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

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  • Richard C Gerkin, Arizona State Univ, Arizona State University
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  • Kathrin Ohla, Forschungszentrum Jülich
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  • Maria G Veldhuizen, Mersin University
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  • Paule V Joseph, National Institutes of Nursing Research
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  • Christine E Kelly, AbScent.
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  • Alyssa J Bakke, The Pennsylvania State University
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  • Kimberley E Steele, National Institute of Environmental Health Sciences, National Institutes of Health
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  • Michael C Farruggia, Yale Univ, Yale University, Yale Peabody Museum Nat Hist
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  • Robert Pellegrino, Univ Tennessee, University of Tennessee Knoxville, University of Tennessee System, Inst Secur & Sustainable Environm
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  • Marta Y Pepino, Department of Kinesiology and Community Health, University of Illinois at Urbana-Champaign Urbana, IL, USA ; Department of English, University of Illinois at Urbana-Champaign Urbana, IL, USA.
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  • Cédric Bouysset, Institut de Chimie de Nice
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  • Graciela M Soler, Grupo de Estudio de Olfato y Gusto (GEOG)
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  • Veronica Pereda-Loth, IMFT UMR 5502, Université de Toulouse og Toulouse University Hospital, Toulouse
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  • Michele Dibattista, Department of Laboratory Animal Science, College of Basic Medical Sciences, Third Military Medical University, Chongqing, 400038, P. R. China.
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  • Keiland W Cooper, Department of Dermatology, University of California, San Diego, California; Department of Pediatrics, University of California, San Diego, California; Rady Children's Hospital, San Diego, California.
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  • Ilja Croijmans, Univ Utrecht, Utrecht University, Utrecht University Medical Center, UMC Utrecht, Dept Hematol
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  • Antonella Di Pizio, Leibniz-Institute for Food Systems Biology at the Technical University of Munich
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  • M Hakan Ozdener, Monell Chemical Senses Center
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  • Alexander W Fjaeldstad
  • Cailu Lin, Monell Chemical Senses Center
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  • Mari A Sandell, Helsinki University Central Hospital, University of Helsinki, Helsinki, Finland.
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  • Preet B Singh, Oslo University Hospital, National Advisory Unit on Late Effects after Cancer Treatment, Oslo University Hospital, Oslo, Norway; Cancer Registry of Norway, University of Oslo, Oslo, Norway; Faculty of Medicine, University of Oslo, Oslo, Norway. Electronic address: sdf@ous-hf.no.
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  • V Evelyn Brindha, Karunya Institute of Technology and Sciences
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  • Shannon B Olsson, Tata Inst Fundamental Res, Tata Institute of Fundamental Research
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  • Luis R Saraiva, Research Branch
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  • Gaurav Ahuja, Indraprastha Institute of Information Technology
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  • Mohammed K Alwashahi, Sultan Qaboos Univ, Sultan Qaboos University, Dept Biol, Coll Sci
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  • Surabhi Bhutani, San Diego State Univ, California State University System, San Diego State University, Dept Biol
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  • Anna D'Errico, Univ Hosp Frankfurt, Goethe University Frankfurt, Goethe University Frankfurt Hospital
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  • Marco A Fornazieri, Cardiac Surgery & Clinical Nursing Research Unit
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  • Jérôme Golebiowski, Institut de Chimie de Nice
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  • Liang-Dar Hwang, The University of Queensland Diamantina Institute, University of Queensland, Australia.
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  • Lina Öztürk, Mersin University
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  • Eugeni Roura, The University of Queensland Diamantina Institute, University of Queensland, Australia.
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  • Sara Spinelli, University of Florence, Florence
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  • Katherine L Whitcroft, Univ Coll London Hosp NHS Fdn Trust, University College London Hospitals NHS Foundation Trust, University of London, University College London, Inst Nucl Med
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  • Farhoud Faraji, Division of Surgery, Department of Clinical and Experimental Medicine, Faculty of Health Sciences, Linköping University, and Department of Surgery, County Council of Östergötland, Linköping, Sweden; Department of Surgery, Unit of Colorectal Surgery, Oxford University Hospitals, Oxford, UK.
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  • Florian PhS Fischmeister, Cancer Biology Unit, Department of Dermatology, Medical University of Graz, Graz, Austria; Center for Medical Research, Medical University of Graz, Graz, Austria.
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  • Thomas Heinbockel, Howard University College of Medicine
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  • Julien W Hsieh, Geneva University Hospitals, Geneva, Switzerland.
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  • Caroline Huart, Department of ENT and Department of Oncology, Aarhus
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  • Iordanis Konstantinidis, Aristotle Univ Thessaloniki, Aristotle University of Thessaloniki, Ahepa University Hospital, Dept Cardiol 1, AHEPA Univ Hosp
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  • Anna Menini, International School for Advanced Studies
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  • Gabriella Morini, University of Gastronomic Sciences
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  • Jonas K Olofsson, Stockholm Univ, Stockholm University, Stockholm Resilience Ctr
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  • Carl M Philpott, Univ East Anglia, University of East Anglia, Norwich Med Sch
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  • Denis Pierron, IMFT UMR 5502, Université de Toulouse og Toulouse University Hospital, Toulouse
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  • Vonnie D C Shields, Towson University
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  • Vera V Voznessenskaya, A.N. Severtsov Institute of Ecology and Evolution RAS
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  • Javier Albayay, University of Padova, Padova, Italy
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  • GCCR group author

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.

OriginalsprogEngelsk
Artikelnummerbjaa081
TidsskriftChemical Senses
Vol/bind46
Antal sider12
ISSN0379-864X
DOI
StatusUdgivet - jan. 2021

    Forskningsområder

  • Smell, Smell impairment, COVID-19, COVID-19 symptoms

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