• Coronaviruses and the Chemical Senses: Past, Present, and Future

      Pellegrino, Robert; Cooper, Keiland W.; Di Pizio, Antonella; Joseph, Paule V.; Bhutani, Surabhi; Parma, Valentina; 0000-0003-0276-7072 (2020-05-14)
      A wealth of rapidly evolving reports suggests that olfaction and taste disturbances may be manifestations of the novel COVID-19 pandemic. While otolaryngological societies worldwide have started to consider chemosensory evaluation as a screening tool for COVID-19 infection, the true nature of the relationship between the changes in chemosensory ability and COVID-19 is unclear. Our goal with this review is to provide a brief overview of published and archived literature, as well as the anecdotal reports and social trends related to this topic up to April 29, 2020. We also aim to draw parallels between the clinical/chemosensory symptomology reported in association to past coronavirus pandemics (such as SARS and MERS) and the novel COVID-19. This review also highlights current evidence on persistent chemosensory disturbances after the infection has resolved. Overall, our analysis pinpoints the need for further studies: (1) to better quantify olfaction and taste disturbances associated with SARS-CoV-2 infection, compared to those of other viral and respiratory infections, (2) to understand the relation between smell, taste, and chemesthesis disturbances in COVID-19, and (3) to understand how persistent are these disturbances after the infection has resolved.
    • Recent Smell Loss Is the Best Predictor of COVID-19 Among Individuals With Recent Respiratory Symptoms

      Gerkin, Richard C.; Ohla, Kathrin; Veldhuizen, Maria G.; Joseph, Paule V.; Kelly, Christine E.; Bakke, Alyssa J.; Steele, Kimberley E.; Farruggia, Michael C.; Pellegrino, Robert; Pepino, Marta Y.; Bouysset, Cédric; Soler, Graciela M.; Pereda-Loth, Veronica; Dibattista, Michele; Cooper, Keiland W.; Croijmans, Ilja; Di Pizio, Antonella; Ozdener, Mehmet Hakan; Fjaeldstad, Alexander W.; Lin, Cailu; Sandell, Mari A.; Singh, Preet B.; Brindha, V. Evelyn; Olsson, Shannon B.; Saraiva, Luis R.; Ahuja, Gaurav; Alwashahi, Mohammed K.; Bhutani, Surabhi; D'Errico, Anna; Fornazieri, Marco A.; Golebiowski, Jérôme; Hwang, Liang Dar; Öztürk, Lina; Roura, Eugeni; Spinelli, Sara; Whitcroft, Katherine L.; Faraji, Farhoud; Fischmeister, Florian Ph S.; Heinbockel, Thomas; Hsieh, Julien W.; Huart, Caroline; Konstantinidis, Iordanis; Menini, Anna; Morini, Gabriella; Olofsson, Jonas K.; Philpott, Carl M.; Pierron, Denis; Shields, Vonnie D.C.; Voznessenskaya, Vera V.; Albayay, Javier; Altundag, Aytug; Bensafi, Moustafa; Bock, María Adelaida; Calcinoni, Orietta; Fredborg, William; Laudamiel, Christophe; Lim, Juyun; Lundström, Johan N.; Macchi, Alberto; Meyer, Pablo; Moein, Shima T.; Santamaría, Enrique; Sengupta, Debarka; Dominguez, Paloma Rohlfs; Yanik, Hüseyin; Hummel, Thomas; Hayes, John E.; Reed, Danielle R.; Niv, Masha Y.; Munger, Steven D.; Parma, Valentina (2020-12-25)
      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.