Recent smell loss is the best predictor of COVID-19 among individuals with recent respiratory symptoms

Richard C. Gerkin (First Author), Kathrin Ohla (Co-Author), Maria G. Veldhuizen (Co-Author), Paule V. Joseph (Co-Author), Christine E. Kelly (Co-Author), Alyssa J. Bakke (Co-Author), Kimberley E. Steele (Co-Author), Michael C. Farruggia (Co-Author), Robert Pellegrino (Co-Author), Marta Y. Pepino (Co-Author), Cédric Bouysset (Co-Author), Graciela M. Soler (Co-Author), Veronica Pereda-Loth (Co-Author), Michele Dibattista (Co-Author), Keiland W. Cooper (Co-Author), Ilja Croijmans (Co-Author), Antonella Di Pizio (Co-Author), Mehmet Hakan Ozdener (Co-Author), Alexander W. Fjaeldstad (Co-Author), Cailu Lin (Co-Author)Mari A. Sandell (Co-Author), Preet B. Singh (Co-Author), V. Evelyn Brindha (Co-Author), Shannon B. Olsson (Co-Author), Luis R. Saraiva (Co-Author), Gaurav Ahuja (Co-Author), Mohammed K. Alwashahi (Co-Author), Surabhi Bhutani (Co-Author), Anna D’Errico (Co-Author), Marco A. Fornazieri (Co-Author), Jérôme Golebiowski (Co-Author), Liang Dar Hwang (Co-Author), Lina Öztürk (Co-Author), Eugeni Roura (Co-Author), Sara Spinelli (Co-Author), Katherine L. Whitcroft (Co-Author), Farhoud Faraji (Co-Author), Florian Ph S. Fischmeister (Co-Author), Thomas Heinbockel (Co-Author), Julien W. Hsieh (Co-Author), Caroline Huart (Co-Author), Iordanis Konstantinidis (Co-Author), Anna Menini (Co-Author), Gabriella Morini (Co-Author), Jonas K. Olofsson (Co-Author), Carl M. Philpott (Co-Author), Denis Pierron (Co-Author), Vonnie D.C. Shields (Co-Author), Vera V. Voznessenskaya (Co-Author), Javier Albayay (Co-Author), Aytug Altundag (Co-Author), Moustafa Bensafi (Co-Author), María Adelaida Bock (Co-Author), Orietta Calcinoni (Co-Author), William Fredborg (Co-Author), Christophe Laudamiel (Co-Author), Juyun Lim (Co-Author), Johan N. Lundström (Co-Author), Alberto Macchi (Co-Author), Pablo Meyer (Co-Author), Shima T. Moein (Co-Author), Enrique Santamaría (Co-Author), Debarka Sengupta (Co-Author), Paloma Rohlfs Dominguez (Co-Author), Hüseyin Yanik (Co-Author), Thomas Hummel (Co-Author), John E. Hayes, Danielle R. Reed (Co-Author), Masha Y. Niv (Co-Author), Steven D. Munger (Co-Author), Sanne Boesveldt (Co-Author), Jasper H.B. de Groot (Co-Author), Caterina Dinnella (Co-Author), Jessica Freiherr (Co-Author), Tatiana Laktionova (Co-Author), Sajidxa Marino (Co-Author), Erminio Monteleone (Co-Author), Alexia Nunez-Parra (Co-Author), Olagunju Abdulrahman (Co-Author), Marina Ritchie (Co-Author), Thierry Thomas-Danguin (Co-Author), Julie Walsh-Messinger (Co-Author), Rashid Al Abri (Co-Author), Rafieh Alizadeh (Co-Author), Emmanuelle Bignon (Co-Author), Elena Cantone (Co-Author), Maria Paola Cecchini (Co-Author), Jingguo Chen (Co-Author), Maria Dolors Guàrdia (Co-Author), Kara C. Hoover (Co-Author), Noam Karni (Co-Author), Marta Navarro (Co-Author), Alissa A. Nolden (Co-Author), Patricia Portillo Mazal (Co-Author), Nicholas R. Rowan (Co-Author), Atiye Sarabi-Jamab (Co-Author), Nicholas S. Archer (Co-Author), Ben Chen (Co-Author), Elizabeth A. Di Valerio (Co-Author), Emma L. Feeney (Co-Author), Johannes Frasnelli (Co-Author), Mackenzie E. Hannum (Co-Author), Claire Hopkins (Co-Author), Hadar Klein (Co-Author), Coralie Mignot (Co-Author), Carla Mucignat (Co-Author), Yuping Ning (Co-Author), Elif E. Ozturk (Co-Author), Mei Peng (Co-Author), Ozlem Saatci (Co-Author), Elizabeth A. Sell (Co-Author), Carol H. Yan (Co-Author), Raul Alfaro (Co-Author), Cinzia Cecchetto (Co-Author), Gérard Coureaud (Co-Author), Riley D. Herriman (Co-Author), Jeb M. Justice, Pavan Kumar Kaushik (Co-Author), Sachiko Koyama (Co-Author), Jonathan B. Overdevest (Co-Author), Nicola Pirastu (Co-Author), Vicente A. Ramirez (Co-Author), S. Craig Roberts (Co-Author), Barry C. Smith (Co-Author), Hongyuan Cao, Hong Wang (Co-Author), Patrick Balungwe Birindwa (Co-Author), Marius Baguma (Co-Author), Valentina Parma* (Last Author)

*Corresponding author for this work

Research output: Contribution to journal › Article › peer-review

129 Scopus citations

Abstract

In a preregistered, cross-sectional study, we investigated whether olfactory loss is a reliable predictor of COVID-19 using a crowdsourced questionnaire in 23 languages to assess symptoms in individuals self-reporting recent respiratory illness. We quantified changes in chemosensory abilities during the course of the respiratory illness using 0–100 visual analog scales (VAS) for participants reporting a positive (C19+; n = 4148) or negative (C19−; n = 546) COVID-19 laboratory test outcome. Logistic regression models identified univariate and multivariate predictors of COVID-19 status and post-COVID-19 olfactory recovery. Both C19+ and C19− groups exhibited smell loss, but it was significantly larger in C19+ participants (mean ± SD, C19+: −82.5 ± 27.2 points; C19−: −59.8 ± 37.7). Smell loss during illness was the best predictor of COVID-19 in both univariate and multivariate models (ROC AUC = 0.72). Additional variables provide negligible model improvement. VAS ratings of smell loss were more predictive than binary chemosensory yes/no-questions or other cardinal symptoms (e.g., fever). Olfactory recovery within 40 days of respiratory symptom onset was reported for ~50% of participants and was best predicted by time since respiratory symptom onset. We find that quantified smell loss is the best predictor of COVID-19 amongst those with symptoms of respiratory illness. To aid clinicians and contact tracers in identifying individuals with a high likelihood of having COVID-19, we propose a novel 0–10 scale to screen for recent olfactory loss, the ODoR-19. We find that numeric ratings ≤2 indicate high odds of symptomatic COVID-19 (4 < OR < 10). Once independently validated, this tool could be deployed when viral lab tests are impractical or unavailable.

Original languageEnglish
JournalChemical Senses
Volume46
DOIs
StatePublished - 2021

Keywords

  • Anosmia
  • Chemosensory
  • Coronavirus
  • Hyposmia
  • Olfactory
  • Prediction

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