Alongside fever checks for COVID-19, physician practices may want to institute smell tests. Data from a new study show that patients who were diagnosed as COVID-19 positive were 27 times more likely than others to have lost their sense of smell but only 2.6 times more likely to have fever or chills.
The study, “Augmented Curation of Clinical Notes from a Massive EHR System Reveals Symptoms of Impending COVID-19 Diagnosis,” by Tyler Wagner and colleagues (eLife. 2020;9:e58227. DOI: 10.7554/eLife.58227), examined clinical notes from 77,167 patients subjected to COVID-19 PCR testing. The authors found that an altered or diminished sense of taste or smell was the most significantly amplified signal (27.1-fold amplification) in COVID-19-positive versus COVID-19-negative patients in the week preceding the PCR testing. Fever and chills also had an increased signal in COVID-19-positive patients compared to the COVID-91-negative cohort, but only by a 2.6-fold amplification. Authors note that if anosmia and dysgeusia’s overall prevalence in the population of 0.4% is taken into consideration, however, this precludes them from being standalone predictors of infection.
This information may still be useful in helping otolaryngology practices form safety protocols for office visits, said Subinoy Das, MD, assistant professor at The Ohio State University, Columbus. “I strongly support smell tests,” he said. “Screening for smell loss is more than eight times more effective for detecting early COVID-19 than screening for a fever. All patients should be, at a minimum, asked about smell loss and possibly offered an alcohol swab to smell to rapidly confirm any symptoms of anosmia.”