Version 1 du 04 Juin 2020
Predictive values of olfactory and gustative disorders for the diagnosis of COVID-19: a cohort of 3,497 patients and 432 healthcare workers
Sophia Boudjema, Julie Finance, Fatoumata Coulibaly, Line Meddeb, Hervé Tissot-Dupont, Moïse Michel, Jean Christophe Lagier, Matthieu Million, Thomas Radulesco, Justin Michel, Philippe Brouqui, Didier Raoult, Florence Fenollar, Philippe Parola
- Objectives– Since the beginning of the COVID-19 outbreak, olfactory and gustative disorders, up to anosmia and ageusia have been described in infected patients. The study aim’s was to measure the prevalence and the predictive values of recent smell and taste loss in a cohort of patients and health care workers (HCWs) tested for SARS-CoV-2 infection.
- Methods– This retrospective study was conducted in Marseille, France, at the Institut Hospitalo-Universitaire Méditerranée Infection. A total of 3,497 adults presented for SARS-CoV-2 PCR between 24 March and 25 April 2020. 432 healthcare workers (HCWs) also asked to be tested by PCR plus a serology assay. The following question was asked before being tested: “have you lost your sense of smell or taste in the past two months?”
- Results– SARS-CoV-2 PCR was positive in 673/3,497 patients (19.24%). The prevalence of the loss of smell and/or taste in COVID-19 patients was 356/673(53%), higher than in non-infected patients (257/2,824; 9.1%, p<0.001). The positive predictive value (PPV) for the diagnosis of COVID-19 was 67.15 % when smell and taste disorders were reported. A total of 432 HCWs were tested for SARS-CoV-2 by RT-PCR and serology. The PPV of olfactory and/or gustatory dysfunction was 58.08%, and the negative predictive value (NPV) was 89.01%. Regarding the diagnosis of COVID-19 in 432 HCWs, the PPV of olfactory and/or gustatory dysfunction was 73%, and the NPV was 99%.
Conclusions Questioning patients and HCWs about their sense of smell and taste could be useful in countries where testing is politically or technically limited.
Key words: COVID-19, SARS-CoV-2, anosmia, ageusia, smell, taste.