A structural equation model to examine the clinical features of mild-to-moderate COVID-19: A multicenter Italian study.
Adolescent
Adult
Aged
COVID-19
/ diagnosis
COVID-19 Nucleic Acid Testing
/ statistics & numerical data
Comorbidity
Female
Humans
Italy
/ epidemiology
Male
Middle Aged
Models, Statistical
Olfaction Disorders
/ epidemiology
Prevalence
Rhinorrhea
/ virology
SARS-CoV-2
/ genetics
Surveys and Questionnaires
Taste Disorders
/ epidemiology
Young Adult
COVID-19
ENT
SARS-CoV-2
anosmia
coronavirus
smell and taste
structural equation model
Journal
Journal of medical virology
ISSN: 1096-9071
Titre abrégé: J Med Virol
Pays: United States
ID NLM: 7705876
Informations de publication
Date de publication:
02 2021
02 2021
Historique:
received:
03
07
2020
accepted:
23
07
2020
pubmed:
28
7
2020
medline:
15
1
2021
entrez:
26
7
2020
Statut:
ppublish
Résumé
The purpose of this study was to evaluate the clinical features of mild-to-moderate coronavirus disease 2019 (COVID-19) in a sample of Italian patients and to investigate the occurrence of smell and taste disorders. Infected individuals with suspected (clinical diagnosis) or laboratory-confirmed COVID-19 infection were recruited. Patients completed a survey-based questionnaire with the aim of assessing their epidemiological and clinical characteristics, general otorhinolaryngological symptoms, and smell and taste disorders. A total of 294 patients with mild-to-moderate COVID-19 completed the survey (147 females). The most prevalent general symptoms included fever, myalgia, cough, and headache. A total of 70.4% and 59.2% of patients reported smell and taste disorders, respectively. A significant association between the two above-mentioned disorders was found (rs: 0.412; P < .001). Smell disorders occurred before the other symptoms in 11.6% of patients and was not significantly associated with nasal obstruction or rhinorrhea. Interestingly, our statistical analysis did not show any significant difference, either for general symptoms or otorhinolaryngological features, between the clinical diagnosis group and the laboratory-confirmed diagnosis (polymerase chain reaction) group. The structural equation model confirmed significant standardized paths (P < .05) between general symptoms, comorbidities, and general otorhinolaryngological complaints in the absence of a significant correlation between these elements and smell and taste alterations. The prevalence of smell and taste disorders in mild-to-moderate Italian COVID-19 patients is significant both in suspected and laboratory-confirmed cases and reveals a strong correlation between these clinical signs regardless of the presence of general or otorhinolaryngological symptoms, such as nasal obstruction or rhinorrhea.
Types de publication
Journal Article
Multicenter Study
Observational Study
Langues
eng
Sous-ensembles de citation
IM
Pagination
983-994Informations de copyright
© 2020 Wiley Periodicals LLC.
Références
Centers for Disease Control and Prevention (CDC). Novel coronavirus. 2019. https://www.cdc.gov/coronavirus/2019-ncov/index.html. Accessed May 17, 2020.
Wan S, Xiang Y, Fang W, et al. Clinical features and treatment of COVID-19 patients in Northeast Chongqing. J Med Virol. 2020;92(7):797-806. https://doi.org/10.1002/jmv.25783
Lauer SA, Grantz KH, Bi Q, et al. The incubation period of coronavirus disease 2019 (COVID-19) from publicly reported confirmed cases: estimation and application. Ann Intern Med. 2020;172(9):577-582. https://doi.org/10.7326/M20-0504
Yuan J, Li M, Lv G, Lu ZK. Monitoring transmissibility and mortality of COVID-19 in Europe. Int J Infect Dis. 2020;95:311-315. https://doi.org/10.1016/j.ijid.2020.03.050
Lechien JR, Chiesa Estomba CM, Place S, et al. Clinical and epidemiological characteristics of 1,420 European patients with mild-to-moderate coronavirus disease 2019. J Intern Med. 2020. https://doi.org/10.1111/joim.13089
Lechien JR, Chiesa-Estomba CM, De Siati DR, et al. Olfactory and gustatory dysfunctions as a clinical presentation of mild-to-moderate forms of the coronavirus disease (COVID-19): a multicenter European study [published online ahead of print April 6, 2020]. Eur Arch Otorhinolaryngol. 2020;277:2251-2261. https://doi.org/10.1007/s00405-020-05965-1
Beltrán-Corbellini Á, Chico-García JL, Martínez-Poles J, et al. Acute-onset smell and taste disorders in the context of Covid-19: a pilot multicenter PCR-based case-control study. Eur J Neurol. 2020. https://doi.org/10.1111/ene.14273
Spinato G, Fabbris C, Polesel J, et al. Alterations in smell or taste in mildly symptomatic outpatients with SARS-CoV-2 infection [published ahead of print April 22, 2020]. JAMA. 2020. https://doi.org/10.1001/jama.2020.6771
Lechien JR, Chiesa Estomba CM, Hans S, Barillari MR, Jouffe L, Saussez S. Loss of smell and taste in 2013 European patients with mild to moderate COVID-19 [published online ahead of print May 26, 2020]. Ann Intern Med. 2020. https://doi.org/10.7326/M20-2428
World Health Organization. Clinical Management of Severe Acute Respiratory Infection When Novel Coronavirus (2019-nCoV) Infection Is Suspected: Interim Guidance [pulished online ahead of print March 13, 2020]. 2020. https://www.who.int/docs/default-source/coronaviruse/clinical-management-of-novel-cov.pdf
Rawal S, Hoffman HJ, Bainbridge KE, Huedo-Medina TB, Duffy VB. Prevalence and risk factors of self-reported smell and taste alterations: results from the 2011-2012 US National Health and Nutrition Examination Survey (NHANES). Chem Senses. 2016;41:69-76. https://doi.org/10.1093/chemse/bjv057. Accessed June 2, 2020.
Mattos JL, Edwards C, Schlosser RJ, et al. A brief version of the questionnaire of olfactory disorders in patients with chronic rhinosinusitis. Int Forum Allergy Rhinol. 2019;9(10):1144-1150. https://doi.org/10.1002/alr.22392
Henriquez P, Matuszewski BJ, Andreu Y, et al. Mirror on the wall. An unobtrusive intelligent multisensory Mirror for well-being status self-assessment and visualization. IEEE Trans Multimedia. 2017;19(7):1467-1481.
Bagozzi RP, Yi Y. Specification, evaluation, and interpretation of structural equation models. J Acad Mark Sci. 2012;40:8-34.
Bartholomew DJ, Knott M. Latent Variable Models and Factor Analysis. 2nd ed. New York, NY: Oxford University Press; 1999.
Gorsuch RL. Common factor analysis versus component analysis: some well and little known facts. Multivar Behav Res. 1990;25:33-39.
Wu J, Liu J, Zhao X, et al. Clinical characteristics of imported cases of COVID-19 in Jiangsu Province: a multicenter descriptive study. Clin Infect Dis. 2020. https://doi.org/10.1093/cid/ciaa199
Zhou F, Yu T, Du R, et al. Clinical course and risk factors for mortality of adult inpatients with COVID-19 in Wuhan, China: a retrospective cohort study [published online ahead of print April 3, 2020]. Lancet. 2020;395(10229):1054-1062. https://doi.org/10.1016/S0140-6736(20)30566-3
Yang W, Cao Q, Qin L, et al. Clinical characteristics and imaging manifestations of the 2019 novel coronavirus disease (COVID-19): a multi-center study in Wenzhou city, Zhejiang, China. J Infect. 2020;80(4):388-393. https://doi.org/10.1016/j.jinf.2020.02.016
Mao L, Jin H, Wang M, et al. Neurological manifestations of hospitalized patients with COVID-19 in Wuhan, China: a retrospective case series study. JAMA Neurol. 2020;77:683-690. https://doi.org/10.1001/jamaneurol.2020.1127
Giacomelli A, Pezzati L, Conti F, et al. Self-reported olfactory and taste disorders in SARS-CoV-2 patients: a cross-sectional study. Clin Infect Dis. 2020. https://doi.org/10.1093/cid/ciaa330
Xydakis MS, Dehgani-Mobaraki P, Holbrook EH, et al. Smell and taste dysfunction in patients with COVID-19 [published online ahead of print April 15, 2020]. Lancet Infect Dis. 2020. https://doi.org/10.1016/S1473-3099(20)30293-0
AAO-HNS: Anosmia, Hyposmia, and Dysgeusia Symptoms of Coronavirus Disease [published online ahead of print March 22, 2020]. 2020. https://www.entnet.org/content/aao-hns-anosmia-hyposmia-and-dysgeusia-symptoms-coronavirus-disease
Netland J, Meyerholz DK, Moore S, Cassell M, Perlman S. Severe acute respiratory syndrome coronavirus infection causes neuronal death in the absence of encephalitis in mice transgenic for human ACE2. J Virol. 2008;82(15):7264-7275. https://doi.org/10.1128/JVI.00737-08. Accessed June 2, 2020.
Hoffmann M, Kleine-Weber H, Schroeder S, et al. SARS-CoV-2 cell entry depends on ACE2 and TMPRSS2 and is blocked by a clinically proven protease inhibitor. Cell. 2020;181(2):271-280. https://doi.org/10.1016/j.cell.2020.02.052
Bilinska K, Jakubowska P, Von Bartheld C, Butowt R. Expression of the SARS-CoV-2 entry proteins, ACE2 and TMPRSS2, in cells of the olfactory epithelium: identification of cell types and trends with age. ACS Chem Neurosci. 2020;11(11):1555-1562. https://doi.org/10.1021/acschemneuro.0c00210
Heydel JM, Coelho A, Thiebaud N, et al. Odorant-binding proteins and xenobiotic metabolizing enzymes: implications in olfactory perireceptor events. Anat Rec. 2013;296(9):1333-1345. https://doi.org/10.1002/ar.22735
Li YC, Bai WZ, Hashikawa T. The neuroinvasive potential of SARS-CoV2 may play a role in the respiratory failure of COVID-19 patients. J Med Virol. 2020;92:552-555. https://doi.org/10.1002/jmv.25728
Vaira LA, Deiana G, Fois AG, et al. Objective evaluation of anosmia and ageusia in COVID-19 patients: a single-center experience on 72 cases. Head Neck. 2020;42:1252-1258. https://doi.org/10.1002/HED.26204
Moein ST, Hashemian SM, Mansourafshar B, Khorram-Tousi A, Tabarsi P, Doty RL. Smell dysfunction: a biomarker for COVID-19. Int Forum Allergy Rhinol. 2020. https://doi.org/10.1111/alr.22587
Vaira LA, Hopkins C, Salzano G, et al. Olfactory and gustatory function impairment in COVID-19 patients: Italian objective multicenter-study [published online ahead of print May 21, 2020]. Head Neck. 2020;42:1560-1569. https://doi.org/10.1002/hed.26269
Paderno A, Schreiber A, Grammatica A, et al. Smell and taste alterations in covid-19: a cross-sectional analysis of different cohorts. Int Forum Allergy Rhinol. 2020. https://doi.org/10.1002/alr.22610
Lechien JR, Cabaraux P, Chiesa Estomba CM, et al. Psychophysical olfactory tests and detection of COVID-19 in patients with sudden onset olfactory dysfunction: a prospective study [published online ahead of print May 29, 2020]. Ear Nose Throat J. 2020.
Boscolo Rizzo P, Borsetto D, Spinato G, et al. New onset of loss of smell or taste in household contacts of home-isolated SARS-CoV-2-positive subjects [published online ahead of print May 24, 2020]. Eur Arch Otorhinolaryngol. 2020;1-4. https://doi.org/10.1007/s00405-020-06066-9
Chiesa Estomba CM, Lechien JR, Portillo-Mazal P. Olfactory and gustatory dysfunctions in COVID-19. First reports of Latin-American ethnic patients. Am J Otolaryngol. 2020;41.
Lechien JR, Barillari MR, Jouffe L, Saussez S. Anosmia is a key symptom of COVID-19 infection and should be used as a diagnostic tool [published online ahead of print May 21, 2020]. Ear Nose Throat J. 2020. https://doi.org/10.1177/0145561320925191
Lechien JR, Hopkins C, Saussez S. Sniffing out the evidence; it's now time for public health bodies recognize the link between COVID-19 and smell and taste disturbance. Rhinology. 2020. https://doi.org/10.4193/Rhin20.159
Krajewska J, Krajewski W, Zub K, Zatońskiet T. COVID-19 in otolaryngologist practice: a review of current knowledge [published online ahead of print April 18, 2020]. Eur Arch Otorhinolaryngol. 2020;277(7):1885-1897. https://doi.org/10.1007/s00405-020-05968-y
Chan J, Wong EWY, Lam W. Practical aspects of otolaryngologic clinical services during the 2019 novel coronavirus epidemic: an experience in Hong Kong. JAMA Otolaryngol Head Neck Surg. 2020;146:519. https://doi.org/10.1001/jamaoto.2020.0488
Hopkins C, Surda P, Kumar N. Presentation of new onset anosmia during the COVID-19 pandemic. Rhinology. 2020;58(3):295-298. https://doi.org/10.4193/Rhin20.116
Li Q, Guan X, Wu P, et al. Early transmission dynamics in Wuhan, China, of novel coronavirus-infected pneumonia. N Engl J Med. 2020;382(13):1199-1207. https://doi.org/10.1056/NEJMoa2001316