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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, M. 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. Guàrdia, Maria Dolors Indústries Alimentàries Qualitat i Tecnologia Alimentària 663/664 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. info:eu-repo/semantics/acceptedVersion 2020-12-25 info:eu-repo/semantics/article Gerkin, Richard C, Kathrin Ohla, Maria G Veldhuizen, Paule V Joseph, Christine E Kelly, Alyssa J Bakke, and Kimberley E Steele et al. 2021. "Recent Smell Loss Is The Best Predictor Of COVID-19 Among Individuals With Recent Respiratory Symptoms". Chemical Senses 46. doi:10.1093/chemse/bjaa081. 0379-864X http://hdl.handle.net/20.500.12327/1702 https://doi.org/10.1093/chemse/bjaa081 eng Chemical Senses Copyright © The Author(s) 2020. Published by Oxford University Press. All rights reserved info:eu-repo/semantics/openAccess 26 Oxford University Press