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

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Richard C. Gerkin
Maria G. Veldhuizen
Christine E. Kelly
  • Function : Author
Cédric Bouysset
Ilja Croijmans
Cailu Lin
Luis R. Saraiva
Mohammed K. Alwashahi
Jérôme Golebiowski
Lina Öztürk
  • Function : Author
Eugeni Roura
Jonas K. Olofsson
Carl M. Philpott
Aytug Altundag
  • Function : Author
Juyun Lim
Johan N. Lundström
Hüseyin Yanik
  • Function : Author
John E. Hayes
Danielle R. Reed
Masha Y. Niv
Steven D. Munger
Emmanuelle Bignon
Claire Hopkins
Hong Wang
Gccr Group
  • Function : Author

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.
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Dates and versions

hal-03367315 , version 1 (07-10-2021)

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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, 2021, 46, pp.bjaa081. ⟨10.1093/chemse/bjaa081⟩. ⟨hal-03367315⟩
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