scholarly journals Recent smell loss is the best predictor of COVID-19 among individuals with recent respiratory symptoms

2020 ◽  
Author(s):  
Richard C Gerkin ◽  
Kathrin Ohla ◽  
Maria G Veldhuizen ◽  
Paule V Joseph ◽  
Christine E Kelly ◽  
...  

Abstract In a preregistered, cross-sectional study we investigated whether olfactory loss is a reliable predictor of COVID-19 using a crowdsourced questionnaire in 23 languages to assess symptoms in individuals self-reporting recent respiratory illness. We quantified changes in chemosensory abilities during the course of the respiratory illness using 0-100 visual analog scales (VAS) for participants reporting a positive (C19+; n=4148) or negative (C19-; n=546) COVID-19 laboratory test outcome. Logistic regression models identified univariate and multivariate predictors of COVID-19 status and post-COVID-19 olfactory recovery. Both C19+ and C19- groups exhibited smell loss, but it was significantly larger in C19+ participants (mean±SD, C19+: -82.5±27.2 points; C19-: -59.8±37.7). Smell loss during illness was the best predictor of COVID-19 in both univariate and multivariate models (ROC AUC=0.72). Additional variables provide negligible model improvement. VAS ratings of smell loss were more predictive than binary chemosensory yes/no-questions or other cardinal symptoms (e.g., fever). Olfactory recovery within 40 days of respiratory symptom onset was reported for ~50% of participants and was best predicted by time since respiratory symptom onset. We find that quantified smell loss is the best predictor of COVID-19 amongst those with symptoms of respiratory illness. To aid clinicians and contact tracers in identifying individuals with a high likelihood of having COVID-19, we propose a novel 0-10 scale to screen for recent olfactory loss, the ODoR-19. We find that numeric ratings ≤2 indicate high odds of symptomatic COVID-19 (4<OR<10). Once independently validated, this tool could be deployed when viral lab tests are impractical or unavailable.

Author(s):  
Richard C. Gerkin ◽  
Kathrin Ohla ◽  
Maria Geraldine Veldhuizen ◽  
Paule V. Joseph ◽  
Christine E. Kelly ◽  
...  

Background: COVID-19 has heterogeneous manifestations, though one of the most common symptoms is a sudden loss of smell (anosmia or hyposmia). We investigated whether olfactory loss is a reliable predictor of COVID-19. Methods: This preregistered, cross-sectional study used a crowdsourced questionnaire in 23 languages to assess symptoms in individuals self-reporting recent respiratory illness. We quantified changes in chemosensory abilities during the course of the respiratory illness using 0-100 visual analog scales (VAS) for participants reporting a positive (C19+; n=4148) or negative (C19-; n=546) COVID-19 laboratory test outcome. Logistic regression models identified singular and cumulative predictors of COVID-19 status and post-COVID-19 olfactory recovery. Results: Both C19+ and C19- groups exhibited smell loss, but it was significantly larger in C19+ participants (mean±SD, C19+: -82.5±27.2 points; C19-: -59.8±37.7). Smell loss during illness was the best predictor of COVID-19 in both single and cumulative feature models (ROC AUC=0.72), with additional features providing no significant model improvement. VAS ratings of smell loss were more predictive than binary chemosensory yes/no-questions or other cardinal symptoms, such as fever or cough. Olfactory recovery within 40 days was reported for ~50% of participants and was best predicted by time since illness onset. Conclusions: As smell loss is the best predictor of COVID-19, we developed the ODoR-19 tool, a 0-10 scale to screen for recent olfactory loss. Numeric ratings ≤2 indicate high odds of symptomatic COVID-19 (10<OR<4), especially when viral lab tests are impractical or unavailable.


Author(s):  
Yves Longtin ◽  
Hugues Charest ◽  
Caroline Quach ◽  
Patrice Savard ◽  
Mariana Baz ◽  
...  

Abstract We performed viral culture of respiratory specimens in 118 severe acute respiratory coronavirus virus 2 (SARS-CoV-2)–infected healthcare workers (HCWs), ∼2 weeks after symptom onset. Only 1 HCW (0.8%) had a positive culture. No factors for prolonged viral shedding were identified. Infectivity is resolved in nearly all HCWs ∼2 weeks after symptom onset.


2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Mi Hong Yim ◽  
Keun Ho Kim ◽  
Bum Ju Lee

AbstractPeptic ulcer disease (PUD) is caused by many sociodemographic and economic risk factors other than H. pylori infection. However, no studies reported an association between PUD and the number of household members. We showed the number of family members affected by PUD based on sex in a Korean population. This cross-sectional study used 1998–2009 data from the Korea National Health and Nutrition Examination Survey of the Korea Centers for Disease Control and Prevention. Multiple binary logistic regression models adjusted for confounders were constructed to analyze the association of PUD with the number of household members. The number of household members was associated with PUD, age, body mass index (BMI), waist circumference, systolic blood pressure, hemoglobin, glucose, location (urban/rural), income, education level, stress, current drinking, and smoking in both sexes. Men with other household members had a higher PUD risk compared to men or women living alone (reference), and the opposite was observed for women. Men with 4 household members had a higher PUD risk than men living alone in the model adjusted for age, BMI, income, location, education, and stress (OR = 2.04 [95% CI 1.28–3.27], p value = .003). Women with more than 6 household members had a lower PUD risk than women living alone in the adjusted model (OR = 0.50 [0.33–0.75], p value = .001). Women with more household members had a lower PUD risk. However, more men had PUD than women regardless of the number of household members.


2018 ◽  
Vol 36 (06) ◽  
pp. 653-658 ◽  
Author(s):  
Sindhu Srinivas ◽  
Katy Kozhimannil ◽  
Peiyin Hung ◽  
Laura Attanasio ◽  
Judy Jou ◽  
...  

Background A recent document by the American Congress of Obstetricians and Gynecologists (ACOG) and the Society for Maternal-Fetal Medicine introduced the concept of uniform levels of maternal care (LMCs). Objective We assessed LMC across hospitals and measured their association with maternal morbidity, focusing on women with high-risk conditions. Study Design We collected data from hospitals from May to November 2015 and linked survey responses to Statewide Inpatient Databases (SID) hospital discharge data in a retrospective cross-sectional study of 247,383 births admitted to 236 hospitals. Generalized logistic regression models were used to examine the associations between hospitals' LMC and the risk of severe maternal morbidity. Stratified analyses were conducted among women with high-risk conditions. Results High-risk pregnancies were more likely to be managed in hospitals with higher LMC (p < 0.001). Women with cardiac conditions had lower odds of maternal morbidity when delivered in level I compared with level IV units (adjusted odds ratio: 0.29; 95% confidence interval: 0.08–0.99; p = 0.049). There were no other significant associations between the LMC and severe maternal morbidity. Conclusion A higher proportion of high-risk pregnancies were managed within level IV units, although there was no overall evidence that these births had superior outcomes. Further prospective evaluation of LMC designation with patient outcomes is necessary to determine the impact of regionalization on maternal outcomes.


BMJ Open ◽  
2021 ◽  
Vol 11 (1) ◽  
pp. e041453
Author(s):  
Xin Xu ◽  
Kimberly Ann Chew ◽  
Xiaolin Xu ◽  
Zhihua Wu ◽  
Xiaohua Xiao ◽  
...  

ObjectivesExamine compliance with personal protective measures in communities for the prevention and control of local transmission of the COVID-19, and explore indicators for such behavioural compliance.DesignCross-sectional design with a self-selecting sample. Data collected in February 2020.SettingCommunity dwellers in China.Participants2956 participants aged 16 and above completed the study and were included in the analysis.Outcome measuresNationwide COVID-19 survey. Demographics and self-reported compliance with four personal protective measures—home quarantine, mask-wearing, temperature-taking and hand-sanitising were collected. Outbreak severity and timeliness of personal protection order were obtained from the China Center for Disease Control and Prevention website. Logistic regression models were employed to examine the association between demographic and social indicators and behavioural compliance.ResultsCompliance with home quarantine was only associated with gender (men, OR=0.61 (0.51–0.73), inverse association) but no other indicators. In contrast, men had higher compliance with mask-wearing (OR=1.79 (1.49–2.16)) and temperature-taking (OR=1.27 (1.05–1.53)). Compared with younger adults (≤20 years), the middle-age groups (31–40 and 41–50 years of age) were more compliant with all protective behaviours, except for home quarantine (OR=0.71 (0.54–0.93) and 0.67 (0.46–0.97), respectively).ConclusionMale gender was associated with lower compliance with home quarantine yet higher compliance with mask-wearing and temperature-taking. The middle-age participants (31–50 years) had lower compliance with home quarantine but higher with other measures. These findings may be supported by the economic considerations and the long-inherited Confucian values among Chinese. In light of the ongoing COVID-19 pandemic, public health authorities should tailor policy implementation to disparities in psychosocial indicators.


2021 ◽  
Vol 11 (1) ◽  
Author(s):  
Li Ran ◽  
Qi Chen ◽  
Jingyi Zhang ◽  
Xinlong Tu ◽  
Xiaodong Tan ◽  
...  

AbstractHypertension (HTN) and osteoarthritis (OA) are frequent in middle-aged and elderly people, and the co-occurrence of these two diseases is common. However, the pathogenesis of the multimorbidity of both diseases and the relation with sleep quality, hyperlipemia, and hyperglycemia is unclear. We conducted a cross-sectional study to make sense of the multimorbidity of HTN and OA and the relation with sleep quality, hyperlipemia, and hyperglycemia. The relation between sleep quality and OA and its joint effect with hyperlipemia or hyperglycemia was evaluated with logistic regression models. The additive interaction was assessed with the relative excess risk due to interaction (REEI), the attributable proportion (AP), and the synergy index (S). According to this research in a remote rural area, approximately 34.2% of HTN patients are accompanied with OA and 49.1% are suffering poor sleep. Both hyperlipemia/hyperglycemia and sleep quality were related to OA prevalence with crude ORs of 1.43 (95% CI 1.014–2.029) and 1.89 (95% CI 1.411–2.519, P < 0.001) respectively. An observed additive effect was found greater than the sum of the effects of sleep quality and hyperlipemia/hyperglycemia posed on OA prevalence alone. This additive interaction was observed in females (OR = 3.19, 95% CI 1.945–5.237) as well as males ≥ 65 years old (OR = 2.78, 95% CI 1.693–4.557), with RERI, AP, and S significant. Therefore, poor sleep and hyperlipemia/hyperglycemia are associated with OA, and further studies on the additive interaction among females and males ≥ 65 are warranted.


2021 ◽  
pp. 014556132110001
Author(s):  
Daniel J. Lee ◽  
Daniella Daliyot ◽  
Ri Wang ◽  
Joel Lockwood ◽  
Paul Das ◽  
...  

Objective: To directly compare the prevalence of chemosensory dysfunction (smell and taste) in geographically distinct regions with the same questionnaires. Methods: A cross-sectional study was performed to evaluate the self-reported symptoms among adults (older than 18 years) who underwent COVID-19 testing at an ambulatory assessment center in Canada and at a hospital in Israel between March 16, 2020, and August 19, 2020. The primary outcome was the prevalence of self-reported chemosensory dysfunction (anosmia/hypomsia and dysgeusia/ageusia). Subgroup analysis was performed to evaluate the prevalence of chemosensory deficits among the outpatients. Results: We identified a total of 350 COVID-19–positive patients (138 Canadians and 212 Israelis). The overall prevalence of chemosensory dysfunction was 47.1%. There was a higher proportion of chemosensory deficits among Canadians compared to Israelis (66.7% vs 34.4%, P < .01). A subgroup analysis for outpatients (never hospitalized) still identified a higher prevalence of chemosensory dysfunction among Canadians compared to Israelis (68.2% vs 36.1%, P < 0.01). A majority of patients recovered their sense of smell after 4 weeks of symptom onset. Conclusion: Although the prevalence of chemosensory deficit in COVID-19 was found to be similar to previously published reports, the prevalence can vary significantly across different geographical regions. Therefore, it is important to obtain regionally specific data so that the symptom of anosmia/dysgeusia can be used as a guide for screening for the clinical diagnosis of COVID-19.


2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Mariam John Munyogwa ◽  
Kaloli Sayi Ntalima ◽  
Secilia Ng’weshemi Kapalata

Abstract Background Obesity at the workplace has been associated with symptoms of lower self-esteem, increased individual and employer healthcare costs, increased absenteeism and presenteeism and reduced productivity. Therefore, this study was designed to study the prevalence and correlates of central obesity among formal sector employees in Dodoma City. Methods Study design was a cross-sectional survey conducted from March to June, 2019. Participants were employees from formal sector employment defined as those paid regular monthly wage and with either a secured permanent or temporary contract. Simple random sampling was used to select four out of fifteen large buildings hosting various establishments. Respondents were obtained conveniently and interviewed face to face. Central obesity was defined as a waist circumference greater than 102 cm for males and greater than 88 cm for females. Chi-square test was conducted to assess the differences among the groups. Simple and multiple logistic regression models were fitted to identify the correlates of central obesity. Results A total of 392 respondents (98% response rate) agreed and participated in the study. The overall prevalence of central obesity was found to be 41.8% (164/392). The prevalence of central obesity was significantly higher among females (67.4% p < 0.001), respondents aged ≥51 years (60%, p = < 0.001), administrators (55.1% p = < 0.05), respondents with salary of > 1,000,000 Tanzanian Shilling (TSh.) per month (54.4%, p = < 0.05), respondents who eat homemade meals at the workplace (64.2%, p = < 0.05) and respondents with hypertension (62.5%, p = < 0.05). Correlates of central obesity were found to be female sex (AOR = 9.53; 95% CI: 5.49, 16.78), increased age, eating homemade meals at the workplace (AOR = 2.32; 95% CI: 1.04, 4.19) and hypertension (AOR = 3.15; 95% CI: 1.41, 6.91). Conclusions The present study revealed high prevalence of central obesity among formal sector employees in Dodoma City. Scholars and stakeholders are urged to generate more evidences and design appropriate interventions to curb the situation.


Stroke ◽  
2021 ◽  
Vol 52 (Suppl_1) ◽  
Author(s):  
Priyadarshee Patel ◽  
Urvish K Patel ◽  
Graca Vanessa ◽  
Abhinav Patel ◽  
Davis Chacko ◽  
...  

Background: Thrombotic Microangiopathy (TMA) is a rare disorder affecting the coagulation system causing microangiopathic thrombus formation within various blood vessels including the cerebral arteries. It may be seen in association with thrombocytopenia, anemia, purpura and kidney failure as well as complications of various systemic viral illnesses. We sought to estimate the trends, predictors, and outcomes of CeVD in patients having ™ from a nationally representative database of the USA. Methods: In this cross-sectional study, we identified hospitalization with TM using ICD-9/10-CM from the National Inpatient Sample (NIS) for the years 2008-2017. Prevalence of CeVD was identified by validated ICD-9/10-CM codes. We utilized Cochran Armitage trend test and multivariable survey logistic regression models to analyze temporal trends, outcomes and predictors of any CeVD in TM patients. Results: Out of a total 58,850 hospitalizations among TMA patients, 4,668 (7.9%) developed CeVD. Prevalence of CeVD increased from 6.2% in 2008 to 8.2% in 2017 (pTrend<0.001). Patients who developed CeVD were older and more likely to be female. In multivariable regression analysis, increasing age (OR 1.2; 95%CI 1.1-1.2; p<0.0001); females (OR 1.3; 95%CI 1.1-1.6;p<0.0004); African American (OR 1.4; 95%CI 1.2-1.7;p<0.001) and hypertension (OR 1.3; 95%CI 1.1-1.6; p<0.0001). CeVD was also associated with higher length of stay (18 vs 12 days; p<0.001). Additionally, CeVD was associated with higher in-hospital mortality (aOR 2.1; 95%CI 1.7-2.5; p<0.001) and discharge to facility (aOR 3.0; 95%CI 2.4-3.5; p<0.001) after adjusting with confounders. Conclusion: We observed the mildly incremental prevalence of CeVD among TMA patients. We were able to identify the TMA patient population susceptible to CeVD, most commonly occurring in older, females and African Americans. CeVD was also associated with significantly poor outcomes in TM. These findings may pose similarities to other systemic viral illness-induced thrombotic microangiopathy such as COVID-19. Further studies are required to improve the outcomes of these susceptible patient populations.


2017 ◽  
pp. 1-4
Author(s):  
S.D. Piña-Escudero ◽  
J.M.A. García-Lara ◽  
J.A. Avila-Funes

Muscle Frailty has been previously associated with increased vulnerability for adverse health-related outcomes that could lead to social consequences such as mistreatment. The aim of this cross-sectional study is to determine the association between frailty and mistreatment in 852 community-dwelling persons aged 70 or older. Mistreatment was defined as one positive answer in the Geriatric Mistreatment Scale and frailty was used as a continuum where the greater number of positive criteria according to Fried et al. indicates a higher frailty score. Multivariate logistic regression models were run to establish this association. The mean age of participants was 77.7 years (SD=6.1). Prevalence of frailty phenotype and mistreatment were 13.9% and 20% respectively. Unadjusted analysis showed frailty score was associated with mistreatment (OR = 1.16; 95% CI 1.02 to 1.3, p=0.022). However, after adjustment, the association was no longer present. The results showed that in the presence of other geriatric syndromes such as disability or depression, frailty did not show association with mistreatment in this population.


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