- Gerkin, Richard;
- Ohla, Kathrin;
- Veldhuizen, Maria;
- Joseph, Paule;
- Kelly, Christine;
- Bakke, Alyssa;
- Steele, Kimberley;
- Farruggia, Michael;
- Pellegrino, Robert;
- Pepino, Marta;
- Bouysset, Cédric;
- Soler, Graciela;
- Pereda-Loth, Veronica;
- Dibattista, Michele;
- Cooper, Keiland;
- Croijmans, Ilja;
- Di Pizio, Antonella;
- Ozdener, Mehmet;
- Fjaeldstad, Alexander;
- Lin, Cailu;
- Sandell, Mari;
- Singh, Preet;
- Brindha, V;
- Olsson, Shannon;
- Saraiva, Luis;
- Ahuja, Gaurav;
- Alwashahi, Mohammed;
- Bhutani, Surabhi;
- DErrico, Anna;
- Fornazieri, Marco;
- Golebiowski, Jérôme;
- Dar Hwang, Liang;
- Öztürk, Lina;
- Roura, Eugeni;
- Spinelli, Sara;
- Whitcroft, Katherine;
- Faraji, Farhoud;
- Fischmeister, Florian;
- Heinbockel, Thomas;
- Hsieh, Julien;
- Huart, Caroline;
- Konstantinidis, Iordanis;
- Menini, Anna;
- Morini, Gabriella;
- Olofsson, Jonas;
- Philpott, Carl;
- Pierron, Denis;
- Shields, Vonnie;
- Voznessenskaya, Vera;
- Albayay, Javier;
- Altundag, Aytug;
- Bensafi, Moustafa;
- Bock, María;
- Calcinoni, Orietta;
- Fredborg, William;
- Laudamiel, Christophe;
- Lim, Juyun;
- Lundström, Johan;
- Macchi, Alberto;
- Meyer, Pablo;
- Moein, Shima;
- Santamaría, Enrique;
- Sengupta, Debarka;
- Rohlfs Dominguez, Paloma;
- Yanik, Hüseyin;
- Hummel, Thomas;
- Hayes, John;
- Reed, Danielle;
- Niv, Masha;
- Munger, Steven;
- Parma, Valentina
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.