Background We developed a self-assessment and participatory web-based triage app to assess the trends of the COVID-19 pandemic in France in March 2020. Objective We compared daily large-scale RT–PCR test results to monitor recent reports of anosmia through a web-based app to assess the dynamics of emergency department visits, hospitalizations, and intensive care unit (ICU) admissions among individuals with COVID-19 in France. Methods Between March 21 and November 18, 2020, users of the maladiecoronavirus.fr self-triage app were asked questions about COVID-19 symptoms. Data on daily hospitalizations, large-scale positive results on RT–PCR tests, emergency department visits, and ICU admission of individuals with COVID-19 were compared to data on daily reports of anosmia on the app. Results As of November 18, 2020, recent anosmia was reported 575,214 times from among approximately 13,000,000 responses. Daily anosmia reports during peak engagement with the app on September 16, 2020, were spatially correlated with the peak in daily COVID-19–related hospitalizations in November 2020 (Spearman rank correlation coefficient [ρ]=0.77; P<.001). This peak in daily anosmia reports was observed primarily among young adults (age range 18-40 years), being observed 49 days before the peak of hospitalizations that corresponded to the first wave of infections among the young population, followed by a peak in hospitalizations among older individuals (aged ≥50 years) in November 2020. The reduction in the daily reports of anosmia associated with the peaks in the number of cases preceded the reduction in daily hospitalizations by 10 and 9 days during the first and the second waves of infection, respectively, although the reduction in the positivity rates on RT–PCR tests preceded the reduction in daily hospitalizations by only 2 days during the second wave of infections. Conclusions Data on daily reports of anosmia collected through a nationwide, web-based self-assessment app can be a relevant tool to anticipate surges in outbreaks, hospitalizations, and ICU admission during the COVID-19 pandemic. Trial Registration ClinicalTrials.gov NCT04331171; https://clinicaltrials.gov/ct2/show/NCT04331171
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 We compared daily large-scale RT-PCR tests results to daily connections to a self-triage application by anosmic users to assess dynamics of emergency visits, hospitalizations and ICU admissions for COVID-19 positive patients in France. METHODS Between 3/21/2020 and 11/18//2020, users of maladiecoronavirus.fr self-triage application were asked questions about COVID-19 symptoms. Data of daily hospitalizations, large-scale RT-PCR positive tests, emergency visits and ICU entrances for COVID-19 patients were compared to data of anosmic users of the applications. RESULTS As of November 18, 2020, 575,214 users reported recent anosmia on near 13 Million responders. Daily anosmia reported during the peak of connections to the application on September 16 were spatially correlated with daily COVID-19–related hospitalizations peak which occurred in November (spearman correlation coefficients=0.77, p<.001). Decrease of the connections of anosmic users after the main peaks of connections preceded the decrease of daily hospitalizations by 10 and 9 days during the first and the second outbreak waves respectively although the decrease of RT-PCR positive tests occurred only 2 days before daily hospitalizations during the second wave. CONCLUSIONS A peak of daily reported anosmia in young adults was observed 49 days before the peak of the hospitalizations corresponding to the first phase of a large-scale contamination of young population followed by older people leading to hospitalization’s peak in November. Data of anosmic users of a national widespread self-assessment application can be a relevant tool to anticipate outbreak surge, and hospitalizations and ICU decrease of COVID-19 patients. CLINICALTRIAL ClinicalTrials.gov NCT04331171
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