Rapid olfactory tools for telemedicine-friendly COVID-19 screening and surveillance

用于远程医疗友好型 COVID-19 筛查和监测的快速嗅觉工具

• 批准号: 10263657
• 负责人: Richard C Gerkin
• 金额: $ 48.54万
• 依托单位: UNIVERSITY OF FLORIDA
• 依托单位国家: 美国
• 财政年份: 2020
• 资助国家: 美国
• 起止时间: 2020-12-21 至 2022-02-28
• 项目状态: 已结题
• 来源: https://reporter.nih.gov/project-details/10263657
• 关键词: 2019-nCoV; Administrator; Anosmia; Appalachian Region; Arizona; COVID-19; COVID-19 pandemic; COVID-19 screening; COVID-19 surveillance; COVID-19 testing; Clinical; Collection; Common Cold; Communicable Diseases; Communities; Complement; Coughing; Country; Custom; Dangerousness; Data; Detection; Diagnosis; Diagnostic; Differential Diagnosis; Disadvantaged; Discrimination; Disease; Disease Outbreaks; Early identification; Economics; Employee; Encapsulated; Fever; Florida; Government; Health; Healthcare Systems; Heterogeneity; Hot Spot; Individual; Influenza; Infrastructure; Laboratories; Link; Logistics; Measures; Methods; Monitor; Municipalities; National Health and Nutrition Examination Survey; Native Americans; Odors; Olfactory dysfunction; Outcome; Participant; Patient Self-Report; Pennsylvania; Persons; PhenX Toolkit; Play; Population; Population Surveillance; Prevalence; Procedures; Public Health; Quarantine; Questionnaires; Rapid screening; Reporting; Safety; Sampling; Screening procedure; Self Administration; Sentinel; Specificity; Symptoms; System; Telemedicine; Telephone; Testing; Time; United States; United States National Institutes of Health; Universities; Upper Respiratory Infections; Viral; Virus; Workplace; authority; base; community setting; cost; cost effective; dalton; design; hyposmia; member; novel; screening; smell test; social health determinants; tool; university student

The COVID-19 pandemic is the most devastating infectious disease outbreak in a century, particularly in underserved and minoritized communities. In 2020 alone, it will cost a million lives. It continues to wreak economic havoc worldwide. Therefore, it is critical to develop new tools that can mitigate the spread of SARS- CoV-2, the virus that causes COVID-19. Rapid screening tools can identify potentially infected individuals who can then be isolated/quarantined from the uninfected and directed towards further testing and treatment. Unfortunately, definitive viral testing for SARS-CoV-2 has proven difficult to implement in many countries, including the US, due to technical, financial and governmental hurdles to universal access and timely processing. Symptom-based screening offers a valuable, albeit imperfect, complement to viral testing that can help identify many individuals with the disease for isolation as well as treatment. A major challenge with symptomatic testing is that COVID-19 is highly protean: the heterogeneity of symptoms means no single symptom or constellation of symptoms is definitive diagnostically. Still, there is growing evidence that sudden partial or complete olfactory loss – even more than other symptoms such as fever or dry cough – is the single best predictor of COVID-19. In this proposal, we will develop and implement objective, self-administered smell tests for the purpose of identifying individuals with COVID-19 prior to, or in the absence of, viral testing, as well as for use in population-level surveillance of COVID-19 spread. Several kinds of objective tests have been used in clinical or laboratory settings to assess an individual's olfactory ability, including those that test the ability to identify or discriminate odors as well as procedures to determine the lowest concentration an individual can reliably perceive (i.e., odor detection threshold). Each approach has technical and logistical advantages and disadvantages, and each captures different aspects of olfactory dysfunction. Regarding COVID-19, it is unknown what type of measure has the highest specificity or sensitivity. In Aim 1, we will use self-administered objective testing of odor identification and odor detection threshold in SARS-CoV-2-tested individuals to determine which olfactory measure is the best predictor of COVID-19. In Aim 2, we will use objective smell testing to assess whether population monitoring of olfactory loss in university, municipal or other community settings can serve as a sentinel of COVID-19 community spread. Together, our studies will provide a rapid, remote-friendly, cost-effective, scalable, non-intrusive method to screen for COVID-19 at the individual level and to assess prevalence in communities, especially those that have been traditionally underserved by the health care system and public health infrastructure.

COVID-19大流行是世纪以来最具破坏性的传染病爆发，特别是在 服务不足和少数族裔社区。仅在2020年，它就将夺走100万人的生命。它继续肆虐 世界范围内的经济灾难。因此，开发能够减缓SARS传播的新工具至关重要- CoV-2，导致COVID-19的病毒。快速筛查工具可以识别可能感染的个体， 然后可以与未感染者隔离/隔离，并用于进一步的测试和治疗。 不幸的是，SARS-CoV-2的确定性病毒检测已被证明难以在许多国家实施， 包括美国在内，由于技术、财政和政府障碍， 处理.基于症状的筛查提供了一个有价值的，虽然不完美的，补充病毒检测，可以 帮助确定许多患有这种疾病的人，以便进行隔离和治疗。一个重大挑战， 症状测试是COVID-19是高度多变的：症状的异质性意味着没有单一的 症状或症状群在诊断上是明确的。然而，越来越多的证据表明， 部分或完全嗅觉丧失-甚至比其他症状，如发烧或干咳-是单一的 COVID-19的最佳预测因子。在本提案中，我们将开发和实施客观、自我管理的气味 在病毒检测之前或在没有病毒检测的情况下，为识别COVID-19患者而进行的检测，以及 用于COVID-19传播的人群水平监测。几种客观的测试已经 在临床或实验室环境中使用，以评估个人的嗅觉能力，包括那些测试 识别或辨别气味的能力，以及确定最低浓度和 个体能够可靠地感知（即，气味检测阈值）。每种方法都有技术和后勤方面的问题， 优点和缺点，每一个都抓住了嗅觉功能障碍的不同方面。关于 COVID-19，目前尚不清楚哪种类型的措施具有最高的特异性或敏感性。在目标1中，我们将使用 SARS-CoV-2患者气味识别和气味检测阈值的自我管理客观测试 以确定哪种嗅觉指标是COVID-19的最佳预测指标。在目标2中，我们将使用 客观的嗅觉测试，以评估是否在大学，市政或 其他社区环境可以作为COVID-19社区传播的哨兵。我们的研究将 提供一种快速、远程友好、具有成本效益、可扩展、非侵入性的方法， 评估社区的流行率，特别是传统上 卫生保健系统和公共卫生基础设施服务不足。