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We quantified changes in chemosensory abilities during the course of the respiratory illness using 0\u2013100 visual analog scales (VAS) for participants reporting a positive (C19+; n = 4148) or negative (C19\u2212; 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\u2212 groups exhibited smell loss, but it was significantly larger in C19+ participants (mean \u00b1 SD, C19+: \u221282.5 \u00b1 27.2 points; C19\u2212: \u221259.8 \u00b1 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\u201310 scale to screen for recent olfactory loss, the ODoR-19. We find that numeric ratings \u22642 indicate high odds of symptomatic COVID-19 (4 &amp;lt; OR &amp;lt; 10). Once independently validated, this tool could be deployed when viral lab tests are impractical or unavailable.<\/jats:p>","DOI":"10.1093\/chemse\/bjaa081","type":"journal-article","created":{"date-parts":[[2020,12,21]],"date-time":"2020-12-21T16:09:13Z","timestamp":1608566953000},"source":"Crossref","is-referenced-by-count":132,"title":["Recent Smell Loss Is the Best Predictor of COVID-19 Among Individuals With Recent Respiratory Symptoms"],"prefix":"10.1093","volume":"46","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2940-3378","authenticated-orcid":false,"given":"Richard C","family":"Gerkin","sequence":"first","affiliation":[{"name":"School of Life Sciences, Arizona State University, Tempe, AZ, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7265-0449","authenticated-orcid":false,"given":"Kathrin","family":"Ohla","sequence":"additional","affiliation":[{"name":"Institute of Neuroscience and Medicine (INM3), Forschungszentrum J\u00fclich, J\u00fclich, Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Maria G","family":"Veldhuizen","sequence":"additional","affiliation":[{"name":"Department of Anatomy, Mersin University, Yeni\u015fehir\/Mersin, Turkey"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Paule V","family":"Joseph","sequence":"additional","affiliation":[{"name":"National Institute of Nursing Research, Bethesda, MD, USA"},{"name":"National Institute of Alcohol Abuse and Alcoholism, Bethesda, MD, USA"},{"name":"National Institutes of Health, Bethesda, MD, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Christine E","family":"Kelly","sequence":"additional","affiliation":[{"name":"AbScent, Andover, Hampshire, UK"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Alyssa J","family":"Bakke","sequence":"additional","affiliation":[{"name":"Department of Food Science, The Pennsylvania State University, University Park, PA, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kimberley E","family":"Steele","sequence":"additional","affiliation":[{"name":"National Institutes of Health, Bethesda, MD, USA"},{"name":"National Institute of Diabetes and Digestive and Kidney Diseases, Bethesda, MD, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michael C","family":"Farruggia","sequence":"additional","affiliation":[{"name":"Interdepartmental Neuroscience Program, Yale University, New Haven, CT, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Robert","family":"Pellegrino","sequence":"additional","affiliation":[{"name":"Department of Food Science, University of Tennessee, Knoxville, TN, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Marta Y","family":"Pepino","sequence":"additional","affiliation":[{"name":"Department of Food Science and Human Nutrition, University of Illinois at Urbana Champaign, Urbana, IL, USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C\u00e9dric","family":"Bouysset","sequence":"additional","affiliation":[{"name":"Institut de Chimie de Nice, UMR CNRS 7272, Universit\u00e9 C\u00f4te d\u2019Azur, Nice, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Graciela M","family":"Soler","sequence":"additional","affiliation":[{"name":"Grupo de Estudio de Olfato y Gusto (GEOG), Buenos Aires, Argentina"},{"name":"Department of Otorhinolaryngology, University of Buenos Aires, Buenos Aires, Argentina"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Veronica","family":"Pereda-Loth","sequence":"additional","affiliation":[{"name":"Medecine Evolutive UMR5288, University of Toulouse, Toulouse, France"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Michele","family":"Dibattista","sequence":"additional","affiliation":[{"name":"Department of Basic Medical Science, Neuroscience and Sense Organs, Universit\u00e0 degli Studi di Bari A. 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