Giving a Voice to Patients With Smell Disorders Associated With COVID-19: Cross-Sectional Longitudinal Analysis Using Natural Language Processing of Self-Reports.

BACKGROUND: Smell disorders are commonly reported with COVID-19 infection. The smell-related issues associated with COVID-19 may be prolonged, even after the respiratory symptoms are resolved. These smell dysfunctions can range from anosmia (complete loss of smell) or hyposmia (reduced sense of smell) to parosmia (smells perceived differently) or phantosmia (smells perceived without an odor source being present). Similar to the difficulty that people experience when talking about their smell experiences, patients find it difficult to express or label the symptoms they experience, thereby complicating diagnosis. The complexity of these symptoms can be an additional burden for patients and health care providers and thus needs further investigation. OBJECTIVE: This study aims to explore the smell disorder concerns of patients and to provide an overview for each specific smell disorder by using the longitudinal survey conducted in 2020 by the Global Consortium for Chemosensory Research, an international research group that has been created ad hoc for studying chemosensory dysfunctions. We aimed to extend the existing knowledge on smell disorders related to COVID-19 by analyzing a large data set of self-reported descriptive comments by using methods from natural language processing. METHODS: We included self-reported data on the description of changes in smell provided by 1560 participants at 2 timepoints (second survey completed between 23 and 291 days). Text data from participants who still had smell disorders at the second timepoint (long-haulers) were compared with the text data of those who did not (non-long-haulers). Specifically, 3 aims were pursued in this study. The first aim was to classify smell disorders based on the participants' self-reports. The second aim was to classify the sentiment of each self-report by using a machine learning approach, and the third aim was to find particular food and nonfood keywords that were more salient among long-haulers than those among non-long-haulers. RESULTS: We found that parosmia (odds ratio [OR] 1.78, 95% CI 1.35-2.37; P<.001) as well as hyposmia (OR 1.74, 95% CI 1.34-2.26; P<.001) were more frequently reported in long-haulers than in non-long-haulers. Furthermore, a significant relationship was found between long-hauler status and sentiment of self-report (P<.001). Finally, we found specific keywords that were more typical for long-haulers than those for non-long-haulers, for example, fire, gas, wine, and vinegar. CONCLUSIONS: Our work shows consistent findings with those of previous studies, which indicate that self-reports, which can easily be extracted online, may offer valuable information to health care and understanding of smell disorders. At the same time, our study on self-reports provides new insights for future studies investigating smell disorders.

Demystifying wine expertise through the lens of imagination: Descriptions and imagery vividness across sensory modalities.

For most untrained novices, talking about wine or imagining the smells and flavours of wine is difficult. Wine experts, on the other hand, have been found to have better imagery for wine, and are also more proficient in describing wine. Some scholars have suggested that imagery and language are based on similar underlying processes, but no conclusive evidence has been found regarding mental imagery and language production. In this study, we examined the relationship between imagery and language use in both novices and experts. In an online experiment, wine experts and novices were asked to imagine the colour, smell, taste and mouthfeel of wines in different situations, and were asked to rate the vividness of the imagined experience as well as describe it with words. The results show that experts differ from novices on a number of linguistic measures when describing wine, including the number of words used, the type of words used, the concreteness of those words, and the adjective to noun ratio. Similarly, imagery for wine was more vivid in wine experts compared to novices in the modalities of smell, taste, and mouthfeel, in alignment with previous work. Surprisingly, we found that no single linguistic variable significantly predicted the reported vividness of wine imagery, neither in experts nor in novices. However, the linguistic model predicted imagery vividness better using data from experts compared to novices. Taken together, these findings underscore that imagery and language are different facets of wine cognition.

Covid-19 affects taste independent of taste-smell confusions: results from a combined chemosensory home test and online survey from a large global cohort.

People often confuse smell loss with taste loss, so it is unclear how much gustatory function is reduced in patients self-reporting taste loss. Our pre-registered cross-sectional study design included an online survey in 12 languages with instructions for self-administering chemosensory tests with 10 household items. Between June 2020 and March 2021, 10,953 individuals participated. Of these, 5,225 self-reported a respiratory illness and were grouped based on their reported COVID test results: COVID-positive (COVID+, N = 3,356), COVID-negative (COVID-, N = 602), and COVID unknown for those waiting for a test result (COVID?, N = 1,267). The participants who reported no respiratory illness were grouped by symptoms: sudden smell/taste changes (STC, N = 4,445), other symptoms excluding smell or taste changes (OthS, N = 832), and no symptoms (NoS, N = 416). Taste, smell, and oral irritation intensities and self-assessed abilities were rated on visual analog scales. Compared to the NoS group, COVID+ was associated with a 21% reduction in taste (95% confidence interval (CI): 15-28%), 47% in smell (95% CI: 37-56%), and 17% in oral irritation (95% CI: 10-25%) intensity. There were medium to strong correlations between perceived intensities and self-reported abilities (r = 0.84 for smell, r = 0.68 for taste, and r = 0.37 for oral irritation). Our study demonstrates that COVID-19-positive individuals report taste dysfunction when self-tested with stimuli that have little to none olfactory components. Assessing the smell and taste intensity of household items is a promising, cost-effective screening tool that complements self-reports and may help to disentangle taste loss from smell loss. However, it does not replace standardized validated psychophysical tests.

Odor-Color Associations Are Not Mediated by Concurrent Verbalization.

Odor and color are strongly associated. Numerous studies demonstrate consistent odor-color associations, as well as effects of color on odor perception and language. Yet, we know little about how these associations arise. Here, we test whether language is a possible mediator of odor-color associations, specifically whether odor-color associations are mediated by implicit odor naming. In two experiments, we used an interference paradigm to prevent the verbalization of odors during an odor-color matching task. If participants generate color associations subsequent to labeling an odor, interfering with verbalization during the task should affect the ability to make color associations. In Experiment 1, contrary to our hypothesis, verbal interference did not affect odor-color matches. However, since performance accuracy on the verbal interference task was high, it is possible our task did not sufficiently disrupt verbal processing. In Experiment 2, we, therefore, used an active verbal interference task, and still found no difference across interference conditions. Odor naming accuracy, odor familiarity, and odor pleasantness, however, did predict odor-color matches. This suggests that although color associations are related to semantic factors, they are not generated by recruiting odor labels in the moment. Overall, our results do not provide evidence that language plays an online role in odor-color associations, instead, they are consistent with the claim that language may have shaped associations during development.

Covid-19 affects taste independently of smell: results from a combined chemosensory home test and online survey from a global cohort (N=10,953).

People often confuse smell loss with taste loss, so it is unclear how much gustatory function is reduced in patients self-reporting taste loss. Our pre-registered cross-sectional study design included an online survey in 12 languages with instructions for self-administering chemosensory tests with ten household items. Between June 2020 and March 2021, 10,953 individuals participated. Of these, 3,356 self-reported a positive and 602 a negative COVID-19 diagnosis (COVID+ and COVID-, respectively); 1,267 were awaiting test results (COVID?). The rest reported no respiratory illness and were grouped by symptoms: sudden smell/taste changes (STC, N=4,445), other symptoms excluding smell or taste loss (OthS, N=832), and no symptoms (NoS, N=416). Taste, smell, and oral irritation intensities and self-assessed abilities were rated on visual analog scales. Compared to the NoS group, COVID+ was associated with a 21% reduction in taste (95% Confidence Interval (CI): 15-28%), 47% in smell (95%-CI: 37-56%), and 17% in oral irritation (95%-CI: 10-25%) intensity. In all groups, perceived intensity of smell (r=0.84), taste (r=0.68), and oral irritation (r=0.37) was correlated. Our findings suggest most reports of taste dysfunction with COVID-19 were genuine and not due to misinterpreting smell loss as taste loss (i.e., a classical taste-flavor confusion). Assessing smell and taste intensity of household items is a promising, cost-effective screening tool that complements self-reports and helps to disentangle taste loss from smell loss. However, it does not replace standardized validated psychophysical tests.

No Evidence for an Effect of the Smell of Hexanal on Trust in Human-Robot Interaction.

The level of interpersonal trust among people is partially determined through the sense of smell. Hexanal, a molecule which smell resembles freshly cut grass, can increase trust in people. Here, we ask the question if smell can be leveraged to facilitate human-robot interaction and test whether hexanal also increases the level of trust during collaboration with a social robot. In a preregistered double-blind, placebo-controlled study, we tested if trial-by-trial and general trust during perceptual decision making in collaboration with a social robot is affected by hexanal across two samples (n = 46 and n = 44). It was hypothesized that unmasked hexanal and hexanal masked by eugenol, a molecule with a smell resembling clove, would increase the level of trust in human-robot interaction, compared to eugenol alone or a control condition consisting of only the neutral smelling solvent propylene glycol. Contrasting previous findings in human interaction, no significant effect of unmasked or eugenol-masked hexanal on trust in robots was observed. These findings indicate that the conscious or nonconscious impact of smell on trust might not generalise to interactions with social robots. One explanation could be category- and context-dependency of smell leading to a mismatch between the natural smell of hexanal, a smell also occurring in human sweat, and the mechanical physical or mental representation of the robot.

Crossmodal Associations with Olfactory, Auditory, and Tactile Stimuli in Children and Adults.

People associate information with different senses but the mechanism by which this happens is unclear. Such associations are thought to arise from innate structural associations in the brain, statistical associations in the environment, via shared affective content, or through language. A developmental perspective on crossmodal associations can help determine which explanations are more likely for specific associations. Certain associations with pitch (e.g., pitch-height) have been observed early in infancy, but others may only occur late into childhood (e.g., pitch-size). In contrast, tactile-chroma associations have been observed in children, but not adults. One modality that has received little attention developmentally is olfaction. In the present investigation, we explored crossmodal associations from sound, tactile stimuli, and odor to a range of stimuli by testing a broad range of participants. Across the three modalities, we found little evidence for crossmodal associations in young children. This suggests an account based on innate structures is unlikely. Instead, the number and strength of associations increased over the lifespan. This suggests that experience plays a crucial role in crossmodal associations from sound, touch, and smell to other senses.

The role of fragrance and self-esteem in perception of body odors and impressions of others.

Human sweat odor serves as social communication signal for a person's traits and emotional states. This study explored whether body odors can also communicate information about one's self-esteem, and the role of applied fragrance in this relationship. Female participants were asked to rate self-esteem and attractiveness of different male contestants of a dating show, while being exposed to male participant's body odors differing in self-esteem. High self-esteem sweat was rated more pleasant and less intense than low self-esteem sweat. However, there was no difference in perceived self-esteem and attractiveness of male contestants in videos, hence explicit differences in body odor did not transfer to judgments of related person characteristics. When the body odor was fragranced using a fragranced body spray, male contestants were rated as having higher self-esteem and being more attractive. The finding that body odors from male participants differing in self-esteem are rated differently and can be discriminated suggests self-esteem has distinct perceivable olfactory features, but the remaining findings imply that only fragrance affect the psychological impression someone makes. These findings are discussed in the context of the role of body odor and fragrance in human perception and social communication.

Wine experts' recognition of wine odors is not verbally mediated.

Experts have better memory for items within their domain of expertise. Critically, this does not depend on more efficient use of language. However, this conclusion is based mainly on findings from experts in visual and auditory domains. Olfactory experts constitute an interesting potential counterexample since language has been implicated to be critically involved in odor memory in previous studies. We examined the role language plays in odor recognition memory for wine experts, who typically display better wine odor memory than novices and who are also able to name odors better than lay people. This suggests wine experts' superior recognition memory for odors may be verbally mediated. In 2 experiments, recognition memory for wine odors, wine-related odors, and common odors was tested in wine experts and novices. The use of language was manipulated in Experiment 1 with an overt naming versus no-naming condition, and in Experiment 2, with a verbal interference task inhibiting covert verbalization. Across the two experiments the results showed wine experts have better recognition memory for wines, but not for wine-related or common odors, indicating their memory advantage is expertise specific. Critically, this effect was not verbally mediated, as there was no relationship between experts' ability to name wines and their memory for them. Likewise, directly inhibiting online use of verbalization did not affect memory for wine odors in experts. In sum, once expertise has been acquired, language does not play a causal role in recognition memory for odors. (PsycInfo Database Record (c) 2021 APA, all rights reserved).

Recent Smell Loss Is the Best Predictor of COVID-19 Among Individuals With Recent Respiratory Symptoms.

In a preregistered, cross-sectional study, we investigated whether olfactory loss is a reliable predictor of COVID-19 using a crowdsourced questionnaire in 23 languages to assess symptoms in individuals self-reporting recent respiratory illness. We quantified changes in chemosensory abilities during the course of the respiratory illness using 0-100 visual analog scales (VAS) for participants reporting a positive (C19+; n = 4148) or negative (C19-; n = 546) COVID-19 laboratory test outcome. Logistic regression models identified univariate and multivariate predictors of COVID-19 status and post-COVID-19 olfactory recovery. Both C19+ and C19- groups exhibited smell loss, but it was significantly larger in C19+ participants (mean ± SD, C19+: -82.5 ± 27.2 points; C19-: -59.8 ± 37.7). Smell loss during illness was the best predictor of COVID-19 in both univariate and multivariate models (ROC AUC = 0.72). Additional variables provide negligible model improvement. VAS ratings of smell loss were more predictive than binary chemosensory yes/no-questions or other cardinal symptoms (e.g., fever). Olfactory recovery within 40 days of respiratory symptom onset was reported for ~50% of participants and was best predicted by time since respiratory symptom onset. We find that quantified smell loss is the best predictor of COVID-19 amongst those with symptoms of respiratory illness. To aid clinicians and contact tracers in identifying individuals with a high likelihood of having COVID-19, we propose a novel 0-10 scale to screen for recent olfactory loss, the ODoR-19. We find that numeric ratings ≤2 indicate high odds of symptomatic COVID-19 (4 < OR < 10). Once independently validated, this tool could be deployed when viral lab tests are impractical or unavailable.

More Data, Please: Machine Learning to Advance the Multidisciplinary Science of Human Sociochemistry.

Communication constitutes the core of human life. A large portion of our everyday social interactions is non-verbal. Of the sensory modalities we use for non-verbal communication, olfaction (i.e., the sense of smell) is often considered the most enigmatic medium. Outside of our awareness, smells provide information about our identity, emotions, gender, mate compatibility, illness, and potentially more. Yet, body odors are astonishingly complex, with their composition being influenced by various factors. Is there a chemical basis of olfactory communication? Can we identify molecules predictive of psychological states and traits? We propose that answering these questions requires integrating two disciplines: psychology and chemistry. This new field, coined sociochemistry, faces new challenges emerging from the sheer amount of factors causing variability in chemical composition of body odorants on the one hand (e.g., diet, hygiene, skin bacteria, hormones, genes), and variability in psychological states and traits on the other (e.g., genes, culture, hormones, internal state, context). In past research, the reality of these high-dimensional data has been reduced in an attempt to isolate unidimensional factors in small, homogenous samples under tightly controlled settings. Here, we propose big data approaches to establish novel links between chemical and psychological data on a large scale from heterogeneous samples in ecologically valid settings. This approach would increase our grip on the way chemical signals non-verbally and subconsciously affect our social lives across contexts.

The best COVID-19 predictor is recent smell loss: a cross-sectional study.

BACKGROUND: COVID-19 has heterogeneous manifestations, though one of the most common symptoms is a sudden loss of smell (anosmia or hyposmia). We investigated whether olfactory loss is a reliable predictor of COVID-19. METHODS: This preregistered, cross-sectional study used a crowdsourced questionnaire in 23 languages to assess symptoms in individuals self-reporting recent respiratory illness. We quantified changes in chemosensory abilities during the course of the respiratory illness using 0-100 visual analog scales (VAS) for participants reporting a positive (C19+; n=4148) or negative (C19-; n=546) COVID-19 laboratory test outcome. Logistic regression models identified singular and cumulative predictors of COVID-19 status and post-COVID-19 olfactory recovery. RESULTS: Both C19+ and C19- groups exhibited smell loss, but it was significantly larger in C19+ participants (mean±SD, C19+: -82.5±27.2 points; C19-: -59.8±37.7). Smell loss during illness was the best predictor of COVID-19 in both single and cumulative feature models (ROC AUC=0.72), with additional features providing no significant model improvement. VAS ratings of smell loss were more predictive than binary chemosensory yes/no-questions or other cardinal symptoms, such as fever or cough. Olfactory recovery within 40 days was reported for ~50% of participants and was best predicted by time since illness onset. CONCLUSIONS: As smell loss is the best predictor of COVID-19, we developed the ODoR-19 tool, a 0-10 scale to screen for recent olfactory loss. Numeric ratings ≤2 indicate high odds of symptomatic COVID-19 (10

Expertise Shapes Multimodal Imagery for Wine.

Although taste and smell seem hard to imagine, some people nevertheless report vivid imagery in these sensory modalities. We investigate whether experts are better able to imagine smells and tastes because they have learned the ability, or whether they are better imaginers in the first place, and so become experts. To test this, we first compared a group of wine experts to yoked novices using a battery of questionnaires. We show for the first time that experts report greater vividness of wine imagery, with no difference in vividness across sensory modalities. In contrast, novices had more vivid color imagery than taste or odor imagery for wines. Experts and novices did not differ on other vividness of imagery measures, suggesting a domain-specific effect of expertise. Critically, in a second study, we followed a group of students commencing a wine course and a group of matched control participants. Students and controls did not differ before the course, but after the wine course students reported more vivid wine imagery. We provide evidence that expertise improves imagery, exemplifying the extent of plasticity of cognition underlying the chemical senses.

Measuring Multisensory Imagery of Wine: the Vividness of Wine Imagery Questionnaire.

When we imagine objects or events, we often engage in multisensory mental imagery. Yet, investigations of mental imagery have typically focused on only one sensory modality - vision. One reason for this is that the most common tool for the measurement of imagery, the questionnaire, has been restricted to unimodal ratings of the object. We present a new mental imagery questionnaire that measures multisensory imagery. Specifically, the newly developed Vividness of Wine Imagery Questionnaire (VWIQ) measures mental imagery of wine in the visual, olfactory, and gustatory modalities. Wine is an ideal domain to explore multisensory imagery because wine drinking is a multisensory experience, it involves the neglected chemical senses (smell and taste), and provides the opportunity to explore the effect of experience and expertise on imagery (from wine novices to experts). The VWIQ questionnaire showed high internal consistency and reliability, and correlated with other validated measures of imagery. Overall, the VWIQ may serve as a useful tool to explore mental imagery for researchers, as well as individuals in the wine industry during sommelier training and evaluation of wine professionals.

High-Tempo and Stinky: High Arousal Sound-Odor Congruence Affects Product Memory.

The tendency to match different sensory modalities together can be beneficial for marketing. Here we assessed the effect of sound-odor congruence on people's attitude and memory for products of a familiar and unfamiliar brand. Participants smelled high- and low-arousal odors and then saw an advertisement for a product of a familiar or unfamiliar brand, paired with a high- or low-arousal jingle. Participants' attitude towards the advertisement, the advertised product, and the product's brand was measured, as well as memory for the product. In general, no sound-odor congruence effect was found on attitude, irrespective of brand familiarity. However, congruence was found to affect recognition: when a high-arousal odor and a high-arousal sound were combined, participants recognized products faster than in the other conditions. In addition, familiar brands were recognized faster than unfamiliar brands, but only when sound or odor arousal was high. This study provides insight into the possible applications of sound-odor congruence for marketing by demonstrating its potential to influence product memory.

What Makes a Better Smeller?

Olfaction is often viewed as difficult, yet the empirical evidence suggests a different picture. A closer look shows people around the world differ in their ability to detect, discriminate, and name odors. This gives rise to the question of what influences our ability to smell. Instead of focusing on olfactory deficiencies, this review presents a positive perspective by focusing on factors that make someone a better smeller. We consider three driving forces in improving olfactory ability: one's biological makeup, one's experience, and the environment. For each factor, we consider aspects proposed to improve odor perception and critically examine the evidence; as well as introducing lesser discussed areas. In terms of biology, there are cases of neurodiversity, such as olfactory synesthesia, that serve to enhance olfactory ability. Our lifetime experience, be it typical development or unique training experience, can also modify the trajectory of olfaction. Finally, our odor environment, in terms of ambient odor or culinary traditions, can influence odor perception too. Rather than highlighting the weaknesses of olfaction, we emphasize routes to harnessing our olfactory potential.

Not All Flavor Expertise Is Equal: The Language of Wine and Coffee Experts.

People in Western cultures are poor at naming smells and flavors. However, for wine and coffee experts, describing smells and flavors is part of their daily routine. So are experts better than lay people at conveying smells and flavors in language? If smells and flavors are more easily linguistically expressed by experts, or more "codable", then experts should be better than novices at describing smells and flavors. If experts are indeed better, we can also ask how general this advantage is: do experts show higher codability only for smells and flavors they are expert in (i.e., wine experts for wine and coffee experts for coffee) or is their linguistic dexterity more general? To address these questions, wine experts, coffee experts, and novices were asked to describe the smell and flavor of wines, coffees, everyday odors, and basic tastes. The resulting descriptions were compared on a number of measures. We found expertise endows a modest advantage in smell and flavor naming. Wine experts showed more consistency in how they described wine smells and flavors than coffee experts, and novices; but coffee experts were not more consistent for coffee descriptions. Neither expert group was any more accurate at identifying everyday smells or tastes. Interestingly, both wine and coffee experts tended to use more source-based terms (e.g., vanilla) in descriptions of their own area of expertise whereas novices tended to use more evaluative terms (e.g., nice). However, the overall linguistic strategies for both groups were en par. To conclude, experts only have a limited, domain-specific advantage when communicating about smells and flavors. The ability to communicate about smells and flavors is a matter not only of perceptual training, but specific linguistic training too.