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. 2022 May;181(5):1859-1869.
doi: 10.1007/s00431-022-04375-1. Epub 2022 Jan 14.

Olfactory function in congenital cytomegalovirus infection: a prospective study

Françoise Lazarini  1 , Sarah Levivien  2 , Yoann Madec  3 , Fabien Taieb  3   4 , Estelle Mottez  4 , Tan-Phuc Buivan  5 , Audrey Maudoux  2   6   7 , Sylvette Wiener-Vacher  2   6 , Jérôme Nevoux  8   9   10 , Thierry Van Den Abbeele  2   6 , Pierre Gressens #  6 , Pierre-Marie Lledo  1 , Natacha Teissier #  11   12
Affiliations

Olfactory function in congenital cytomegalovirus infection: a prospective study

Françoise Lazarini et al. Eur J Pediatr. 2022 May.

Abstract

Congenital cytomegalovirus (CMV) infection leads to olfactory bulb lesions in the fetus, yet little is known about its impact on olfaction after birth. Here, we have assessed in a prospective study conducted on children in two French hospitals from 2016 to 2019, infection severity and olfactory performance after congenital CMV infection. Children with congenital CMV infection aged 3 to 10 years and healthy controls (CTL) matched for age and sex to CMV children symptomatic at birth (sCMV) were enrolled. Olfactory discrimination was assessed using mono-odorants and binary mixtures. Data were analyzed for 54 children with PCR-confirmed congenital CMV infection, including 34 sCMV (median [IQR] age, 6 [5-8] years; 19 [55.9%] male), and 20 CMV asymptomatic at birth (aCMV, median [IQR] age, 4 [3-6] years; 12 [60.0%] male). sCMV were compared to 34 CTL children. Olfactory scores in CMV-infected children were independent from vestibular deficit and hearing loss. The olfactory score was efficient to discriminate between CTL and sCMV for children > 6 years (area under the receiver-operating characteristic curve (AUC, 0.85; P = 0.0006), but not for children < 7 years. For children > 6 years, the proportion of children with total olfactory score < 4 differed between sCMV and CTL groups (91.2% and 18.7%, P < 0.001), but not between aCMV and age-matched healthy control groups. Conclusion: Congenital CMV infection is associated with reduced olfactory performance in children with infection symptoms at birth. Clinical trial registration: NCT02782988 (registration date: May 26, 2016). What is Known: •Congenital cytomegalovirus infection leads to olfactory bulb lesions in the fetus, yet little is known about its impact on olfaction after birth. •Depending on neonatal clinical presentation, children are either categorized as having a symptomatic or asymptomatic infection at birth. What is New: •Congenital cytomegalovirus infection is associated with reduced olfactory performance in children with infection symptoms at birth.

Keywords: Children; Diagnosis; Discrimination; Odorant mixture; Olfaction; Smell.

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Conflict of interest statement

The odorant mixtures are the subject of a patent (WO2017198816A1 published on November 23, 2017) by Institut Pasteur, Centre National de la Recherche Scientifique, and Assistance Publique–Hôpitaux de Paris on which Drs Lazarini, Lledo, Teissier, and Levivien are named as inventors. Drs Lazarini, Madec, Taieb, Mottez, Lledo, and Mr Buivan are employees of Institut Pasteur of Paris that sponsored this research. The remaining authors declare no other disclosures.

Figures

Fig. 1
Fig. 1
Enrolment in the INFECSMELL-CLIN study. This study was performed between May 2016 and December 2019 in two hospital centers in Paris, France
Fig. 2
Fig. 2
ROC curves for the discrimination of children with congenital cytomegalovirus infection and controls using the olfactory scores. Panels a–d show the ROC curves for the discrimination of sCMV and matched controls between 3–6 years (a) and 7–10 years (b–d) using the olfactory score (a, b), the monomolecular odorant score (c), and the mixture score (d). N = 34 sCMV; N = 34 CTL
Fig. 3
Fig. 3
Olfactory scores in children with congenital cytomegalovirus infection and controls. Panels a–e show the total olfactory score (a, d, e), the monomolecular odorant (b), and mixture (c) scores. Box and whiskers showing median, 10 percentile, 25 percentile, 75 percentile, and 90 percentile in bar graphs. P < 0.05 are shown. N = 54 CMV including 34 sCMV and 20 aCMV. N = 34 CTL
See this image and copyright information in PMC

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