Anosmia is associated with lower in-hospital mortality in COVID-19.
Anosmia
COVID-19
Clinical presentation
Mortality
Prognosis
Journal
Journal of the neurological sciences
ISSN: 1878-5883
Titre abrégé: J Neurol Sci
Pays: Netherlands
ID NLM: 0375403
Informations de publication
Date de publication:
15 12 2020
15 12 2020
Historique:
received:
22
08
2020
revised:
26
09
2020
accepted:
28
09
2020
pubmed:
10
10
2020
medline:
19
12
2020
entrez:
9
10
2020
Statut:
ppublish
Résumé
Anosmia is common in Coronavirus disease 2019, but its impact on prognosis is unknown. We analysed whether anosmia predicts in-hospital mortality; and if patients with anosmia have a different clinical presentation, inflammatory response, or disease severity. Retrospective cohort study including all consecutive hospitalized patients with confirmed Covid-19 from March 8th to April 11th, 2020. We determined all-cause mortality and need of intensive care unit (ICU) admission. We registered the first and worst laboratory parameters. Statistical analysis was done by multivariate logistic and linear regression. We included 576 patients, 43.3% female, and aged 67.2 years in mean. Anosmia was present in 146 (25.3%) patients. Patients with anosmia were more frequently females, younger and less disabled and had less frequently hypertension, diabetes, smoking habit, cardiac and neurological comorbidities. Anosmia was independently associated with lower mortality (OR: 0.180, 95% CI: 0.069-0.472) and ICU admission (OR: 0.438, 95% CI: 0.229-0.838, p = 0.013). In the multivariate analysis, patients with anosmia had a higher frequency of cough (OR: 1.96, 95%CI: 1.18-3.28), headache (OR: 2.58, 95% CI: 1.66-4.03), and myalgia (OR: 1.74, 95% CI: 1.12-2.71). They had higher adjusted values of hemoglobin (+0.87, 95% CI: 0.40-1.34), lymphocytes (+849.24, 95% CI: 157.45-1541.04), glomerular filtration rate (+6.42, 95% CI: 2.14-10.71), and lower D-dimer (-4886.52, 95% CI: -8655.29-(-1117.75)), and C-reactive protein (-24.92, 95% CI: -47.35-(-2.48)). Hospitalized Covid-19 patients with anosmia had a lower adjusted mortality rate and less severe course of the disease. This could be related to a distinct clinical presentation and a different inflammatory response.
Sections du résumé
BACKGROUND
Anosmia is common in Coronavirus disease 2019, but its impact on prognosis is unknown. We analysed whether anosmia predicts in-hospital mortality; and if patients with anosmia have a different clinical presentation, inflammatory response, or disease severity.
METHODS
Retrospective cohort study including all consecutive hospitalized patients with confirmed Covid-19 from March 8th to April 11th, 2020. We determined all-cause mortality and need of intensive care unit (ICU) admission. We registered the first and worst laboratory parameters. Statistical analysis was done by multivariate logistic and linear regression.
RESULTS
We included 576 patients, 43.3% female, and aged 67.2 years in mean. Anosmia was present in 146 (25.3%) patients. Patients with anosmia were more frequently females, younger and less disabled and had less frequently hypertension, diabetes, smoking habit, cardiac and neurological comorbidities. Anosmia was independently associated with lower mortality (OR: 0.180, 95% CI: 0.069-0.472) and ICU admission (OR: 0.438, 95% CI: 0.229-0.838, p = 0.013). In the multivariate analysis, patients with anosmia had a higher frequency of cough (OR: 1.96, 95%CI: 1.18-3.28), headache (OR: 2.58, 95% CI: 1.66-4.03), and myalgia (OR: 1.74, 95% CI: 1.12-2.71). They had higher adjusted values of hemoglobin (+0.87, 95% CI: 0.40-1.34), lymphocytes (+849.24, 95% CI: 157.45-1541.04), glomerular filtration rate (+6.42, 95% CI: 2.14-10.71), and lower D-dimer (-4886.52, 95% CI: -8655.29-(-1117.75)), and C-reactive protein (-24.92, 95% CI: -47.35-(-2.48)).
CONCLUSIONS
Hospitalized Covid-19 patients with anosmia had a lower adjusted mortality rate and less severe course of the disease. This could be related to a distinct clinical presentation and a different inflammatory response.
Identifiants
pubmed: 33035870
pii: S0022-510X(20)30499-8
doi: 10.1016/j.jns.2020.117163
pmc: PMC7527278
pii:
doi:
Types de publication
Journal Article
Observational Study
Langues
eng
Sous-ensembles de citation
IM
Pagination
117163Informations de copyright
Copyright © 2020 Elsevier B.V. All rights reserved.
Références
Clin Infect Dis. 2020 Jul 28;71(15):889-890
pubmed: 32215618
Lancet. 2020 Mar 28;395(10229):1054-1062
pubmed: 32171076
Eur Arch Otorhinolaryngol. 2020 Aug;277(8):2251-2261
pubmed: 32253535
J Headache Pain. 2020 Jul 29;21(1):94
pubmed: 32727345
Tidsskr Nor Laegeforen. 2020 Apr 03;140(7):
pubmed: 32378854
Int J Infect Dis. 2020 Nov;100:117-122
pubmed: 32771635
Head Neck. 2020 Jul;42(7):1560-1569
pubmed: 32437022
Lancet. 2020 Feb 15;395(10223):497-506
pubmed: 31986264
Rev Neurol. 2020 May 1;70(9):311-322
pubmed: 32329044
Ann Allergy Asthma Immunol. 2020 Oct;125(4):481-483
pubmed: 32717301
Int Forum Allergy Rhinol. 2020 Jul;10(7):821-831
pubmed: 32329222
J Med Virol. 2020 Jun;92(6):552-555
pubmed: 32104915
Med Mal Infect. 2020 Aug;50(5):436-439
pubmed: 32305563
JAMA. 2020 Mar 17;323(11):1061-1069
pubmed: 32031570
Clin Chem Lab Med. 2020 Jun 25;58(7):1131-1134
pubmed: 32119647
JAMA. 2020 May 26;323(20):2089-2090
pubmed: 32320008
N Engl J Med. 2020 Apr 30;382(18):1708-1720
pubmed: 32109013
Rhinology. 2020 Jun 1;58(3):295-298
pubmed: 32277751
BMJ. 2007 Oct 20;335(7624):806-8
pubmed: 17947786
Otolaryngol Head Neck Surg. 2020 Jul;163(1):3-11
pubmed: 32369429
Int Forum Allergy Rhinol. 2020 Aug;10(8):944-950
pubmed: 32301284
JAMA. 2020 Jun 23;323(24):2512-2514
pubmed: 32432682
Virus Res. 2012 Feb;163(2):628-35
pubmed: 22248641
Otolaryngol Head Neck Surg. 2020 Jul;163(1):96-97
pubmed: 32366195
Stroke. 2009 Oct;40(10):3393-5
pubmed: 19679846
Sci Adv. 2020 Jul 31;6(31):
pubmed: 32937591
JAMA. 2020 May 12;323(18):1824-1836
pubmed: 32282022
JAMA Intern Med. 2020 Jul 1;180(7):934-943
pubmed: 32167524
Otolaryngol Head Neck Surg. 2020 Jul;163(1):132-134
pubmed: 32340555
Front Neurol. 2020 Jul 07;11:781
pubmed: 32733373
Acad Radiol. 2020 Jun;27(6):892-893
pubmed: 32295727
J Otolaryngol Head Neck Surg. 2020 Aug 6;49(1):56
pubmed: 32762737
Lancet. 2020 Feb 15;395(10223):507-513
pubmed: 32007143