Tracking smell loss to identify healthcare workers with SARS-CoV-2 infection

Julian J. Weiss; Tuki N. Attuquayefio; Elizabeth B. White; Fangyong Li; Rachel S. Herz; Theresa L. White; Melissa Campbell; Bertie Geng; Rupak Datta; Anne L. Wyllie; Nathan D. Grubaugh; Arnau Casanovas-Massana; M. Catherine Muenker; Adam J. Moore; Ryan Handoko; Akiko Iwasaki; Richard A. Martinello; Albert I. Ko; Dana M. Small; Shelli F. Farhadian; null the Yale IMPACT Research Team; Staci Cahill; Edward Courchaine; Christina Harden; Chaney Kalinch; Daniel Kim; Lynda Knaggs; Eriko Kudo; Peiwen Lu; Alice Lu-Culligan; Nida Naushad; Allison Nelson; Isabel M. Ott; Annsea Park; Mary Petrone; Sarah Prophet; Lorenzo Sewanan; Maria Tokuyama; Jordan Valdez; Arvidn Venkataraman; Chantal B. F. Vogels; Annie Watkins; Yexin Yang

doi:10.1371/journal.pone.0248025

Tracking smell loss to identify healthcare workers with SARS-CoV-2 infection

Julian J. Weiss, Tuki N. Attuquayefio, Elizabeth B. White, Fangyong Li, Rachel S. Herz, Theresa L. White, Melissa Campbell, Bertie Geng, Rupak Datta, Anne L. Wyllie, Nathan D. Grubaugh, Arnau Casanovas-Massana, M. Catherine Muenker, Adam J. Moore, Ryan Handoko, Akiko Iwasaki, Richard A. Martinello, Albert I. Ko, Dana M. Small, Shelli F. Farhadianthe Yale IMPACT Research Team, Staci Cahill, Edward Courchaine, Christina Harden, Chaney Kalinch, Daniel Kim, Lynda Knaggs, Eriko Kudo, Peiwen Lu, Alice Lu-Culligan, Nida Naushad, Allison Nelson, Isabel M. Ott, Annsea Park, Mary Petrone, Sarah Prophet, Lorenzo Sewanan, Maria Tokuyama, Jordan Valdez, Arvidn Venkataraman, Chantal B. F. Vogels, Annie Watkins, Yexin Yang

Western Sydney University

Research output: Contribution to journal › Article › peer-review

9 Citations (Scopus)

Abstract

Introduction Healthcare workers (HCW) treating COVID-19 patients are at high risk for infection and may also spread infection through their contact with vulnerable patients. Smell loss has been associated with SARS-CoV-2 infection, but it is unknown whether monitoring for smell loss can be used to identify asymptomatic infection among high risk individuals. In this study we sought to determine if tracking smell sensitivity and loss using an at-home assessment could identify SARS-CoV-2 infection in HCW. Methods and findings We performed a prospective cohort study tracking 473 HCW across three months to determine if smell loss could predict SARS-CoV-2 infection in this high-risk group. HCW subjects completed a longitudinal, behavioral at-home assessment of olfaction with household items, as well as detailed symptom surveys that included a parosmia screening questionnaire, and real-time quantitative polymerase chain reaction testing to identify SARS-CoV-2 infection. Our main measures were the prevalence of smell loss in SARS-CoV-2-positive HCW versus SARS-CoV- 2-negative HCW, and timing of smell loss relative to SARS-CoV-2 test positivity. SARS-CoV-2 was identified in 17 (3.6%) of 473 HCW. HCW with SARS-CoV-2 infection were more likely to report smell loss than SARS-CoV-2-negative HCW on both the at-home assessment and the screening questionnaire (9/17, 53% vs 105/456, 23%, P < .01). 6/9 (67%) of SARS-CoV-2-positive HCW reporting smell loss reported smell loss prior to having a positive SARS-CoV-2 test, and smell loss was reported a median of two days before testing positive. Neurological symptoms were reported more frequently among SARS-CoV-2-positive HCW who reported smell loss compared to those without smell loss (9/9, 100% vs 3/8, 38%, P < .01). Conclusions In this prospective study of HCW, self-reported changes in smell using two different measures were predictive of SARS-CoV-2 infection. Smell loss frequently preceded a positive test and was associated with neurological symptoms.

Original language	English
Article number	e0248025
Number of pages	12
Journal	PLoS One
Volume	16
Issue number	3
DOIs	https://doi.org/10.1371/journal.pone.0248025
Publication status	Published - 2021

Open Access - Access Right Statement

© 2021 Weiss et al. This is an open access article distributed under the terms of the Creative Commons Attribution License (https://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided the original author and source are credited.

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10.1371/journal.pone.0248025

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Weiss, J. J., Attuquayefio, T. N., White, E. B., Li, F., Herz, R. S., White, T. L., Campbell, M., Geng, B., Datta, R., Wyllie, A. L., Grubaugh, N. D., Casanovas-Massana, A., Muenker, M. C., Moore, A. J., Handoko, R., Iwasaki, A., Martinello, R. A., Ko, A. I., Small, D. M., ... Yang, Y. (2021). Tracking smell loss to identify healthcare workers with SARS-CoV-2 infection. PLoS One, 16(3), Article e0248025. https://doi.org/10.1371/journal.pone.0248025

@article{7cd0e5ff5c154185b18ff4e0dd278beb,

title = "Tracking smell loss to identify healthcare workers with SARS-CoV-2 infection",

abstract = "Introduction Healthcare workers (HCW) treating COVID-19 patients are at high risk for infection and may also spread infection through their contact with vulnerable patients. Smell loss has been associated with SARS-CoV-2 infection, but it is unknown whether monitoring for smell loss can be used to identify asymptomatic infection among high risk individuals. In this study we sought to determine if tracking smell sensitivity and loss using an at-home assessment could identify SARS-CoV-2 infection in HCW. Methods and findings We performed a prospective cohort study tracking 473 HCW across three months to determine if smell loss could predict SARS-CoV-2 infection in this high-risk group. HCW subjects completed a longitudinal, behavioral at-home assessment of olfaction with household items, as well as detailed symptom surveys that included a parosmia screening questionnaire, and real-time quantitative polymerase chain reaction testing to identify SARS-CoV-2 infection. Our main measures were the prevalence of smell loss in SARS-CoV-2-positive HCW versus SARS-CoV- 2-negative HCW, and timing of smell loss relative to SARS-CoV-2 test positivity. SARS-CoV-2 was identified in 17 (3.6%) of 473 HCW. HCW with SARS-CoV-2 infection were more likely to report smell loss than SARS-CoV-2-negative HCW on both the at-home assessment and the screening questionnaire (9/17, 53% vs 105/456, 23%, P < .01). 6/9 (67%) of SARS-CoV-2-positive HCW reporting smell loss reported smell loss prior to having a positive SARS-CoV-2 test, and smell loss was reported a median of two days before testing positive. Neurological symptoms were reported more frequently among SARS-CoV-2-positive HCW who reported smell loss compared to those without smell loss (9/9, 100% vs 3/8, 38%, P < .01). Conclusions In this prospective study of HCW, self-reported changes in smell using two different measures were predictive of SARS-CoV-2 infection. Smell loss frequently preceded a positive test and was associated with neurological symptoms.",

author = "Weiss, {Julian J.} and Attuquayefio, {Tuki N.} and White, {Elizabeth B.} and Fangyong Li and Herz, {Rachel S.} and White, {Theresa L.} and Melissa Campbell and Bertie Geng and Rupak Datta and Wyllie, {Anne L.} and Grubaugh, {Nathan D.} and Arnau Casanovas-Massana and Muenker, {M. Catherine} and Moore, {Adam J.} and Ryan Handoko and Akiko Iwasaki and Martinello, {Richard A.} and Ko, {Albert I.} and Small, {Dana M.} and Farhadian, {Shelli F.} and {the Yale IMPACT Research Team} and Staci Cahill and Edward Courchaine and Christina Harden and Chaney Kalinch and Daniel Kim and Lynda Knaggs and Eriko Kudo and Peiwen Lu and Alice Lu-Culligan and Nida Naushad and Allison Nelson and Ott, {Isabel M.} and Annsea Park and Mary Petrone and Sarah Prophet and Lorenzo Sewanan and Maria Tokuyama and Jordan Valdez and Arvidn Venkataraman and Vogels, {Chantal B. F.} and Annie Watkins and Yexin Yang",

year = "2021",

doi = "10.1371/journal.pone.0248025",

language = "English",

volume = "16",

journal = "PLoS One",

issn = "1932-6203",

publisher = "Public Library of Science",

number = "3",

}

Weiss, JJ, Attuquayefio, TN, White, EB, Li, F, Herz, RS, White, TL, Campbell, M, Geng, B, Datta, R, Wyllie, AL, Grubaugh, ND, Casanovas-Massana, A, Muenker, MC, Moore, AJ, Handoko, R, Iwasaki, A, Martinello, RA, Ko, AI, Small, DM, Farhadian, SF, the Yale IMPACT Research Team, Cahill, S, Courchaine, E, Harden, C, Kalinch, C, Kim, D, Knaggs, L, Kudo, E, Lu, P, Lu-Culligan, A, Naushad, N, Nelson, A, Ott, IM, Park, A, Petrone, M, Prophet, S, Sewanan, L, Tokuyama, M, Valdez, J, Venkataraman, A, Vogels, CBF, Watkins, A & Yang, Y 2021, 'Tracking smell loss to identify healthcare workers with SARS-CoV-2 infection', PLoS One, vol. 16, no. 3, e0248025. https://doi.org/10.1371/journal.pone.0248025

TY - JOUR

T1 - Tracking smell loss to identify healthcare workers with SARS-CoV-2 infection

AU - Weiss, Julian J.

AU - Attuquayefio, Tuki N.

AU - White, Elizabeth B.

AU - Li, Fangyong

AU - Herz, Rachel S.

AU - White, Theresa L.

AU - Campbell, Melissa

AU - Geng, Bertie

AU - Datta, Rupak

AU - Wyllie, Anne L.

AU - Grubaugh, Nathan D.

AU - Casanovas-Massana, Arnau

AU - Muenker, M. Catherine

AU - Moore, Adam J.

AU - Handoko, Ryan

AU - Iwasaki, Akiko

AU - Martinello, Richard A.

AU - Ko, Albert I.

AU - Small, Dana M.

AU - Farhadian, Shelli F.

AU - the Yale IMPACT Research Team, null

AU - Cahill, Staci

AU - Courchaine, Edward

AU - Harden, Christina

AU - Kalinch, Chaney

AU - Kim, Daniel

AU - Knaggs, Lynda

AU - Kudo, Eriko

AU - Lu, Peiwen

AU - Lu-Culligan, Alice

AU - Naushad, Nida

AU - Nelson, Allison

AU - Ott, Isabel M.

AU - Park, Annsea

AU - Petrone, Mary

AU - Prophet, Sarah

AU - Sewanan, Lorenzo

AU - Tokuyama, Maria

AU - Valdez, Jordan

AU - Venkataraman, Arvidn

AU - Vogels, Chantal B. F.

AU - Watkins, Annie

AU - Yang, Yexin

PY - 2021

Y1 - 2021

N2 - Introduction Healthcare workers (HCW) treating COVID-19 patients are at high risk for infection and may also spread infection through their contact with vulnerable patients. Smell loss has been associated with SARS-CoV-2 infection, but it is unknown whether monitoring for smell loss can be used to identify asymptomatic infection among high risk individuals. In this study we sought to determine if tracking smell sensitivity and loss using an at-home assessment could identify SARS-CoV-2 infection in HCW. Methods and findings We performed a prospective cohort study tracking 473 HCW across three months to determine if smell loss could predict SARS-CoV-2 infection in this high-risk group. HCW subjects completed a longitudinal, behavioral at-home assessment of olfaction with household items, as well as detailed symptom surveys that included a parosmia screening questionnaire, and real-time quantitative polymerase chain reaction testing to identify SARS-CoV-2 infection. Our main measures were the prevalence of smell loss in SARS-CoV-2-positive HCW versus SARS-CoV- 2-negative HCW, and timing of smell loss relative to SARS-CoV-2 test positivity. SARS-CoV-2 was identified in 17 (3.6%) of 473 HCW. HCW with SARS-CoV-2 infection were more likely to report smell loss than SARS-CoV-2-negative HCW on both the at-home assessment and the screening questionnaire (9/17, 53% vs 105/456, 23%, P < .01). 6/9 (67%) of SARS-CoV-2-positive HCW reporting smell loss reported smell loss prior to having a positive SARS-CoV-2 test, and smell loss was reported a median of two days before testing positive. Neurological symptoms were reported more frequently among SARS-CoV-2-positive HCW who reported smell loss compared to those without smell loss (9/9, 100% vs 3/8, 38%, P < .01). Conclusions In this prospective study of HCW, self-reported changes in smell using two different measures were predictive of SARS-CoV-2 infection. Smell loss frequently preceded a positive test and was associated with neurological symptoms.

AB - Introduction Healthcare workers (HCW) treating COVID-19 patients are at high risk for infection and may also spread infection through their contact with vulnerable patients. Smell loss has been associated with SARS-CoV-2 infection, but it is unknown whether monitoring for smell loss can be used to identify asymptomatic infection among high risk individuals. In this study we sought to determine if tracking smell sensitivity and loss using an at-home assessment could identify SARS-CoV-2 infection in HCW. Methods and findings We performed a prospective cohort study tracking 473 HCW across three months to determine if smell loss could predict SARS-CoV-2 infection in this high-risk group. HCW subjects completed a longitudinal, behavioral at-home assessment of olfaction with household items, as well as detailed symptom surveys that included a parosmia screening questionnaire, and real-time quantitative polymerase chain reaction testing to identify SARS-CoV-2 infection. Our main measures were the prevalence of smell loss in SARS-CoV-2-positive HCW versus SARS-CoV- 2-negative HCW, and timing of smell loss relative to SARS-CoV-2 test positivity. SARS-CoV-2 was identified in 17 (3.6%) of 473 HCW. HCW with SARS-CoV-2 infection were more likely to report smell loss than SARS-CoV-2-negative HCW on both the at-home assessment and the screening questionnaire (9/17, 53% vs 105/456, 23%, P < .01). 6/9 (67%) of SARS-CoV-2-positive HCW reporting smell loss reported smell loss prior to having a positive SARS-CoV-2 test, and smell loss was reported a median of two days before testing positive. Neurological symptoms were reported more frequently among SARS-CoV-2-positive HCW who reported smell loss compared to those without smell loss (9/9, 100% vs 3/8, 38%, P < .01). Conclusions In this prospective study of HCW, self-reported changes in smell using two different measures were predictive of SARS-CoV-2 infection. Smell loss frequently preceded a positive test and was associated with neurological symptoms.

UR - https://hdl.handle.net/1959.7/uws:72225

U2 - 10.1371/journal.pone.0248025

DO - 10.1371/journal.pone.0248025

M3 - Article

SN - 1932-6203

VL - 16

JO - PLoS One

JF - PLoS One

IS - 3

M1 - e0248025

ER -

Tracking smell loss to identify healthcare workers with SARS-CoV-2 infection

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