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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.

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Authors+Show Affiliations

Salmon Ceron D
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.
Bartier S
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.
Hautefort C
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.
Nguyen Y
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.
Nevoux J
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.
Hamel AL
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.
Camhi Y
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.
Canouï-Poitrine F
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.
Verillaud B
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.
Slama D
Department of Infectious Diseases and Immunology, Hotel Dieu Hospital, Paris Public Hospitals (APHP), 1 Place du Parvis de Notre-Dame, Paris 75004, France.
Haim-Boukobza S
Cerba Laboratory, Saint-Ouen L'Aumône, France.
Sourdeau E
Emergency Department, Hotel Dieu Hospital, Paris Public Hospitals (APHP), Paris 75004, France.
Cantin D
Emergency Department, Hotel Dieu Hospital, Paris Public Hospitals (APHP), Paris 75004, France.
Corré A
Department of Oto-rhino-laryngology Head and Neck Surgery, Hopital Rothschild Foundation, Paris, France.
Bryn A
University of Paris, School of Medicine, Paris 75005, France; General Medical Practioner, Paris, France.
Etienne N
Department of Infectious Diseases and Immunology, Hotel Dieu Hospital, Paris Public Hospitals (APHP), 1 Place du Parvis de Notre-Dame, Paris 75004, France.
Rozenberg F
University of Paris, School of Medicine, Paris 75005, France; Virology Department, Cochin Hospital, Paris Public Hospitals (APHP), Paris 75004, France.
Layese R
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.
Papon JF
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.
Bequignon E
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.
APHP COVID-19 research collaboration
No affiliation info available

MeSH

AdultBetacoronavirusCOVID-19Coronavirus InfectionsFemaleHumansMaleOlfaction DisordersPandemicsPneumonia, ViralProspective StudiesSARS-CoV-2Self ReportSmellTaste DisordersTaste Perception

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 -