@Article{info:doi/10.2196/19855,
author="Denis, Fabrice
and Galmiche, Simon
and Dinh, Aur{\'e}lien
and Fontanet, Arnaud
and Scherpereel, Arnaud
and Benezit, Francois
and Lescure, Fran{\c{c}}ois-Xavier",
title="Epidemiological Observations on the Association Between Anosmia and COVID-19 Infection: Analysis of Data From a Self-Assessment Web Application",
journal="J Med Internet Res",
year="2020",
month="Jun",
day="11",
volume="22",
number="6",
pages="e19855",
keywords="COVID-19; anosmia; epidemiological surveillance; self-assessment; web application; outbreak; symptoms; surveillance; epidemiology",
abstract="Background: We developed a self-assessment and participatory surveillance web application for coronavirus disease (COVID-19), which was launched in France in March 2020. Objective: Our objective was to determine if self-reported symptoms could help monitor the dynamics of the COVID-19 outbreak in France. Methods: Users were asked questions about underlying conditions, sociodemographic status, zip code, and COVID-19 symptoms. Depending on the symptoms reported and the presence of coexisting disorders, users were told to either stay at home, contact a general practitioner (GP), or call an emergency phone number. Data regarding COVID-19--related hospitalizations were retrieved from the Ministry of Health. Results: As of March 29, 2020, the application was opened 4,126,789 times; 3,799,535 electronic questionnaires were filled out; and 2,477,174 users had at least one symptom. In total, 34.8{\%} (n=1,322,361) reported no symptoms. The remaining users were directed to self-monitoring (n=858,878, 22.6{\%}), GP visit or teleconsultation (n=1,033,922, 27.2{\%}), or an emergency phone call (n=584,374, 15.4{\%}). Emergency warning signs were reported by 39.1{\%} of participants with anosmia, a loss of the sense of smell (n=127,586) versus 22.7{\%} of participants without anosmia (n=1,597,289). Anosmia and fever and/or cough were correlated with hospitalizations for COVID-19 (Spearman correlation coefficients=0.87 and 0.82, respectively; P<.001 for both). Conclusions: This study suggests that anosmia may be strongly associated with COVID-19 and its severity. Despite a lack of medical assessment and virological confirmation, self-checking application data could be a relevant tool to monitor outbreak trends. Trial Registration: ClinicalTrials.gov NCT04331171; https://clinicaltrials.gov/ct2/show/NCT04331171 ",
issn="1438-8871",
doi="10.2196/19855",
url="http://www.jmir.org/2020/6/e19855/",
url="https://doi.org/10.2196/19855",
url="http://www.ncbi.nlm.nih.gov/pubmed/32496206"
}