ABSTRACT Objectives To slow down the transmission of coronavirus disease 2019 (COVID-19), it is important to identify specific symptoms for effective screening. While anosmia/hyposmia and dysgeusia/ageusia have been identified as highly prevalent symptoms, there are wide geographic variations, necessitating the regional evaluation of the prevalence of the symptoms. Methods A cross-sectional study was performed to evaluate the self-reported symptoms among adults (over 18 years old) who underwent COVID-19 tests at an ambulatory assessment centre. We identified 1,345 patients (102 positive and 1,243 negative) who visited the assessment centre between March 16 and April 15, 2020. We randomly sampled negative patients in a 1:3 ratio. The primary outcome was the prevalence of self-reported anosmia/hyposmia and dysgeusia/ageusia. Logistic regression was performed to evaluate the association between COVID-19 positivity and loss of smell and taste. Results Fifty-six of 102 (50%) positive patients and 72 of 306 (23.5%) negative patients completed the survey. Anosmia/hyposmia and dysgeusia/ageusia were more prevalent among COVID-19 positive patients (41.1% v. 4.2%, p < 0.001 for smell and 46.4% v. 5.6%, p < 0.001 for taste). Anosmia/hyposmia and dysgeusia/ageusia were independently highly associated with COVID-19 positivity (adjusted odds ratios 14.4 and 11.4 for smell and taste, respectively). Conclusion In this Canadian study, smell and taste loss may be key symptoms of COVID-19. This evidence can be helpful in the clinical diagnosis of COVID-19, particularly settings of limited testing capacity.

n any given night, more than half a million people in the United States 1 and more than 35 000 in Canada 2 experience homelessness. Homelessness has always been associated with poor health outcomes, 3 but its risks to health have only been heightened by coronavirus disease 2019 (COVID-19), with consequences extending to the broader community. People experiencing homelessness are at increased risk of acquiring severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infections and spreading the virus to others. 4,5 Many people experiencing homelessness stay in congregate living settings such as shelters, where it is difficult to practise social distancing. Others live rough, on the street or in encampments, and do not have access to basic hygiene supplies or showering facilities. In any of these scenarios, selfisolation is not possible. People who experience homelessness also have higher rates of chronic conditions such as diabetes and hypertension, which puts them at increased risk of complications if they acquire the infection. 3,6 Recent data from Boston suggest that people experiencing homelessness have a higher prevalence of SARS-CoV-2 positivity 7 and more severe

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