Of included subjects, 10% had only olfactory or gustatory symptoms, and 19% had olfactory and/or gustatory complaints prior to any other COVID-19 symptom. Of subjects with objective olfactory testing, 10/90 demonstrated abnormal chemosensory function despite reporting normal subjective olfaction. 43% (44/102) of subjects with follow-up showed symptomatic improvement in olfaction or gustation. ConclusionsOlfactory and/or gustatory disorders may represent early or isolated symptoms of SARS-CoV-2 infection. They may serve as a useful additional screening criterion, particularly for the identification of patients in the early stages of infection.
