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Self-reported loss of smell without nasal obstruction to identify COVID-19. The multicenter Coranosmia cohort study.
J Infect. 2020 Oct; 81(4):614-620.JI

Abstract

OBJECTIVES

To determine the frequency of SARS-CoV-2 positive samples in a subset of patients consulting for primarily isolated acute (<7 days) loss of smell and to assess the diagnostic accuracy of olfactory/gustatory dysfunction for COVID-19 diagnosis in the overall population tested for COVID-19 in the same period.

METHODS

Prospective multicentric cohort study in four olfactory ENT units and a screening center for COVID-19.

RESULTS

i) Among a subset of 55 patients consulting for primarily recent loss of smell, we found that 51 (92.7%) had a COVID-19 positive test (median viral load of 28.8 cycle threshold). Loss of smell was mostly total (anosmia), rarely associated with nasal obstruction but associated with a taste disorder in 80%. Olfactory dysfunction occurred suddenly, either as first complaint or preceded by mild symptoms occurring a median of 3 days. The majority of patients (72.9%) partially recovered the sense of smell within 15 days. ii) In a population of 1824 patients tested for COVID-19, the positive predictive value and the specificity of loss of smell and/or taste were 78.5% and 90.3% respectively (sensitivity (40.8%), negative predictive value (63.6%)).

CONCLUSIONS

Self-reported loss of smell had a high predictive positive value to identify COVID-19. Making this sign well known publicly could help to adopt isolation measures and inform potential contacts.

Authors+Show Affiliations

Department of Infectious Diseases and Immunology, Hotel Dieu Hospital, Paris Public Hospitals (APHP), 1 Place du Parvis de Notre-Dame, Paris 75004, France; University of Paris, School of Medicine, Paris 75005, France. Electronic address: dominique.salmon@aphp.fr.Department of Oto-rhino-laryngology, Head and Neck Surgery, Intercommunal Hospital of Créteil, Créteil 94000, France; University Paris-Est Créteil (UPEC), School of Medicine, Créteil 94000, France; INSERM U955, IMRB- CEpiA team, 94000 Créteil, France Paris Public Hospitals Henri Mondor Hospital (APHP), Créteil 94000, France; Department of Oto-rhino-laryngology, Henri Mondor Hospital of Créteil, Paris Public Hospitals, Créteil 94000, France; Centre National de la Recherche Scientifique CNRS, ERL 7000, Créteil 94000, France.Department of Oto-rhino-laryngology Head and Neck Surgery, Paris Public Hospitals, Lariboisière Hospital (APHP), Paris 75010, France; University Paris Diderot, School of Medicine, Paris 75010, France.Department of Oto-rhino-laryngology Head and Neck Surgery, Paris Public Hospitals, AP-HP Sorbonne University Hospital Pitié Salpêtrière Hospital (AP-HP), Paris 75006, France; Sorbonne University, Paris 75013, France.Groupe Hospitalier Paris-Saclay, Hôpital Bicêtre, Department of Oto-rhino-laryngology Head and Neck Surgery, Paris Public Hospitals. Le Kremlin-Bicêtre 94270, France; Université Paris-Saclay, Faculté de Médecine, Le Kremlin-Bicêtre F-94275, France.Department of Oto-rhino-laryngology Head and Neck Surgery, Paris Public Hospitals, Lariboisière Hospital (APHP), Paris 75010, France; University Paris Diderot, School of Medicine, Paris 75010, France.Department of Oto-rhino-laryngology Head and Neck Surgery, Paris Public Hospitals, AP-HP Sorbonne University Hospital Pitié Salpêtrière Hospital (AP-HP), Paris 75006, France.University Paris-Est Créteil (UPEC), School of Medicine, Créteil 94000, France; INSERM U955, IMRB- CEpiA team, 94000 Créteil, France Paris Public Hospitals Henri Mondor Hospital (APHP), Créteil 94000, France; Clinical Research Unit: (URC-Mondor), Department of Public Health, Henri Mondor Hospital Paris Public Hospitals (AP-HP), Créteil 94000, France.Department of Oto-rhino-laryngology Head and Neck Surgery, Paris Public Hospitals, Lariboisière Hospital (APHP), Paris 75010, France; University Paris Diderot, School of Medicine, Paris 75010, France.Department of Infectious Diseases and Immunology, Hotel Dieu Hospital, Paris Public Hospitals (APHP), 1 Place du Parvis de Notre-Dame, Paris 75004, France.Cerba Laboratory, Saint-Ouen L'Aumône, France.Emergency Department, Hotel Dieu Hospital, Paris Public Hospitals (APHP), Paris 75004, France.Emergency Department, Hotel Dieu Hospital, Paris Public Hospitals (APHP), Paris 75004, France.Department of Oto-rhino-laryngology Head and Neck Surgery, Hopital Rothschild Foundation, Paris, France.University of Paris, School of Medicine, Paris 75005, France; General Medical Practioner, Paris, France.Department of Infectious Diseases and Immunology, Hotel Dieu Hospital, Paris Public Hospitals (APHP), 1 Place du Parvis de Notre-Dame, Paris 75004, France.University of Paris, School of Medicine, Paris 75005, France; Virology Department, Cochin Hospital, Paris Public Hospitals (APHP), Paris 75004, France.University Paris-Est Créteil (UPEC), School of Medicine, Créteil 94000, France; INSERM U955, IMRB- CEpiA team, 94000 Créteil, France Paris Public Hospitals Henri Mondor Hospital (APHP), Créteil 94000, France; Clinical Research Unit: (URC-Mondor), Department of Public Health, Henri Mondor Hospital Paris Public Hospitals (AP-HP), Créteil 94000, France.INSERM U955, IMRB- CEpiA team, 94000 Créteil, France Paris Public Hospitals Henri Mondor Hospital (APHP), Créteil 94000, France; Centre National de la Recherche Scientifique CNRS, ERL 7000, Créteil 94000, France; Groupe Hospitalier Paris-Saclay, Hôpital Bicêtre, Department of Oto-rhino-laryngology Head and Neck Surgery, Paris Public Hospitals. Le Kremlin-Bicêtre 94270, France; Université Paris-Saclay, Faculté de Médecine, Le Kremlin-Bicêtre F-94275, France.Department of Oto-rhino-laryngology, Head and Neck Surgery, Intercommunal Hospital of Créteil, Créteil 94000, France; University Paris-Est Créteil (UPEC), School of Medicine, Créteil 94000, France; INSERM U955, IMRB- CEpiA team, 94000 Créteil, France Paris Public Hospitals Henri Mondor Hospital (APHP), Créteil 94000, France; Department of Oto-rhino-laryngology, Henri Mondor Hospital of Créteil, Paris Public Hospitals, Créteil 94000, France; Centre National de la Recherche Scientifique CNRS, ERL 7000, Créteil 94000, France.No affiliation info available

Pub Type(s)

Journal Article
Multicenter Study
Observational Study

Language

eng

PubMed ID

32650110

Citation

Salmon Ceron, Dominique, et al. "Self-reported Loss of Smell Without Nasal Obstruction to Identify COVID-19. the Multicenter Coranosmia Cohort Study." The Journal of Infection, vol. 81, no. 4, 2020, pp. 614-620.
Salmon Ceron D, Bartier S, Hautefort C, et al. Self-reported loss of smell without nasal obstruction to identify COVID-19. The multicenter Coranosmia cohort study. J Infect. 2020;81(4):614-620.
Salmon Ceron, D., Bartier, S., Hautefort, C., Nguyen, Y., Nevoux, J., Hamel, A. L., Camhi, Y., Canouï-Poitrine, F., Verillaud, B., Slama, D., Haim-Boukobza, S., Sourdeau, E., Cantin, D., Corré, A., Bryn, A., Etienne, N., Rozenberg, F., Layese, R., Papon, J. F., & Bequignon, E. (2020). Self-reported loss of smell without nasal obstruction to identify COVID-19. The multicenter Coranosmia cohort study. The Journal of Infection, 81(4), 614-620. https://doi.org/10.1016/j.jinf.2020.07.005
Salmon Ceron D, et al. Self-reported Loss of Smell Without Nasal Obstruction to Identify COVID-19. the Multicenter Coranosmia Cohort Study. J Infect. 2020;81(4):614-620. PubMed PMID: 32650110.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Self-reported loss of smell without nasal obstruction to identify COVID-19. The multicenter Coranosmia cohort study. AU - Salmon Ceron,Dominique, AU - Bartier,Sophie, AU - Hautefort,Charlotte, AU - Nguyen,Yann, AU - Nevoux,Jérôme, AU - Hamel,Anne-Laure, AU - Camhi,Yohan, AU - Canouï-Poitrine,Florence, AU - Verillaud,Benjamin, AU - Slama,Dorsaf, AU - Haim-Boukobza,Stephanie, AU - Sourdeau,Elise, AU - Cantin,Delphine, AU - Corré,Alain, AU - Bryn,Agnes, AU - Etienne,Nicolas, AU - Rozenberg,Flore, AU - Layese,Richard, AU - Papon,Jean-François, AU - Bequignon,Emilie, AU - ,, Y1 - 2020/07/07/ PY - 2020/05/14/received PY - 2020/07/02/revised PY - 2020/07/03/accepted PY - 2020/7/11/pubmed PY - 2020/10/6/medline PY - 2020/7/11/entrez KW - Anosmia KW - COVID-19 KW - Dysguageusia KW - Loss of smell KW - Positive predictive value KW - SARS-CoV-2 KW - Viral load SP - 614 EP - 620 JF - The Journal of infection JO - J Infect VL - 81 IS - 4 N2 - OBJECTIVES: To determine the frequency of SARS-CoV-2 positive samples in a subset of patients consulting for primarily isolated acute (<7 days) loss of smell and to assess the diagnostic accuracy of olfactory/gustatory dysfunction for COVID-19 diagnosis in the overall population tested for COVID-19 in the same period. METHODS: Prospective multicentric cohort study in four olfactory ENT units and a screening center for COVID-19. RESULTS: i) Among a subset of 55 patients consulting for primarily recent loss of smell, we found that 51 (92.7%) had a COVID-19 positive test (median viral load of 28.8 cycle threshold). Loss of smell was mostly total (anosmia), rarely associated with nasal obstruction but associated with a taste disorder in 80%. Olfactory dysfunction occurred suddenly, either as first complaint or preceded by mild symptoms occurring a median of 3 days. The majority of patients (72.9%) partially recovered the sense of smell within 15 days. ii) In a population of 1824 patients tested for COVID-19, the positive predictive value and the specificity of loss of smell and/or taste were 78.5% and 90.3% respectively (sensitivity (40.8%), negative predictive value (63.6%)). CONCLUSIONS: Self-reported loss of smell had a high predictive positive value to identify COVID-19. Making this sign well known publicly could help to adopt isolation measures and inform potential contacts. SN - 1532-2742 UR - https://www.unboundmedicine.com/medline/citation/32650110/Self_reported_loss_of_smell_without_nasal_obstruction_to_identify_COVID_19__The_multicenter_Coranosmia_cohort_study_ L2 - https://linkinghub.elsevier.com/retrieve/pii/S0163-4453(20)30463-1 DB - PRIME DP - Unbound Medicine ER -