Pediatric Smell Wheel Efficacy in Children During the COVID-19 Pandemic

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Is the Pediatric Smell Wheel a clinically useful tool for measuring odor detection ability in children affected by COVID-19?

The Pediatric Smell Wheel (PSW) may not have adequate reliability for measuring the odor detection ability of children affected by COVID-19, according to study findings presented at the American Academy of Otolaryngology-Head and Neck Surgery Foundation (AAO-HNSF) 2022 Annual Meeting and OTO Experience, held in Philadelphia, Pennsylvania, September 10 to 14, 2022.

Researchers aimed to assess whether the PSW can be used effectively in a COVID-19 setting. A prospective study was conducted of 43 children who were consecutive patients at a pediatric otolaryngology clinic (mean age 9.1 years, range 5-17 years; 44.2% girls); 20 of these children had a previous COVID-19 infection. Of the children studied, 13 had used nasal sprays, 10 had undergone adenoidectomy, and 4 had experienced other nasal surgery.

All children performed the PSW test. The mean and median of the PSW scores was 7 (with the score indicating how many of 11 odorants were identified) (95% CI, 6.4-7.7; range 2-10). The researchers found no significant difference in scores based on previous COVID-19 infection, use of nasal topicals, previous nasal surgery, race, gender, or age. For each odorant tested on the PSW, percentage correct ranged from 27.9% (popcorn) to 86.0% (onion). Further statistical analysis showed that the PSW had low internal consistency (the reliability score was 0.54, and the removal of any 1 item from the test did not improve the score above 0.57).

Study limitations include the underpowered sample size, particularly in subgroups.

Researchers noted that “During the COVID-19 pandemic, children performed more poorly identifying odors on the PSW than previously reported.” They concluded that “The reliability of the PSW may not be adequate in today’s context.”


Fahmy J, Bacon B, Knorz A, Carr MM. Utility of the pediatric smell wheel in children during the COVID-19 pandemic. Otolaryngol Head Neck Surg. 2022;167(1 suppl):P289.