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[Preprint]. 2020 Jul 28:2020.07.22.20157263.
doi: 10.1101/2020.07.22.20157263.

The best COVID-19 predictor is recent smell loss: a cross-sectional study

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

The best COVID-19 predictor is recent smell loss: a cross-sectional study

Richard C Gerkin et al. medRxiv. .

Update in

  • Recent Smell Loss Is the Best Predictor of COVID-19 Among Individuals With Recent Respiratory Symptoms.
    Gerkin RC, Ohla K, Veldhuizen MG, Joseph PV, Kelly CE, Bakke AJ, Steele KE, Farruggia MC, Pellegrino R, Pepino MY, Bouysset C, Soler GM, Pereda-Loth V, Dibattista M, Cooper KW, Croijmans I, Di Pizio A, Ozdener MH, Fjaeldstad AW, Lin C, Sandell MA, Singh PB, Brindha VE, Olsson SB, Saraiva LR, Ahuja G, Alwashahi MK, Bhutani S, D'Errico A, Fornazieri MA, Golebiowski J, Dar Hwang L, Öztürk L, Roura E, Spinelli S, Whitcroft KL, Faraji F, Fischmeister FPS, Heinbockel T, Hsieh JW, Huart C, Konstantinidis I, Menini A, Morini G, Olofsson JK, Philpott CM, Pierron D, Shields VDC, Voznessenskaya VV, Albayay J, Altundag A, Bensafi M, Bock MA, Calcinoni O, Fredborg W, Laudamiel C, Lim J, Lundström JN, Macchi A, Meyer P, Moein ST, Santamaría E, Sengupta D, Rohlfs Dominguez P, Yanik H, Hummel T, Hayes JE, Reed DR, Niv MY, Munger SD, Parma V; GCCR Group Author. Gerkin RC, et al. Chem Senses. 2021 Jan 1;46:bjaa081. doi: 10.1093/chemse/bjaa081. Chem Senses. 2021. PMID: 33367502 Free PMC article.

Abstract

Background: COVID-19 has heterogeneous manifestations, though one of the most common symptoms is a sudden loss of smell (anosmia or hyposmia). We investigated whether olfactory loss is a reliable predictor of COVID-19.

Methods: This preregistered, cross-sectional study used 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 singular and cumulative predictors of COVID-19 status and post-COVID-19 olfactory recovery.

Results: 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 single and cumulative feature models (ROC AUC=0.72), with additional features providing no significant model improvement. VAS ratings of smell loss were more predictive than binary chemosensory yes/no-questions or other cardinal symptoms, such as fever or cough. Olfactory recovery within 40 days was reported for ~50% of participants and was best predicted by time since illness onset.

Conclusions: As smell loss is the best predictor of COVID-19, we developed the ODoR-19 tool, a 0-10 scale to screen for recent olfactory loss. Numeric ratings ≤2 indicate high odds of symptomatic COVID-19 (10<OR<4), especially when viral lab tests are impractical or unavailable.

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