Anosmia and Ageusia as Predictive Signs of COVID-19 in Healthcare Workers in Italy: A Prospective Case-Control Study

doi:10.3390/jcm9092870

. 2020 Sep 4;9(9):2870.

doi: 10.3390/jcm9092870.

Anosmia and Ageusia as Predictive Signs of COVID-19 in Healthcare Workers in Italy: A Prospective Case-Control Study

Giuseppe La Torre¹, Anna Paola Massetti^{1

2}, Guido Antonelli³, Caterina Fimiani^{1

2}, Mauro Fantini¹, Mattia Marte¹, Augusto Faticoni¹, Carlo Maria Previte¹, Ombretta Turriziani³, Francesco Pugliese⁴, Paolo Villari¹, Ferdinando Romano¹, Claudio Maria Mastroianni^{1

2}, Covid-Sapienza Collaborative Group⁵

Affiliations

¹ Department of Public health and Infectious Diseases, Sapienza University of Rome, 00185 Rome, Italy.
² Department of Infectious Diseases, Teaching Hospital "Policlinico Umberto I", Sapienza University, 00185 Rome, Italy.
³ Department of Molecular Medicine, Teaching Hospital "Policlinico Umberto I", Sapienza University, 00185 Rome, Italy.
⁴ Division of Anesthesiology and Intensive Care, Teaching Hospital "Policlinico Umberto I", Sapienza University of Rome, 00185 Rome, Italy.
⁵ Covid-19 Sapienza Collaborative group, Sapienza University of Rome, 00185 Rome, Italy.

PMID: 32899778
PMCID: PMC7564490
DOI: 10.3390/jcm9092870

Anosmia and Ageusia as Predictive Signs of COVID-19 in Healthcare Workers in Italy: A Prospective Case-Control Study

Giuseppe La Torre et al. J Clin Med. 2020.

. 2020 Sep 4;9(9):2870.

doi: 10.3390/jcm9092870.

Authors

Affiliations

¹ Department of Public health and Infectious Diseases, Sapienza University of Rome, 00185 Rome, Italy.
² Department of Infectious Diseases, Teaching Hospital "Policlinico Umberto I", Sapienza University, 00185 Rome, Italy.
³ Department of Molecular Medicine, Teaching Hospital "Policlinico Umberto I", Sapienza University, 00185 Rome, Italy.
⁴ Division of Anesthesiology and Intensive Care, Teaching Hospital "Policlinico Umberto I", Sapienza University of Rome, 00185 Rome, Italy.
⁵ Covid-19 Sapienza Collaborative group, Sapienza University of Rome, 00185 Rome, Italy.

PMID: 32899778
PMCID: PMC7564490
DOI: 10.3390/jcm9092870

Abstract

Background: The aim of this study was to investigate the diagnostic accuracy of symptoms and signs in healthcare workers (HCW) with Sars-CoV-2.

Methods: This was a case-control study. Cases consisted of symptomatic healthcare workers who had a positive SARS-CoV-2 real-time polymerase chain reaction (RT-PCR) test, while controls were symptomatic healthcare workers with a negative RT-PCR test. For each symptom, ROCs were plotted. Diagnostic accuracy was calculated using the sensitivity, specificity, and positive and negative predictive values. A logistic regression analysis was carried out for calculating the OR (95% CI) for each symptom associated to the SARS-CoV-2 positivity.

Results: We recruited 30 cases and 75 controls. Fever had the best sensitivity while dyspnea, anosmia, and ageusia had the highest specificity. The highest PPVs were found again for dyspnea (75%), anosmia (73.7%), and ageusia (66.7%). Lastly, the highest NPVs were related to anosmia (81.4%) and ageusia (79.3%). Anosmia (OR = 14.75; 95% CI: 4.27-50.87), ageusia (OR = 9.18; 95% CI: 2.80-30.15), and headache (OR = 3.92; 95% CI: 1.45-10.56) are significantly associated to SARS-CoV-2 positivity.

Conclusions: Anosmia and ageusia should be considered in addition to the well-established fever, cough, and dyspnea. In a resource-limited setting, this method could save time and money.

Keywords: COVID-19; Italy; SARS-CoV-2; ageusia; anosmia; healthcare workers; signs; symptoms.

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Conflict of interest statement

The authors declare no conflict of interest.

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[1] Chen N., Zhou M., Dong X., Qu J., Gong F., Han Y., Qiu Y., Wang J., Liu Y., Wei Y., et al. Epidemiological and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan, China: A descriptive study. Lancet. 2020;395:507–513. doi: 10.1016/S0140-6736(20)30211-7. - DOI - PMC - PubMed

[2] Chen N., Zhou M., Dong X., Qu J., Gong F., Han Y., Qiu Y., Wang J., Liu Y., Wei Y., et al. Epidemiological and clinical characteristics of 99 cases of 2019 novel coronavirus pneumonia in Wuhan, China: A descriptive study. Lancet. 2020;395:507–513. doi: 10.1016/S0140-6736(20)30211-7. - DOI - PMC - PubMed

[3] Lauer S.A., Grantz K.H., Bi Q., Jones F.K., Zheng Q., Meredith H.R., Azman A.S., Reich N.G., Lessler J. The Incubation Period of Coronavirus Disease 2019 (COVID-19) From Publicly Reported Confirmed Cases: Estimation and Application. Ann. Intern. Med. 2020;172:577–582. doi: 10.7326/M20-0504. - DOI - PMC - PubMed

[4] Lauer S.A., Grantz K.H., Bi Q., Jones F.K., Zheng Q., Meredith H.R., Azman A.S., Reich N.G., Lessler J. The Incubation Period of Coronavirus Disease 2019 (COVID-19) From Publicly Reported Confirmed Cases: Estimation and Application. Ann. Intern. Med. 2020;172:577–582. doi: 10.7326/M20-0504. - DOI - PMC - PubMed

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[6] Task force COVID-19 del Dipartimento Malattie Infettive e Servizio di Informatica, Istituto Superiore di Sanità. [(accessed on 26 July 2020)]; Epidemia COVID-19, Aggiornamento Nazionale: 30 Marzo 2020. Available online: https://www.epicentro.iss.it/coronavirus/bollettino/Bollettino-sorveglia....

[7] Wu J., Liu J., Zhao X., Liu C., Wang W., Wang D., Xu W., Zhang C., Yu J., Jiang B., et al. Clinical Characteristics of Imported Cases of COVID-19 in Jiangsu Province: A Multicenter Descriptive Study. Clin. Infect. Dis. 2020;10 doi: 10.1093/cid/ciaa199. - DOI - PMC - PubMed

[8] Wu J., Liu J., Zhao X., Liu C., Wang W., Wang D., Xu W., Zhang C., Yu J., Jiang B., et al. Clinical Characteristics of Imported Cases of COVID-19 in Jiangsu Province: A Multicenter Descriptive Study. Clin. Infect. Dis. 2020;10 doi: 10.1093/cid/ciaa199. - DOI - PMC - PubMed

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[10] Sun Y., Koh V., Marimuthu K., Ng O.T., Young B., Vasoo S., Chan M., Lee V.J.M., De P.P., Barkham T., et al. Epidemiological and Clinical Predictors of COVID-19. Clin. Infect. Dis. 2020 doi: 10.1093/cid/ciaa322. - DOI - PMC - PubMed

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Anosmia and Ageusia as Predictive Signs of COVID-19 in Healthcare Workers in Italy: A Prospective Case-Control Study

Affiliations

Anosmia and Ageusia as Predictive Signs of COVID-19 in Healthcare Workers in Italy: A Prospective Case-Control Study

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Affiliations

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