Recent smell loss is the best predictor of COVID-19 among individuals with recent respiratory symptoms
2 FZJ - Forschungszentrum Jülich GmbH | Centre de recherche de Jülich | Juelich Research Centre
3 Mersin University
4 NIH - National Institutes of Health [Bethesda, MD, USA]
5 AbScent
6 Penn State - Pennsylvania State University [State College, PA]
7 Yale University [New Haven]
8 University of Tennessee
9 UIUC - University of Illinois at Urbana-Champaign [Urbana]
10 ICN - Institut de Chimie de Nice
11 Buenos Aires University and GEOG (Grupo de Estudio de Olfato y Gusto)
12 CAGT - Centre d'anthropobiologie et de génomique de Toulouse
13 UNIBA - Università degli studi di Bari Aldo Moro = University of Bari Aldo Moro
14 UC - University of California
15 Universiteit Utrecht / Utrecht University [Utrecht]
16 TUM - Technische Universität Munchen = Technical University Munich = Université Technique de Munich
17 Monell Chemical Senses Center
18 Regional Hospital West Jutland [Denmark]
19 Helsingin yliopisto = Helsingfors universitet = University of Helsinki
20 UiO - University of Oslo
21 Karunya Institute of Technology and Sciences
22 Tata Institute of Fundamental Research [Bangalore]
23 Sidra Medicine [Doha, Qatar]
24 IIIT-Delhi - Indraprastha Institute of Information Technology [New Delhi]
25 SQU - Sultan Qaboos University
26 SDSU - San Diego State University
27 Goethe University Frankfurt = Goethe-Universität Frankfurt am Main
28 State University of Londrina = Universidade Estadual de Londrina
29 Elena Cantone
30 UQ [All campuses : Brisbane, Dutton Park Gatton, Herston, St Lucia and other locations] - The University of Queensland
31 UniFI - Università degli Studi di Firenze = University of Florence = Université de Florence
32 UCL - University College London [UCL]
33 UC San Diego Health
34 Universität Graz = University of Graz
35 Howard University College of Medicine [Washington, DC, USA]
36 Geneva University Hospitals and Geneva University
37 Cliniques Universitaires Saint-Luc [Bruxelles]
38 Aristotle University of Thessaloniki
39 SISSA / ISAS - Scuola Internazionale Superiore di Studi Avanzati = International School for Advanced Studies [Trieste]
40 Stockholm University
41 UEA - University of East Anglia [Norwich]
42 Towson University [Towson, MD, United States]
43 A.N. Severtsov Institute of Ecology and Evolution
44 Unipd - Università degli Studi di Padova = University of Padua
45 Biruni Üniversitesi = Biruni University
46 CRNL - Centre de recherche en neurosciences de Lyon - Lyon Neuroscience Research Center
47 Public Hospital Barrio Obrero - Hospital General de Barrio Obrero [Asunción, Paraguay]
48 Private practice [Milan]
49 DreamAir Llc
50 OSU - Oregon State University
51 Karolinska Institutet = Karolinska Institute [Stockholm]
52 Uninsubria - Universitá degli Studi dell’Insubria = University of Insubria [Varese]
53 IBM Watson Research Center
54 Navarrabiomed-IdiSNA
55 UEX - Universidad de Extremadura - University of Extremadura
56 TU Dresden - Technische Universität Dresden = Dresden University of Technology
57 HUJ - The Hebrew University of Jerusalem
58 UF - University of Florida [Gainesville]
59 Temple University [Philadelphia]
60 WUR - Wageningen University and Research [Wageningen]
61 Radboud University [Nijmegen]
62 FAU - Friedrich-Alexander Universität Erlangen-Nürnberg = University of Erlangen-Nuremberg
63 UCHILE - Universidad de Chile = University of Chile [Santiago]
64 FUTA - Federal University of Technology of Akure
65 UC Berkeley - University of California [Berkeley]
66 CSGA - Centre des Sciences du Goût et de l'Alimentation [Dijon]
67 UBFC - Université Bourgogne Franche-Comté [COMUE]
68 University of Dayton
69 IUMS - Iran University of Medical Sciences [Tehran, Iran]
70 "Federico II" University of Naples Medical School
71 UNIVR - Università degli studi di Verona = University of Verona
72 Xjtu - Xi'an Jiaotong University
73 IRTA - Institut de Recerca i Tecnologia Agroalimentàries = Institute of Agrifood Research and Technology
74 UAF - University of Alaska [Fairbanks]
75 Hadassah Hebrew University Medical Center [Jerusalem]
76 UMASS - University of Massachusetts System
77 Instituto Universitario del Hospital Italiano [Buenos Aires, Argentina]
78 Johns Hopkins University School of Medicine [Baltimore]
79 IPM - Institute for Research in Fundamental Sciences [Tehran]
80 CSIRO AF - CSIRO Agriculture and Food
81 GMU - The First Affiliated Hospital of Guangzhou Medical University
82 UCD - University College Dublin [Dublin]
83 UQTR - Université du Québec à Trois-Rivières
84 Guy’s and St. Thomas’ Hospitals
85 Kilis Yedi Aralik University
86 University of Otago [Dunedin, Nouvelle-Zélande]
87 Sancaktepe Education and Research Hospital
88 University of Pennsylvania [Philadelphia]
89 UC San Diego - University of California [San Diego]
90 Tata Institute of Fundamental Research
91 Indiana University [Bloomington]
92 CUMC - Columbia University Medical Center
93 The University of Edinburgh
94 UC Merced - University of California [Merced]
95 University of Stirling
96 University of London [London]
97 FSU - Florida State University [Tallahassee]
98 Université catholique de Bukavu
99 USQ - University of Southern Queensland
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Résumé
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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