Utility of the Pediatric Smell Wheel in Children During the COVID-19 Pandemic

ABSTRACT

Introduction: Measuring pediatric odor detection in a COVID-19-impacted context is important. Our goal was to determine whether the Pediatric Smell Wheel (PSW) can be used effectively in this clinical setting. Method(s) Consecutive patients at a pediatric otolaryngology clinic who were aged 5-17 years were recruited. Demographics including gender, race, use of nasal topical medications, previous nasal surgery, and previous COVID-19 infection were collected. Each child performed a test of their sense of smell using the PSW (Sensonics International) under direct supervision, and scores were compared. Result(s) Forty-three children were included;mean age was 9.1 years (95% CI, 8.0-10.1);19 (44.2%) were female and 24 (55.8%) male. Thirteen (30.2%) used nasal sprays, 10 (23.2%) had undergone adenoidectomy, and 4 (9.3%) had other nasal surgery. Twenty (46.5%) had a previous COVID-19 infection. Mean and median PSW score out of 11 was 7 (95% CI, 6.4-7.7), ranging from 2 to 10. There was no significant difference in scores based on age, gender, race, use of nasal topicals, previous nasal surgery, or previous COVID-19 infection. Children were able to perform the task as directed. Percentage correct for each odorant on the PSW ranged from 86% for identifying the onion scent to 27.9% for identifying the popcorn scent. Cronbach alpha was 0.54, and deleting any individual item did not improve it above 0.57, indicating low internal consistency of the PSW. Conclusion(s) During the COVID-19 pandemic, children performed more poorly identifying odors on the PSW than previously reported. The reliability of the PSW may not be adequate in today's context.