Performance of formal smell testing and symptom screening for identifying SARS-CoV-2 infection

Abstract

Background Altered sense of smell is a commonly reported COVID-19 symptom. The performance of smell testing to identify SARS-CoV-2 infection status is unknown. We measured the ability of formal smell testing to identify SARS-CoV-2 infection and compared its performance with symptom screening. Methods A convenience sample of emergency department patients with COVID-19 symptom screening participated in smell testing using an eight odor Pocket Smell Test (PST). Participants received a SARS-CoV-2 viral PCR test after smell testing and completed a health conditions survey. Descriptive analysis and receiver operating characteristic (ROC) curve models compared the accuracy of smell testing versus symptom screening in identifying SARS-CoV-2 infection. Results Two hundred and ninety-five patients completed smell testing and 87 (29.5%) had a positive SARS-CoV-2 PCR test. Twenty-eight of the SARS-CoV-2 positive patients (32.2%) and 49 of the SARS-CoV-2 negative patients (23.6%) reported at least one of seven screening symptoms (OR = 1.54, P = 0.13). SARS-CoV-2 positive patients were more likely to have hyposmia (≤5 correctly identified odors) than SARS-CoV-2 negative patients (56.1% vs. 19.3%, OR = 5.36, PConclusion Smell testing was superior to symptom screening for identifying SARS-CoV-2 infection in our study.