Abstract
Background. Hemodialysis patients are susceptible population for COVID-19 the disease caused by SARS-CoV-2, with early diagnosis being an urgent and needed because they are considered a population with high risk for severe and serious conditions.
Purpose. The objective of our study was to estimate whether sudden-onset anosmia allow to detect COVID-19 infection early in hemodialysis patients without classic symptoms (who did not present malaise, respiratory or gastrointestinal symptoms at the beginning of the disease).
Methodology. A diagnostic test study was accomplished during the months of September and October 2020 in three hemodialysis units in Colombia. Adult patients without classic symptoms for COVID-19 were included. Patients with previous COVID-19 infection or with a history of smell alteration were excluded. Demographic, clinical, and laboratory data were collected, prior signature of informed consent endorsed by the ethics committee. Anosmia was evaluated with objective test for odor detection before the start of hemodialysis session.
Results. 587 patients were included. Anosmia prevalence was 0.85% (5 patients) and the incidence of COVID-19 was 1.19% (7 patients). There was no statistically difference in demographic, clinical, and laboratory comparison between patients with and without anosmia. The presence of anosmia had a sensitivity and a positive predictive value of 0%, but a specificity of 99.14% and a negative predictive value of 98.8%. The accuracy was 97.9%.
Conclusions. The prevalence of anosmia in our hemodialysis population was low. Any symptoms (including altered sense of smell) should be investigated in TRIAGE as a strategy to detect early individual cases of COVID-19 or an outbreak in hemodialysis units.
Methods: a diagnostic test study was accomplished in three hemodialysis units in Colombia. Adult patients without classic symptoms for COVID-19 were included. Patients with previous COVID-19 infection or with a history of smell alteration were excluded. Demographic, clinical, and laboratory data were collected. Anosmia was evaluated with objective test for odor detection before the start of hemodialysis session.
Results: 587 patients were included. Anosmia prevalence was 0.85% (5 patients) and the incidence of COVID-19 was 1.19% (7 patients). There was no statistically difference in demographic, clinical, and laboratory comparison between patients with and without anosmia. The presence of anosmia had a sensitivity and a positive predictive value of 0%, but a specificity of 99.14% and a negative predictive value of 98.8%. The accuracy was 97.9%.
Conclusion: Anosmia prevalence in hemodialysis population is low. Any symptoms should be investigated in the TRIAGE as a strategy to detect early individual cases of COVID-19 or outbreak in hemodialysis units.
Keywords: Chronic Kidney Disease, Hemodialysis, Anosmia, COVID-19, Prevalence, pandemics
References
Wu Z, McGoogan JM. Characteristics of and Important Lessons From the Coronavirus Disease 2019 (COVID-19) Outbreak in China. JAMA. 2020;323(13):1239-42. https://doi.org/10.1001/jama.2020.2648
Walker A, Hopkins C, Surda P. Use of Google Trends to investigate loss?of?smell?related searches during the COVID?19 outbreak. Int Forum Allergy Rhinol. 2020;10(7):839-47. https://doi.org/10.1002/alr.22580
Doty RL. Epidemiology of smell and taste dysfunction. Handb Clinical Neurol. 2019;164:3-13. https://doi.org/10.1016/B978-0-444-63855-7.00001-0
Griep M, van der Niepen P, Sennesael J, Mets T, Massart D, Verbeelen L. Odour perception in chronic renal disease. Nephrol Dial Transplant. 1997;12(10):2093-8. https://doi.org/10.1093/ndt/12.10.2093
Bossola M, Luciani G, Rosa F, Tazza L. Appetite and Gastrointestinal Symptoms in Chronic Hemodialysis Patients. J Ren Nutr. 2011;21(6):448-54. https://doi.org/10.1053/j.jrn.2010.09.003
Frasnelli JA, Temmel AF, Quint C, Oberbauer R, Hummel T. Olfactory function in chronic renal failure. Am J Rhinol. 2002;16(5):275-9. https://doi.org/10.1177/194589240201600511
Gorayeb-Polacchini FS, Caldas HC, Bottazzo AC, Abbud-Filho M. SARS-CoV-2 assessment in an outpatient dialysis facility of a single center in Brazil. Braz J Infect Dis. 2021;25(3):101595. https://doi.org/10.1016/j.bjid.2021.101595
Feehan AK, Fort D, Velasco C, Burton JH, Garcia-Diaz J, Price-Haywood EG, et al. The importance of anosmia, ageusia and age in community presentation of symptomatic and asymptomatic SARS-CoV-2 infection in Louisiana, USA; a cross-sectional prevalence study. CMI. 2021;27(4):633.e9-16. https://doi.org/10.1016/j.cmi.2020.12.029
Pierron D, Pereda-Loth V, Mantel M, Moranges M, Bignon E, Alva O, et al. Smell and taste changes are early indicators of the COVID-19 pandemic and political decision effectiveness. Nat Commun. 2020;11:5152. https://doi.org/10.1038/s41467-020-18963-y
Zayet S, Klopfenstein T, Mercier J, Kadiane-Oussou NJ, Lan-Cheong L, Royer PY, et al. Contribution of anosmia and dysgeusia for diagnostic of COVID-19 in outpatients. Infection. 2021;49(2):361-5. https://doi.org/10.1007/s15010-020-01442-3
Mizrahi B, Shilo S, Rossman H, Kalkstein N, Marcus K, Barer Y, et al. Longitudinal symptom dynamics of COVID-19 infection. Nat Commun. 2020;11(1):6208. https://doi.org/10.1038/s41467-020-20053-y
Polat B, Yilmaz NH, Altin G, Atakcan Z, Mert A. Olfactory and Gustatory Dysfunctions in COVID-19 Patients: From a Different Perspective. J Craniofac Sur. 2021;32(6):2119-22. https://doi.org/10.1097/SCS.0000000000007412
Robles-Osorio ML, Corona R, Morales T, Sabath E. Enfermedad renal crónica y olfato. Nefrología. 2020;40(2):120-5. https://doi.org/10.1016/j.nefro.2019.04.009
Schiffman SS, Nash ML, Dackis C. Reduced olfactory discrimination in patients on chronic hemodialysis. Physiol Behav. 1978;21(2):239-42. https://doi.org/10.1016/0031-9384(78)90046-X
This work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.