Smell and taste symptom-based predictive model for COVID-19 diagnosis

Lauren T. Roland, Jose G. Gurrola, Patricia A. Loftus, Steven W. Cheung, Jolie L. Chang

Research output: Contribution to journalArticlepeer-review

74 Scopus citations


Background: The presentation of coronavirus 2019 (COVID-19) overlaps with common influenza symptoms. There is limited data on whether a specific symptom or collection of symptoms may be useful to predict test positivity. Methods: An anonymous electronic survey was publicized through social media to query participants with COVID-19 testing. Respondents were questioned regarding 10 presenting symptoms, demographic information, comorbidities, and COVID-19 test results. Stepwise logistic regression was used to identify predictors for COVID-19 positivity. Selected classifiers were assessed for prediction performance using receiver operating characteristic (ROC) curve analysis. Results: A total of 145 participants with positive COVID-19 testing and 157 with negative results were included. Participants had a mean age of 39 years, and 214 (72%) were female. Smell or taste change, fever, and body ache were associated with COVID-19 positivity, and shortness of breath and sore throat were associated with a negative test result (p < 0.05). A model using all 5 diagnostic symptoms had the highest accuracy with a predictive ability of 82% in discriminating between COVID-19 results. To maximize sensitivity and maintain fair diagnostic accuracy, a combination of 2 symptoms, change in sense of smell or taste and fever was found to have a sensitivity of 70% and overall discrimination accuracy of 75%. Conclusion: Smell or taste change is a strong predictor for a COVID-19–positive test result. Using the presence of smell or taste change with fever, this parsimonious classifier correctly predicts 75% of COVID-19 test results. A larger cohort of respondents will be necessary to refine classifier performance.

Original languageEnglish
Pages (from-to)832-838
Number of pages7
JournalInternational Forum of Allergy and Rhinology
Issue number7
StatePublished - Jul 1 2020


  • COVID-19
  • predictors
  • receiver operating characteristic curve
  • smell
  • symptoms
  • taste


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