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456. Implementing an At-Home Smell Test for Early Assessment of COVID-19 in High-Risk Healthcare Workers

BACKGROUND: Smell loss has been recognized as an important, and potentially early, sign of COVID-19. However, to date smell loss has only been assessed in retrospective, COVID+ cohorts, and largely through self-report. The objective of this study was to implement a daily standardized behavioral test...

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Autores principales: Weiss, Julian J, Attuquayefio, Tuki, White, Elizabeth B, Geng, Bertie, Handoko, Ryan, Herz, Rachel S, White, Theresa L, Iwasaki, Akiko, Grubaugh, Nathan D, Datta, Rupak, Campbell, Melissa, Martinello, Richard A, Ko, Albert I, Small, Dana M, Farhadian, Shelli F
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Oxford University Press 2020
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7776583/
http://dx.doi.org/10.1093/ofid/ofaa439.649
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author Weiss, Julian J
Attuquayefio, Tuki
White, Elizabeth B
Geng, Bertie
Handoko, Ryan
Herz, Rachel S
White, Theresa L
Iwasaki, Akiko
Grubaugh, Nathan D
Datta, Rupak
Campbell, Melissa
Martinello, Richard A
Ko, Albert I
Small, Dana M
Farhadian, Shelli F
author_facet Weiss, Julian J
Attuquayefio, Tuki
White, Elizabeth B
Geng, Bertie
Handoko, Ryan
Herz, Rachel S
White, Theresa L
Iwasaki, Akiko
Grubaugh, Nathan D
Datta, Rupak
Campbell, Melissa
Martinello, Richard A
Ko, Albert I
Small, Dana M
Farhadian, Shelli F
author_sort Weiss, Julian J
collection PubMed
description BACKGROUND: Smell loss has been recognized as an important, and potentially early, sign of COVID-19. However, to date smell loss has only been assessed in retrospective, COVID+ cohorts, and largely through self-report. The objective of this study was to implement a daily standardized behavioral test of smell sensitivity in healthcare workers (HCW) to capture changes in smell sensitivity over time and to assess whether these changes occur prior to positive COVID test. METHODS: The study enrolled 500 high-risk COVID-negative HCW during the COVID-19 epidemic in Connecticut, beginning March 28, 2020 (80% F, mean age 38, 58% nurses). Initially, HCW received a daily symptom questionnaire with parosmia screening questions. On April 23 we introduced the “Jiffy”, a daily at-home psychophysical test of smell sensitivity, where olfactory stimuli are sampled and rated for perceived intensity. SARS-CoV-2 infection was tested every three days by PCR of nasopharyngeal swabs or saliva. Screening Questionnaire for Parosmia [Image: see text] The “Jiffy” Survey and Test [Image: see text] RESULTS: Of the first 500 enrolled HCW, 376 HCW (75%) completed the Jiffy 4528 times (mean 12 times/HCW). 17/500 HCW (3.4%) had a COVID+ test, of which 9/17 (53%) reported smell loss through the Jiffy or the daily symptom survey. 6/9 (67%) reported smell loss that preceded or was concurrent with a COVID+ test. 8/17 COVID+ HCW completed the Jiffy, with 5/8 (63%) reporting reductions in smell versus 42/368 (11%) COVID- HCW (OR=13, 95% CI: 2.4–85, p=.001). COVID+ HCW rated their greatest reduction in smell sensitivity as slight (40%) and severe (60%), versus slight (88%) and moderate (12%) in COVID- HCW. 16/17 COVID+ HCW completed a daily symptom survey (mean 14 times/HCW), with 8/16 (50%) ever reporting parosmia versus 90/466 (19%) of COVID- HCW (OR=4.2, 95% CI: 1.3–13, p=.007). Overall, parosmia was the first reported symptom in 3/13 (23%) COVID+ HCW who reported symptoms. Smell Changes in COVID+ and COVID- HCW Reported in the “Jiffy” Test [Image: see text] Smell Changes in COVID+ and COVID- HCW Reported in Daily Symptom Questionnaire [Image: see text] Smell Changes among COVID+ HCW by Day, Relative to Day of Positive PCR Test [Image: see text] CONCLUSION: We conducted a prospective study of smell testing in a population at high risk for COVID-19 using two parallel approaches. Our results demonstrate the feasibility of at-home smell testing for assessing parosmia during COVID-19, in some cases even prior to a positive PCR result. Given the urgent need for widespread, low-cost, non-invasive testing for COVID-19, we are now developing an easy-to-use app to distribute this survey more widely to high-risk populations. DISCLOSURES: Julian J. Weiss, BA, Nothing to disclose
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spelling pubmed-77765832021-01-07 456. Implementing an At-Home Smell Test for Early Assessment of COVID-19 in High-Risk Healthcare Workers Weiss, Julian J Attuquayefio, Tuki White, Elizabeth B Geng, Bertie Handoko, Ryan Herz, Rachel S White, Theresa L Iwasaki, Akiko Grubaugh, Nathan D Datta, Rupak Campbell, Melissa Martinello, Richard A Ko, Albert I Small, Dana M Farhadian, Shelli F Open Forum Infect Dis Poster Abstracts BACKGROUND: Smell loss has been recognized as an important, and potentially early, sign of COVID-19. However, to date smell loss has only been assessed in retrospective, COVID+ cohorts, and largely through self-report. The objective of this study was to implement a daily standardized behavioral test of smell sensitivity in healthcare workers (HCW) to capture changes in smell sensitivity over time and to assess whether these changes occur prior to positive COVID test. METHODS: The study enrolled 500 high-risk COVID-negative HCW during the COVID-19 epidemic in Connecticut, beginning March 28, 2020 (80% F, mean age 38, 58% nurses). Initially, HCW received a daily symptom questionnaire with parosmia screening questions. On April 23 we introduced the “Jiffy”, a daily at-home psychophysical test of smell sensitivity, where olfactory stimuli are sampled and rated for perceived intensity. SARS-CoV-2 infection was tested every three days by PCR of nasopharyngeal swabs or saliva. Screening Questionnaire for Parosmia [Image: see text] The “Jiffy” Survey and Test [Image: see text] RESULTS: Of the first 500 enrolled HCW, 376 HCW (75%) completed the Jiffy 4528 times (mean 12 times/HCW). 17/500 HCW (3.4%) had a COVID+ test, of which 9/17 (53%) reported smell loss through the Jiffy or the daily symptom survey. 6/9 (67%) reported smell loss that preceded or was concurrent with a COVID+ test. 8/17 COVID+ HCW completed the Jiffy, with 5/8 (63%) reporting reductions in smell versus 42/368 (11%) COVID- HCW (OR=13, 95% CI: 2.4–85, p=.001). COVID+ HCW rated their greatest reduction in smell sensitivity as slight (40%) and severe (60%), versus slight (88%) and moderate (12%) in COVID- HCW. 16/17 COVID+ HCW completed a daily symptom survey (mean 14 times/HCW), with 8/16 (50%) ever reporting parosmia versus 90/466 (19%) of COVID- HCW (OR=4.2, 95% CI: 1.3–13, p=.007). Overall, parosmia was the first reported symptom in 3/13 (23%) COVID+ HCW who reported symptoms. Smell Changes in COVID+ and COVID- HCW Reported in the “Jiffy” Test [Image: see text] Smell Changes in COVID+ and COVID- HCW Reported in Daily Symptom Questionnaire [Image: see text] Smell Changes among COVID+ HCW by Day, Relative to Day of Positive PCR Test [Image: see text] CONCLUSION: We conducted a prospective study of smell testing in a population at high risk for COVID-19 using two parallel approaches. Our results demonstrate the feasibility of at-home smell testing for assessing parosmia during COVID-19, in some cases even prior to a positive PCR result. Given the urgent need for widespread, low-cost, non-invasive testing for COVID-19, we are now developing an easy-to-use app to distribute this survey more widely to high-risk populations. DISCLOSURES: Julian J. Weiss, BA, Nothing to disclose Oxford University Press 2020-12-31 /pmc/articles/PMC7776583/ http://dx.doi.org/10.1093/ofid/ofaa439.649 Text en © The Author 2020. Published by Oxford University Press on behalf of Infectious Diseases Society of America. http://creativecommons.org/licenses/by-nc-nd/4.0/ This is an Open Access article distributed under the terms of the Creative Commons Attribution-NonCommercial-NoDerivs licence (http://creativecommons.org/licenses/by-nc-nd/4.0/), which permits non-commercial reproduction and distribution of the work, in any medium, provided the original work is not altered or transformed in any way, and that the work is properly cited. For commercial re-use, please contact journals.permissions@oup.com
spellingShingle Poster Abstracts
Weiss, Julian J
Attuquayefio, Tuki
White, Elizabeth B
Geng, Bertie
Handoko, Ryan
Herz, Rachel S
White, Theresa L
Iwasaki, Akiko
Grubaugh, Nathan D
Datta, Rupak
Campbell, Melissa
Martinello, Richard A
Ko, Albert I
Small, Dana M
Farhadian, Shelli F
456. Implementing an At-Home Smell Test for Early Assessment of COVID-19 in High-Risk Healthcare Workers
title 456. Implementing an At-Home Smell Test for Early Assessment of COVID-19 in High-Risk Healthcare Workers
title_full 456. Implementing an At-Home Smell Test for Early Assessment of COVID-19 in High-Risk Healthcare Workers
title_fullStr 456. Implementing an At-Home Smell Test for Early Assessment of COVID-19 in High-Risk Healthcare Workers
title_full_unstemmed 456. Implementing an At-Home Smell Test for Early Assessment of COVID-19 in High-Risk Healthcare Workers
title_short 456. Implementing an At-Home Smell Test for Early Assessment of COVID-19 in High-Risk Healthcare Workers
title_sort 456. implementing an at-home smell test for early assessment of covid-19 in high-risk healthcare workers
topic Poster Abstracts
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7776583/
http://dx.doi.org/10.1093/ofid/ofaa439.649
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