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

新冠肺炎大流行是一个世纪以来最具破坏性的传染病爆发，特别是在 服务不足和小型化的社区。仅在2020年，它就将夺走100万人的生命。它继续肆虐 世界范围内的经济浩劫。因此，开发能够缓解SARS传播的新工具至关重要-- 冠状病毒-2，引起新冠肺炎的病毒。快速筛查工具可以识别潜在的感染者 然后可以与未感染的人隔离/隔离，并用于进一步的检测和治疗。 不幸的是，事实证明，针对SARS-CoV-2的明确病毒检测在许多国家很难实施， 包括美国在内，由于技术、财政和政府方面的障碍，普遍获得和及时 正在处理。基于症状的筛查为病毒检测提供了一个有价值的补充，尽管不是完美的，但可以 帮助识别许多患有这种疾病的人，以便进行隔离和治疗。一项重大挑战是 症状测试是新冠肺炎是高度多变的：症状的异质性意味着不只一个 症状或一系列症状是明确诊断的。尽管如此，越来越多的证据表明，突然 部分或完全嗅觉丧失--甚至比发烧或干咳等其他症状更严重--是唯一 新冠肺炎的最佳预测者。在这项提案中，我们将开发和实施客观的、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，用于识别新冠肺炎患者的测试 至于用于人群层面监测的新冠肺炎传播。已经有几种类型的客观测试 在临床或实验室环境中用于评估个人的嗅觉能力，包括那些测试 识别或区分气味的能力以及确定最低浓度和 个体可以可靠地感知(即气味检测阈值)。每种方法都有技术和后勤保障 优点和缺点，每个都捕捉到了嗅觉障碍的不同方面。关于 新冠肺炎，目前尚不清楚哪种测量方法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检测中气味识别和气味检测阈值的自控客观测试 以确定哪种嗅觉指标是新冠肺炎的最佳预测指标。在目标2中，我们将使用 目的通过嗅觉测试来评估在大学、市政或社区中对嗅觉丧失的人群监测 其他社区设置可以作为新冠肺炎社区传播的哨兵。共同努力，我们的研究将 提供一种快速、远程友好、经济高效、可扩展、非侵入性的方法来在 在个人层面，并评估社区的流行率，特别是那些传统上 卫生保健系统和公共卫生基础设施服务不足。

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.