{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"institution":[{"name":"medRxiv"}],"indexed":{"date-parts":[[2026,1,16]],"date-time":"2026-01-16T07:39:09Z","timestamp":1768549149257,"version":"3.49.0"},"posted":{"date-parts":[[2020,7,26]]},"group-title":"Infectious Diseases (except HIV\/AIDS)","reference-count":39,"publisher":"openRxiv","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"accepted":{"date-parts":[[2020,7,28]]},"abstract":"<jats:title>Abstract<\/jats:title>\n                <jats:sec>\n                  <jats:title>Background<\/jats:title>\n                  <jats:p>COVID-19 has heterogeneous manifestations, though one of the most common symptoms is a sudden loss of smell (anosmia or hyposmia). We investigated whether olfactory loss is a reliable predictor of COVID-19.<\/jats:p>\n                <\/jats:sec>\n                <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>This preregistered, cross-sectional study used 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 singular and cumulative predictors of COVID-19 status and post-COVID-19 olfactory recovery.<\/jats:p>\n                <\/jats:sec>\n                <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>Both C19+ and C19-groups exhibited smell loss, but it was significantly larger in C19+ participants (mean\u00b1SD, C19+: -82.5\u00b127.2 points; C19-: -59.8\u00b137.7). Smell loss during illness was the best predictor of COVID-19 in both single and cumulative feature models (ROC AUC=0.72), with additional features providing negligible model improvement. VAS ratings of smell loss were more predictive than binary chemosensory yes\/no-questions or other cardinal symptoms, such as fever or cough. Olfactory recovery within 40 days was reported for \u223c50% of participants and was best predicted by time since illness onset.<\/jats:p>\n                <\/jats:sec>\n                <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>As smell loss is the best predictor of COVID-19, we developed the ODoR-19 tool, a 0-10 scale to screen for recent olfactory loss. Numeric ratings \u22642 indicate high odds of symptomatic COVID-19 (4&lt;OR&lt;10), which can be deployed when viral lab tests are impractical or unavailable.<\/jats:p>\n                <\/jats:sec>","DOI":"10.1101\/2020.07.22.20157263","type":"posted-content","created":{"date-parts":[[2020,7,26]],"date-time":"2020-07-26T12:15:11Z","timestamp":1595765711000},"source":"Crossref","is-referenced-by-count":15,"title":["The best COVID-19 predictor is recent smell loss: a cross-sectional study"],"prefix":"10.64898","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-2940-3378","authenticated-orcid":false,"given":"Richard C.","family":"Gerkin","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7265-0449","authenticated-orcid":false,"given":"Kathrin","family":"Ohla","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8375-7719","authenticated-orcid":false,"given":"Maria G.","family":"Veldhuizen","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1198-9622","authenticated-orcid":false,"given":"Paule V.","family":"Joseph","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Christine E.","family":"Kelly","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1685-2000","authenticated-orcid":false,"given":"Alyssa J.","family":"Bakke","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5096-6549","authenticated-orcid":false,"given":"Kimberley E.","family":"Steele","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5306-6754","authenticated-orcid":false,"given":"Michael C.","family":"Farruggia","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5319-828X","authenticated-orcid":false,"given":"Robert","family":"Pellegrino","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-2381-1095","authenticated-orcid":false,"given":"Marta Y.","family":"Pepino","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7814-8158","authenticated-orcid":false,"given":"C\u00e9dric","family":"Bouysset","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Graciela M.","family":"Soler","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7365-6217","authenticated-orcid":false,"given":"Veronica","family":"Pereda-Loth","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3955-4663","authenticated-orcid":false,"given":"Michele","family":"Dibattista","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-0358-9645","authenticated-orcid":false,"given":"Keiland W.","family":"Cooper","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9812-0040","authenticated-orcid":false,"given":"Ilja","family":"Croijmans","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8520-5165","authenticated-orcid":false,"given":"Antonella","family":"Di Pizio","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9259-4683","authenticated-orcid":false,"given":"M. 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