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

Richard C. Gerkin 1 Kathrin Ohla 2 Maria G. Veldhuizen 3 Paule V. Joseph 4 Christine E. Kelly 5 Alyssa J. Bakke 6 Kimberley E. Steele 4 Michael C. Farruggia 7 Robert Pellegrino 8 Marta Y. Pepino 9 Cédric Bouysset 10 Graciela M. Soler 11 Veronica Pereda-Loth 12 Michele Dibattista 13 Keiland W. Cooper 14 Ilja Croijmans 15 Antonella Di Pizio 16 Mehmet Hakan Ozdener 17 Alexander W. Fjaeldstad 18 Cailu Lin 17 Mari A. Sandell 19 Preet B. Singh 20 Evelyn Brindha 21 Shannon B. Olsson 22 Luis R. Saraiva 23 Gaurav Ahuja 24 Mohammed K. Alwashahi 25 Surabhi Bhutani 26 Anna D’errico 27 Marco A. Fornazieri 28 Jérôme Golebiowski 29 Liang Dar Hwang 30 Lina Öztürk 3 Eugeni Roura 31 Sara Spinelli 32 Katherine L. Whitcroft 33 Farhoud Faraji 34 Florian Ph. S. Fischmeister 35 Thomas Heinbockel 36 Julien W. Hsieh 37 Caroline Huart 38 Iordanis Konstantinidis 39 Anna Menini 40 Gabriella Morini 41 Jonas K. Olofsson 41 Carl M. Philpott 42 Denis Pierron 12 Vonnie D. C. Shields 43 Vera V. Voznessenskaya 44 Javier Albayay 45 Aytug Altundag 46 Moustafa Bensafi 47 María Adelaida Bock 48 Orietta Calcinoni 49 William Fredborg 41 Christophe Laudamiel 50 Juyun Lim 51 Johan N. Lundström 52 Alberto Macchi 53 Pablo Meyer 54 Shima T. Moein 55 Enrique Santamaría 55 Debarka Sengupta 24 Paloma Rohlfs Dominguez 56 Hüseyin Yanik 3 Thomas Hummel 57 John E. Hayes 6 Danielle R. Reed 17 Masha Y. Niv 58 Steven D. Munger 59 Valentina Parma 60, * Sanne Boesveldt 61 Jasper H. B. de Groot 62 Caterina Dinnella 32 Jessica Freiherr 63 Tatiana Laktionova 45 Sajidxa Marino 64 Erminio Monteleone 32 Alexia Nunez-Parra 64 Olagunju Abdulrahman 65 Marina Ritchie 66 Thierry Thomas-Danguin 67, 68 Julie Walsh-Messinger 69 Rashid Al Abri 25 Rafieh Alizadeh 70 Emmanuelle Bignon 10 Elena Cantone 71 Maria Paola Cecchini 72 Jingguo Chen 73 Maria Dolors Guàrdia 74 Kara C. Hoover 75 Noam Karni 76 Marta Navarro 31 Alissa A. Nolden 77 Patricia Portillo Mazal 78 Nicholas R. Rowan 79 Atiye Sarabi-Jamab 80 Nicholas S. Archer 81 Ben Chen 82 Elizabeth A. Di Valerio 59 Emma L. Feeney 83 Johannes Frasnelli 84 Mackenzie E Hannum 17 Claire Hopkins 85 Hadar Klein 58 Coralie Mignot 57 Carla Mucignat 45 Yuping Ning 82 Elif E. Ozturk 86 Mei Peng 87 Ozlem Saatci 88 Elizabeth A. Sell 89 Carol H. Yan 90 Raul Alfaro 9 G. Coureaud 47 Riley D. Herriman 17 Jeb M. Justice 59 Pavan Kumar Kaushik 91 Sachiko Koyama 92 Jonathan B. Overdevest 93 Nicola Pirastu 94 Vicente A. Ramirez 95 S. Craig Roberts 96 Barry C. Smith 97 Hongyuan Cao 98 Hong Wang 17 Patrick Balungwe Birindwa 99 Marius Baguma 99 Mehmet Hakan Ozdener 17 Florian Ph.S Fischmeister 35 María Adelaida Bock 48 Pavan Kumar Kaushik 91 Antonella Di Pizio 16 Mehmet Hakan Ozdener 17 Preet B. Singh 20 Anna d'Errico 27 Liang Dar Hwang 100 Gccr Group Maria Paola Cecchini 72 Elizabeth A. Di Valerio 59 Loïc Briand 67 Sophie Nicklaus 67 Charlotte Sinding 67 Anne Tromelin 67 
* Corresponding author
1 ASU - Arizona State University [Tempe]
2 Forschungszentrum Jülich GmbH | Centre de recherche de Juliers
3 Mersin University
4 NIH - National Institutes of Health [Bethesda]
5 AbScent
6 Penn State - Pennsylvania State University
7 Yale University [New Haven]
8 University of Tennessee
9 University of Illinois at Urbana-Champaign [Urbana]
10 ICN - Institut de Chimie de Nice
11 Buenos Aires University and GEOG (Grupo de Estudio de Olfato y Gusto)
12 CAGT - Centre d'anthropologie et de génomique de Toulouse
13 UNIBA - Università degli studi di Bari Aldo Moro
14 University of California
15 Utrecht University [Utrecht]
16 TUM - Technische Universität Munchen - Université Technique de Munich [Munich, Allemagne]
17 Monell Chemical Senses Center
18 Regional Hospital West Jutland [Denmark]
19 Helsingin yliopisto = Helsingfors universitet = University of Helsinki
20 UiO - University of Oslo
21 Karunya Institute of Technology and Sciences
22 Tata Institute of Fundamental Research [Bangalore]
23 Sidra Medicine [Doha, Qatar]
24 IIIT-Delhi - Indraprastha Institute of Information Technology [New Delhi]
25 SQU - Sultan Qaboos University
26 SDSU - San Diego State University
27 Goethe-University Frankfurt am Main
28 State University of Londrina = Universidade Estadual de Londrina
29 Elena Cantone
30 University of Queensland - The Diamantina Institute
31 University of Queensland [Brisbane]
32 UNIFI - Università degli Studi di Firenze = University of Florence [Firenze]
33 UCL - University College of London [London]
34 UC San Diego Health
35 Karl-Franzens-Universität Graz
36 Howard University College of Medicine [Washington, DC, USA]
37 Geneva University Hospitals and Geneva University
38 Cliniques Universitaires Saint-Luc [Bruxelles]
39 Aristotle University of Thessaloniki
40 SISSA / ISAS - Scuola Internazionale Superiore di Studi Avanzati / International School for Advanced Studies
41 Stockholm University
42 UEA - University of East Anglia [Norwich]
43 Towson University [Towson, MD, United States]
44 A.N. Severtsov Institute of Ecology and Evolution
45 Universita degli Studi di Padova
46 Biruni University
47 CRNL - Centre de recherche en neurosciences de Lyon - Lyon Neuroscience Research Center
48 Public Hospital Barrio Obrero - Hospital General de Barrio Obrero [Asunción, Paraguay]
49 Private practice [Milan]
50 DreamAir Llc
51 OSU - Oregon State University
52 Karolinska Institutet [Stockholm]
53 Universitá degli Studi dell’Insubria
54 IBM Watson Research Center
55 Navarrabiomed-IdiSNA
56 University of Extremadura
57 TU Dresden - Technische Universität Dresden = Dresden University of Technology
58 HUJ - The Hebrew University of Jerusalem
59 UF - University of Florida [Gainesville]
60 Temple University [Philadelphia]
61 WUR - Wageningen University and Research [Wageningen]
62 Radboud university [Nijmegen]
63 FAU - Friedrich-Alexander Universität Erlangen-Nürnberg
64 UCHILE - Universidad de Chile = University of Chile [Santiago]
65 FUTA - Federal University of Technology of Akure
66 University of California [Berkeley]
67 CSGA - Centre des Sciences du Goût et de l'Alimentation [Dijon]
68 UBFC - Université Bourgogne Franche-Comté [COMUE]
69 University of Dayton
70 IUMS - Iran University of Medical Sciences [Tehran, Iran]
71 "Federico II" University of Naples Medical School
72 UNIVR - Università degli studi di Verona = University of Verona
73 Xjtu - Xi'an Jiaotong University
74 IRTA - Institute of Agrifood Research and Technology
75 UAF - University of Alaska [Fairbanks]
76 The Hebrew University Medical Center
77 UMASS - University of Massachusetts System
78 Instituto Universitario del Hospital Italiano [Buenos Aires, Argentina]
79 Johns Hopkins University School of Medicine [Baltimore]
80 IPM - Institute for Research in Fundamental Sciences [Tehran]
81 CSIRO - CSIRO Agriculture and Food
82 GMU - The First Affiliated Hospital of Guangzhou Medical University
83 UCD - University College Dublin [Dublin]
84 UQTR - Université du Québec à Trois-Rivières
85 Guy’s and St. Thomas’ Hospitals
86 Kilis Yedi Aralik University
87 University of Otago [Dunedin, Nouvelle-Zélande]
88 Sancaktepe Education and Research Hospital
89 University of Pennsylvania [Philadelphia]
90 University of California San Diego Health
91 Tata Institute of Fundamental Research
92 Indiana University [Bloomington]
93 CUMC - Columbia University Medical Center
94 University of Edinburgh
95 University of California [Merced]
96 University of Stirling
97 University of London [London]
98 FSU - Florida State University [Tallahassee]
99 Université catholique de Bukavu
100 USQ - University of Southern Queensland
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.
Keywords : anosmia chemosensory coronavirus hyposmia olfactory prediction
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Journal articles
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https://hal-cnrs.archives-ouvertes.fr/hal-03367315
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Submitted on : Thursday, October 7, 2021 - 11:06:51 AM
Last modification on : Friday, September 30, 2022 - 9:32:08 AM
Long-term archiving on: : Saturday, January 8, 2022 - 6:07:36 PM

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Richard C. Gerkin, Kathrin Ohla, Maria G. Veldhuizen, Paule V. Joseph, Christine E. Kelly, et al.. Recent smell loss is the best predictor of COVID-19 among individuals with recent respiratory symptoms. Chemical Senses, Oxford University Press (OUP), 2020, 46, pp.bjaa081. ⟨10.1093/chemse/bjaa081⟩. ⟨hal-03367315⟩

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