Different Modalities in the Management of Post-COVID-19 Olfactory Dysfunction

Area of Science:

• Otolaryngology
• Infectious Diseases
• Pharmacology

Background:

• SARS-CoV-2 infection frequently causes olfactory dysfunction, impacting patients' quality of life.
• Evidence supporting effective therapies for post-COVID-19 olfactory dysfunction remains limited.
• Olfactory training is a common intervention, but its efficacy can be enhanced.

Purpose of the Study:

• To evaluate the efficacy of nasal steroids, nasal vitamin A, and intranasal theophylline in treating post-COVID-19 olfactory dysfunction.
• To compare the recovery time and smell scores of patients receiving these treatments combined with olfactory training versus olfactory training alone.
• To identify factors that may influence the duration and severity of smell dysfunction.

Main Methods:

• A multi-center retrospective case-controlled study involving 120 patients with post-COVID-19 olfactory dysfunction (hyposmia or anosmia).
• Patients received either olfactory training alone (control group) or olfactory training combined with nasal steroid, nasal vitamin A, or intranasal theophylline.
• Data collected included demographics, medical history, duration of COVID-19, and smell recovery metrics.

Main Results:

• Nasal steroid, nasal vitamin A, and intranasal theophylline significantly reduced the time to complete smell recovery compared to olfactory training alone (25.7 ± 9.20 days, 24.8 ± 6.67 days, 23.5 ± 7.13 days vs. 28.97 ± 4.29 days, P=0.02).
• No significant correlation was found between age, gender, COVID-19 severity, or obesity and the duration of smell dysfunction.
• Diabetes, hypertension, smoking, and asthma were significantly associated with a longer time to complete smell recovery within four weeks (P<0.001).

Conclusions:

• Combining topical mometasone furoate, vitamin A, or intranasal theophylline with olfactory training may shorten the duration of post-COVID-19 olfactory dysfunction.
• Despite faster recovery times, no significant improvement in smell scores was observed after four weeks compared to olfactory training alone.
• Comorbidities such as diabetes, hypertension, smoking, and asthma negatively impact complete smell recovery within four weeks.