• Dominique Salmon Ceron, Sophie Bartier, Charlotte Hautefort, Yann Nguyen, Jérôme Nevoux, Anne-Laure Hamel, Yohan Camhi, Florence Canouï-Poitrine, Benjamin Verillaud, Dorsaf Slama, Stephanie Haim-Boukobza, Elise Sourdeau, Delphine Cantin, Alain Corré, Agnes Bryn, Nicolas Etienne, Flore Rozenberg, Richard Layese, Jean-François Papon, Emilie Bequignon, and APHP COVID-19 research collaboration.
• 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.
• J. Infect. 2020 Oct 1; 81 (4): 614-620.

ObjectivesTo 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.MethodsProspective multicentric cohort study in four olfactory ENT units and a screening center for COVID-19.Resultsi) 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%)).ConclusionsSelf-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.Copyright © 2020. Published by Elsevier Ltd.

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