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Recent Smell Loss Is the Best Predictor of COVID-19 Among Individuals With Recent Respiratory Symptoms

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https://ir-staging.library.oregonstate.edu/concern/articles/0v838079h

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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 similar to 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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  • 46
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  • Deployment of the GCCR survey was supported by an unrestricted gift from James and Helen Zallie to support sensory science research at Penn State. R.C.G. is supported by National Institute of Neurological Disorders and Stroke (NINDS) (U19NS112953) and National Institute on Deafness and Other Communication Disorders (NIDCD) (R01DC018455). P.V.J. is supported by the National Institute of Nursing Research (NINR) under award number 1ZIANR000035-01. P.V.J. is also supported by the Office of Workforce Diversity, National Institutes of Health and The Rockefeller University Heilbrunn Nurse Scholar Award. V.V.V. is supported by Institute of Ecology and Evolution Russian Academy of Sciences (IEE RAS) basic project 0109-2018-0079. M.E.H. is supported by National Institutes of Health (NIH) T32 funding (DC000014). M.Y.N. is supported by Israel Science Foundation (ISF) grant #1129/19.
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  • 12 pages
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  • 0379-864X
  • 1464-3553

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