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

Richard Gerkin 1 Kathrin Ohla 2 Maria Veldhuizen 3 Paule Joseph 4 Christine Kelly 5 Alyssa Bakke 6 Kimberley Steele 4 Michael Farruggia 7 Robert Pellegrino 8 Marta Pepino 9 Cédric Bouysset 10 Graciela Soler 11 Veronica Pereda-Loth 12 Michele Dibattista 13 Keiland Cooper 14 Ilja Croijmans 15 Antonella Di Pizio 16 Mehmet Hakan Ozdener 17 Alexander Fjaeldstad 18 Cailu Lin 17 Mari Sandell 19 Preet Singh 20 Evelyn Brindha 21 Shannon Olsson 22 Luis Saraiva 23 Gaurav Ahuja 24 Mohammed Alwashahi 25 Surabhi Bhutani 26 Anna D’errico 27 Marco Fornazieri 28 Jérôme Golebiowski 29 Liang Dar Hwang 30 Lina Öztürk 3 Eugeni Roura 31 Sara Spinelli 32 Katherine Whitcroft 33 Farhoud Faraji 34 Florian Fischmeister 35 Thomas Heinbockel 36 Julien Hsieh 37 Caroline Huart 38 Iordanis Konstantinidis 39 Anna Menini 40 Gabriella Morini 41 Jonas Olofsson 41 Carl Philpott 42 Denis Pierron 12 Vonnie Shields 43 Vera 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 Lundström 52 Alberto Macchi 53 Pablo Meyer 54 Shima Moein 55 Enrique Santamaría 55 Debarka Sengupta 24 Paloma Rohlfs Dominguez 56 Hüseyin Yanik 3 Thomas Hummel 57 John Hayes 6 Danielle Reed 17 Masha Niv 58 Steven Munger 59 Valentina Parma 60, * Sanne Boesveldt 61 Jasper 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 Hoover 75 Noam Karni 76 Marta Navarro 31 Alissa Nolden 77 Patricia Portillo Mazal 78 Nicholas Rowan 79 Atiye Sarabi-Jamab 80 Nicholas Archer 81 Ben Chen 82 Elizabeth Di Valerio 59 Emma Feeney 83 Johannes Frasnelli 84 Mackenzie Hannum 17 Claire Hopkins 85 Hadar Klein 58 Coralie Mignot 57 Carla Mucignat 86 Yuping Ning 82 Elif Ozturk 87 Mei Peng 88 Ozlem Saatci 89 Elizabeth Sell 90 Carol Yan 91 Raul Alfaro 9 G. Coureaud 47 Riley Herriman 17 Jeb Justice 59 Pavan Kumar Kaushik 92 Sachiko Koyama 93 Jonathan Overdevest 94 Nicola Pirastu 95 Vicente Ramirez 96 S. Craig Roberts 97 Barry Smith 98 Hongyuan Cao 99 Hong Wang 17 Patrick Balungwe Birindwa 100 Marius Baguma 100 Mehmet Ozdener 17 Florian Fischmeister 35 María Bock 48 Pavan Kaushik 92 Antonella Pizio 16 Mehmet Hakan Ozdener 17 Preet Singh 20 Anna d'Errico 27 Liang Dar Hwang 101 Gccr Group Maria Cecchini 72 Elizabeth Di Valerio 59
* Corresponding 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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Submitted on : Thursday, October 7, 2021 - 11:06:51 AM
Last modification on : Tuesday, May 3, 2022 - 6:26:04 PM
Long-term archiving on: : Saturday, January 8, 2022 - 6:07:36 PM

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Richard Gerkin, Kathrin Ohla, Maria Veldhuizen, Paule Joseph, Christine 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), 2021, 46, pp.bjaa081. ⟨10.1093/chemse/bjaa081⟩. ⟨hal-03367315⟩

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