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Kreesaeng P, Tangbumrungtham N, Rachapattayakhom R, Roongpuvapaht B, Tanjararak K. Prevalence and Prognostic Factors Associated with Early Recovery of Olfactory Dysfunction in COVID-19 Patients. EAR, NOSE & THROAT JOURNAL 2024; 103:68S-75S. [PMID: 37743845 DOI: 10.1177/01455613231202207] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 09/26/2023] Open
Abstract
BACKGROUND The prevalence of smell dysfunction, along with its risk factors, has been evaluated in previous literature; however, little has been established regarding its relation to other factors such as disease severity, history of coronavirus disease-2019 (COVID-19) vaccinations, and medical treatment for COVID-19 infection. These factors may impact the overall recovery of olfaction in COVID-19 patients. OBJECTIVE This study investigated the prevalence of early olfactory recovery from COVID-19 infection and its associated factors. METHODS This study was a prospective cohort study on 348 COVID-19 patients with a new onset of anosmia or hyposmia. Smell sensation scores on the olfactory self-assessment test were collected at baseline and every week until 6 weeks of follow-up. The primary outcome was the prevalence of early olfactory recovery. The secondary outcomes were analyzing factors associated with early olfactory recovery and the median time to complete recovery of smell loss. RESULTS The prevalence of early olfactory recovery was 63.1% (95% CI: 0.58-0.68), and significant associated factors in multivariate analysis included patients without allergic rhinitis (OR 2.22, 95% CI: 1.12-4.40, P = 0.023) and no alteration of taste perception (OR 1.62, 95% CI: 1.02-2.57, P = 0.042). The median time to complete recovery from smell loss was 2 weeks. CONCLUSION The present study found that the prevalence of early olfactory recovery within 2 weeks was 63.1%. The median time to olfactory recovery was also 2 weeks. Patients without allergic rhinitis and taste alteration had a significantly better chance of early recovery of olfactory function.
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Affiliation(s)
- Pattraporn Kreesaeng
- Department of Otolaryngology Head & Neck Surgery, Ramathibodi Hospital, Faculty of Medicine, Mahidol University, Bangkok, Thailand
| | - Navarat Tangbumrungtham
- Department of Otolaryngology Head & Neck Surgery, Ramathibodi Hospital, Faculty of Medicine, Mahidol University, Bangkok, Thailand
| | - Ratchaporn Rachapattayakhom
- Department of Otolaryngology Head & Neck Surgery, Ramathibodi Hospital, Faculty of Medicine, Mahidol University, Bangkok, Thailand
| | - Boonsam Roongpuvapaht
- Department of Otolaryngology Head & Neck Surgery, Ramathibodi Hospital, Faculty of Medicine, Mahidol University, Bangkok, Thailand
| | - Kangsadarn Tanjararak
- Department of Otolaryngology Head & Neck Surgery, Ramathibodi Hospital, Faculty of Medicine, Mahidol University, Bangkok, Thailand
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Fornazieri MA, Cunha BM, Nicácio SP, Anzolin LK, da Silva JLB, Neto AF, Neto DB, Voegels RL, Pinna FDR. Effect of drug therapies on self-reported chemosensory outcomes after COVID-19. World J Otorhinolaryngol Head Neck Surg 2024; 10:88-96. [PMID: 38855284 PMCID: PMC11156686 DOI: 10.1002/wjo2.183] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/11/2023] [Accepted: 02/08/2024] [Indexed: 06/11/2024] Open
Abstract
Objective The aim of this study was to assess the relative efficacy of medications used following severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection on self-reported alterations in taste and/or smell function. Methods Seven hundred and fourteen persons with self-reported postcoronavirus disease 2019 (post-COVID-19) chemosensory disorders were personally interviewed regarding specific medications they were administered following the acute phase of the disease. The dependent measure-self-reported total recovery of chemosensory symptoms-was subjected to stepwise logistic regression. Independent predictors included demographic and clinical variables, in addition to specific medications used to mitigate disease symptoms (i.e., systemic corticosteroids, oseltamivir, vitamin C, ibuprofen, hydroxychloroquine, azithromycin, ivermectin, nitazoxanide, anticoagulants, and zinc). Results The median time between COVID-19 symptom onset and the interviews was 81 days (interquartile range: 60-104). Of the 714 subjects, 249 (34.9%) reported total recovery of their chemosensory function; 437 (61.2%) had at least one treatment since the beginning of the disease. Women and those with more comorbidities had undergone more treatments. The recovery rates of the treated and nontreated groups did not differ significantly. Nonetheless, respondents who had used nitazoxanide tended to have a higher rate of self-reported taste or smell recovery. Those who took oral zinc were less likely to improve. Conclusions No medication employed during the first months after SARS-CoV-2 infection had a clear positive effect on returning self-reported smell or taste function to normal, although nitrazoxide trended in a positive direction. Oral zinc had a negative effect on the reported recovery of these senses.
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Affiliation(s)
- Marco A. Fornazieri
- Department of SurgeryLondrina State UniversityLondrinaBrazil
- Department of MedicinePontifical Catholic University of ParanáLondrinaBrazil
- Department of OtorhinolaryngologyUniversity of São PauloSao PauloBrazil
- Department of Otorhinolaryngology: Head and Neck Surgery, Perelman School of Medicine, Smell and Taste CenterUniversity of PennsylvaniaPhiladelphiaPennsylvaniaUSA
| | - Bruno M. Cunha
- Department of SurgeryLondrina State UniversityLondrinaBrazil
| | | | | | | | | | | | | | - Fábio D. R. Pinna
- Department of OtorhinolaryngologyUniversity of São PauloSao PauloBrazil
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Chen RD, Yang CW, Chen XB, Hu HF, Cui GZ, Zhu QR, Kuang MJ. Therapeutic Efficacy of Nasal Corticosteroids in COVID-19-Related Olfactory Dysfunction: A Comprehensive Systematic Review and Meta-analysis. Otolaryngol Head Neck Surg 2024; 170:999-1008. [PMID: 38124278 DOI: 10.1002/ohn.621] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/15/2023] [Revised: 11/02/2023] [Accepted: 12/02/2023] [Indexed: 12/23/2023]
Abstract
OBJECTIVE Olfactory disturbance is one of the main symptoms of coronavirus disease-2019 (COVID-19). Various olfactory disorders caused by viral infections are treated with nasal corticosteroids. This study aimed to evaluate the safety and efficacy of nasal corticosteroids in the treatment of olfactory disorders caused by the severe acute respiratory syndrome coronavirus 2. DATA SOURCES We searched the Web of Science, Embase, PubMed, and Cochrane Library databases for clinical trials of nasal corticosteroids for treating COVID-19 olfactory dysfunction. REVIEW METHODS We assessed the effect of nasal corticosteroids on olfactory function in COVID-19-affected individuals using a Meta-analysis of published studies, considering the number of patients who fully recovered from olfactory dysfunction, olfactory scores following treatment, and olfactory recovery time. RESULTS Seven studies involving 930 patients were analyzed. The Meta-analysis results revealed that the olfactory score of the experimental group was 1.40 points higher than that of the control group (standardized mean difference [MD]: 1.40, 95% confidence interval [95% CI]: 0.34-2.47, P < .00001). However, the differences in the outcomes of cure rate (risk ratio: 1.18, 95% CI: 0.89-1.69, P = .21) and recovery time (MD: -1.78, 95% CI: -7.36 to 3.81, P = .53) were not statistically significant. Only 1 study reported adverse effects of nasal steroid treatment, namely tension, anger, and stomach irritation. CONCLUSION Although nasal steroid therapy does not result in significant adverse effects, it proves ineffective in the treatment of COVID-19 olfactory dysfunction.
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Affiliation(s)
- Ru-Dong Chen
- Department of Orthopedics, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, China
| | - Cong-Wen Yang
- School of Clinical Medicine, Weifang Medical University, Weifang, Shandong, China
| | - Xiao-Bin Chen
- Department of Orthopedics, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, China
| | - Hai-Feng Hu
- Department of Orthopedics, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, China
| | - Guan-Zheng Cui
- Department of Orthopedics, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, China
| | - Qing-Run Zhu
- Department of Orthopedics, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, China
| | - Ming-Jie Kuang
- Department of Orthopedics, Shandong Provincial Hospital Affiliated to Shandong First Medical University, Jinan, Shandong, China
- Post-Doctoral Scientific Research Workstation, Shandong Academy of Pharmaceutical Science, Jinan, Shandong, China
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4
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Shevela EY, Davydova MN, Meledina IV, Bogachev SS, Ostanin AA, Kozlov VA, Chernykh ER. Intranasal immunotherapy with M2 macrophage soluble factors in post-COVID hyposmia: A pilot study. Int Immunopharmacol 2024; 126:111260. [PMID: 38000231 DOI: 10.1016/j.intimp.2023.111260] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/03/2023] [Revised: 11/16/2023] [Accepted: 11/16/2023] [Indexed: 11/26/2023]
Abstract
Olfactory dysfunction is an early marker of COVID-19 infection. However, individuals may develop chronic olfactory impairment for more than six months in 1-10 % of cases. The study's objective is to evaluate the efficacy and safety of intranasal immunotherapy using bioactive substances produced by M2 macrophages for the treatment of people with long-term post-COVID-19 hyposmia. Seven individuals with long-term persistent hyposmia (7 to 24 months), associated with PCR-confirmed coronavirus infection were evaluated for olfactory function at baseline, one, and six to twelve months after therapy. The intranasal inhalation of M2 macrophage conditioned medum (one time per day for 28-30 days) was well tolerated. Furthermore, olfactometry demonstrated that the patients restored their capacity to perceive (Kruskal-Wallis H test 14.123, p = 0.0009) and recognize odours (H = 11.674, p = 0.0029). In addition, the subjective evaluation of smell significantly improved (H = 11.935, p = 0.0026). At the 6- to 12-month follow-up, the majority of patients (5/7) reported extremely high levels of satisfaction with the outcomes, and the remaining two patients also felt generally positive about the therapy's success. Overall, our study showed that the use of intranasal inhalations as a method of delivering bioactive factors and the conditioned medium of M2 macrophages as a therapeutic agent are both safe, well tolerated and, according to preliminary data, clinically effective in the treatment of patients with long-term post-COVID-19 hyposmia.
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Affiliation(s)
- E Ya Shevela
- Research Institute of Fundamental and Clinical Immunology, Novosibirsk 630099, Russian Federation.
| | - M N Davydova
- Research Institute of Fundamental and Clinical Immunology, Novosibirsk 630099, Russian Federation.
| | - I V Meledina
- Research Institute of Fundamental and Clinical Immunology, Novosibirsk 630099, Russian Federation.
| | - S S Bogachev
- Institute of Cytology and Genetics, Siberian Branch of the Russian Academy of Sciences, Prospekt Lavrentyeva 10, Novosibirsk 630090, Russian Federation.
| | - A A Ostanin
- Research Institute of Fundamental and Clinical Immunology, Novosibirsk 630099, Russian Federation.
| | - V A Kozlov
- Research Institute of Fundamental and Clinical Immunology, Novosibirsk 630099, Russian Federation.
| | - E R Chernykh
- Research Institute of Fundamental and Clinical Immunology, Novosibirsk 630099, Russian Federation.
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Jegatheeswaran L, Gokani SA, Luke L, Klyvyte G, Espehana A, Garden EM, Tarantino A, Al Omari B, Philpott CM. Assessment of COVID-19-related olfactory dysfunction and its association with psychological, neuropsychiatric, and cognitive symptoms. Front Neurosci 2023; 17:1165329. [PMID: 37599993 PMCID: PMC10436231 DOI: 10.3389/fnins.2023.1165329] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/13/2023] [Accepted: 07/18/2023] [Indexed: 08/22/2023] Open
Abstract
Purpose of review To provide a detailed overview of the assessment of COVID-19-related olfactory dysfunction and its association with psychological, neuropsychiatric, and cognitive symptoms. Recent findings COVID-19-related olfactory dysfunction can have a detrimental impact to the quality of life of patients. Prior to the COVID-19 pandemic, olfactory and taste disorders were a common but under-rated, under-researched and under-treated sensory loss. The pandemic has exacerbated the current unmet need for accessing good healthcare for patients living with olfactory disorders and other symptoms secondary to COVID-19. This review thus explores the associations that COVID-19 has with psychological, neuropsychiatric, and cognitive symptoms, and provide a framework and rationale for the assessment of patients presenting with COVID-19 olfactory dysfunction. Summary Acute COVID-19 infection and long COVID is not solely a disease of the respiratory and vascular systems. These two conditions have strong associations with psychological, neuropsychiatric, and cognitive symptoms. A systematic approach with history taking and examination particularly with nasal endoscopy can determine the impact that this has on the patient. Specific olfactory disorder questionnaires can demonstrate the impact on quality of life, while psychophysical testing can objectively assess and monitor olfaction over time. The role of cross-sectional imaging is not yet described for COVID-19-related olfactory dysfunction. Management options are limited to conservative adjunctive measures, with some medical therapies described.
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Affiliation(s)
- Lavandan Jegatheeswaran
- Department of Ear, Nose and Throat Surgery, James Paget University Hospitals NHS Foundation Trust, Great Yarmouth, United Kingdom
| | - Shyam Ajay Gokani
- Rhinology and ENT Research Group, Norwich Medical School, University of East Anglia, Norwich, United Kingdom
| | - Louis Luke
- Department of Ear, Nose and Throat Surgery, James Paget University Hospitals NHS Foundation Trust, Great Yarmouth, United Kingdom
- Rhinology and ENT Research Group, Norwich Medical School, University of East Anglia, Norwich, United Kingdom
| | - Gabija Klyvyte
- Rhinology and ENT Research Group, Norwich Medical School, University of East Anglia, Norwich, United Kingdom
| | - Andreas Espehana
- Rhinology and ENT Research Group, Norwich Medical School, University of East Anglia, Norwich, United Kingdom
| | - Elizabeth Mairenn Garden
- Rhinology and ENT Research Group, Norwich Medical School, University of East Anglia, Norwich, United Kingdom
| | - Alessia Tarantino
- Department of Ear, Nose and Throat Surgery, James Paget University Hospitals NHS Foundation Trust, Great Yarmouth, United Kingdom
| | - Basil Al Omari
- Department of Ear, Nose and Throat Surgery, James Paget University Hospitals NHS Foundation Trust, Great Yarmouth, United Kingdom
| | - Carl Martin Philpott
- Department of Ear, Nose and Throat Surgery, James Paget University Hospitals NHS Foundation Trust, Great Yarmouth, United Kingdom
- Rhinology and ENT Research Group, Norwich Medical School, University of East Anglia, Norwich, United Kingdom
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Winn PZ, Hlaing T, Tun KM, Lei SL. Effect of any form of steroids in comparison with that of other medications on the duration of olfactory dysfunction in patients with COVID-19: A systematic review of randomized trials and quasi-experimental studies. PLoS One 2023; 18:e0288285. [PMID: 37531338 PMCID: PMC10395913 DOI: 10.1371/journal.pone.0288285] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/02/2022] [Accepted: 06/25/2023] [Indexed: 08/04/2023] Open
Abstract
BACKGROUND The life quality of about two-thirds of patients with COVID-19 is affected by related olfactory dysfunctions. The negative impact of olfactory dysfunction ranged from the decreased pleasure of eating to impaired quality of life. This research aimed to provide a comprehensive understanding of the effects of corticosteroid treatments by comparing that to other currently available treatments and interventions. METHODS The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) checklist's 27-point checklist was used to conduct this review. PubMed (Public/Publisher MEDLINE), PubMed Central and EMBASE (Excerpta Medica Database) databases were conveniently selected and Boolean search commands were used for a comprehensive literature search. Five core search terms were "effects of treatments", " COVID-19-related olfactory dysfunction", "corticosteroids", "treatments" and "interventions". The reporting qualities of the included studies were appraised using JBI (Joanna Briggs Institute) appraisal tools. The characteristics of the 21 experimental studies with a total sample (of 130,550) were aggregated using frequencies and percentages and presented descriptively. The main interventions and their effects on the duration of the COVID-19-related olfactory dysfunction were narratively analyzed. RESULTS Among patients with COVID-19, the normal functions of the olfactory lobe were about 23 days earlier to gain with the treatments of fluticasone and triamcinolone acetonide nasal spray compared with that of mometasone furoate nasal spray and oral corticosteroid. The smell loss duration was reduced by fluticasone and triamcinolone acetonide nasal spray 9 days earlier than the inflawell syrup and 16 days earlier than the lavender syrup. The nasal spray of corticosteroids ended the COVID-19-related smell loss symptoms 2 days earlier than the zinc supplementation, about 47 days earlier than carbamazepine treatment and was more effective than palmitoylethanolamide (PEA) and luteolin and omega-3 supplementations and olfactory training. Treatment with oral corticosteroid plus olfactory training significantly improved Threshold, Discrimination and Identification (TDI) scores compared with olfactory training alone. A full dose of the COVID-19 vaccination was not uncertain to reduce the COVID-19-related smell loss duration. CONCLUSION Corticosteroid treatment is effective in reducing the duration of COVID-19-related smell loss and olfactory training, the basic, essential and effective intervention, should be used as a combination therapy.
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Affiliation(s)
- Phyo Zin Winn
- Community-initiated COVID-19 Response Project, Myanmar Health Assistant Association, Magway Region, Myanmar
| | - Thein Hlaing
- District Public Health Department (Ministry of Health), Pyay District, Pyay, Bago Region, Myanmar
| | - Kyaw Myo Tun
- Department of Health and Social Sciences, STI Myanmar University, Yangon, Myanmar
| | - Seim Lei Lei
- Community Initiative COVID-19 Response Project, Myanmar Health Assistant Association, Sagaing Region, Myanmar
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Badi Y, Hammad M, Tawfik AG, Eshag MME, Elhady MM, Ragab KM, Nourelden AZ, Gamal MH, Fathallah AH. Inhaled corticosteroids' effect on COVID-19 patients: A systematic review and meta-analysis of randomized controlled trials. CANADIAN JOURNAL OF RESPIRATORY THERAPY : CJRT = REVUE CANADIENNE DE LA THERAPIE RESPIRATOIRE : RCTR 2023; 59:154-166. [PMID: 37781348 PMCID: PMC10540159 DOI: 10.29390/001c.84260] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 01/11/2023] [Accepted: 07/17/2023] [Indexed: 10/03/2023]
Abstract
Background More than six million people died due to COVID-19, and 10-15% of infected individuals suffer from post-covid syndrome. Corticosteroids are widely used in the management of severe COVID-19 and post-acute COVID-19 symptoms. This study synthesizes current evidence of the effectiveness of inhaled corticosteroids (ICS) on mortality, hospital length-of-stay (LOS), and improvement of smell scores in patients with COVID-19. Methods We searched Embase, Web of Science, PubMed, Cochrane Library, and Scopus until Aug 2022. The Cochrane risk of bias tool was used to assess the quality of studies. We evaluated the effectiveness of ICS in COVID-19 patients through measures of mortality, LOS, alleviation of post-acute COVID-19 symptoms, time to sustained self-reported cure, and sense of smell (visual analog scale (VAS)). Results Ten studies were included in the meta-analysis. Our study showed a significant decrease in the LOS in ICS patients over placebo (MD = -1.52, 95% CI [-2.77 to -0.28], p-value = 0.02). Patients treated with intranasal corticosteroids (INC) showed a significant improvement in VAS smell scores from week three to week four (MD =1.52, 95% CI [0.27 to 2.78], p-value = 0.02), and alleviation of COVID-related symptoms after 14 days (RR = 1.17, 95% CI [1.09 to 1.26], p-value < 0.0001). No significant differences were detected in mortality (RR= 0.69, 95% CI [0.36 to 1.35], p-value = 0.28) and time to sustained self-reported cure (MD = -1.28, 95% CI [-6.77 to 4.20], p-value = 0.65). Conclusion We concluded that the use of ICS decreased patient LOS and improved COVID-19-related symptoms. INC may have a role in improving the smell score. Therefore, using INC and ICS for two weeks or more may prove beneficial. Current data do not demonstrate an effect on mortality or time to sustained self-reported cure. However, the evidence is inconclusive, and more studies are needed for more precise data.
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Affiliation(s)
- Yasra Badi
- All Saints University School of Medicine
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Espetvedt A, Wiig S, Myrnes-Hansen KV, Brønnick KK. The assessment of qualitative olfactory dysfunction in COVID-19 patients: a systematic review of tools and their content validity. Front Psychol 2023; 14:1190994. [PMID: 37408960 PMCID: PMC10319418 DOI: 10.3389/fpsyg.2023.1190994] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/21/2023] [Accepted: 05/31/2023] [Indexed: 07/07/2023] Open
Abstract
Background There is a lack of overview of the tools used to assess qualitative olfactory dysfunction, including parosmia and phantosmia, following COVID-19 illness. This could have an impact on the diagnosis and treatment offered to patients. Additionally, the formulations of symptoms are inconsistent and often unclear, and consensus around the wording of questions and responses is needed. Aim of study The aim of this systematic review is to provide an overview of tools used to assess qualitative olfactory dysfunction after COVID-19, in addition to addressing the content validity (i.e., item and response formulations) of these tools. Methods MEDLINE, Web of Science, and EMBASE were searched 5th of August 2022 and updated on the 25th of April 2023 to identify studies that assess qualitative olfactory dysfunction in COVID-19 patients. Primary outcomes were the tool used (i.e., questionnaire or objective test) and item and response formulations. Secondary outcomes included psychometric properties, study design, and demographic variables. Results The assessment of qualitative olfactory dysfunction is characterized by heterogeneity, inconsistency, and lack of validated tools to determine the presence and degree of symptoms. Several tools with overlapping and distinct features were identified in this review, of which some were thorough and detailed, while others were merely assessing the presence of symptoms as a binary measure. Item and response formulations are also inconsistent and often used interchangeably, which may lead to confusion, incorrect diagnoses, and inappropriate methods for solving the problem. Conclusions There is an unmet need for a reliable and validated tool for assessing qualitative olfactory dysfunction, preferably one that also captures quantitative olfactory issues (i.e., loss of smell), to ensure time-effective and specific assessment of the ability to smell. A consensus around the formulation of items and response options is also important to increase the understanding of the problem, both for clinicians, researchers, and the patient, and ultimately to provide the appropriate diagnosis and treatment. Registration and protocol The URL is https://www.crd.york.ac.uk/PROSPERO/display_record.php?RecordID=351621. A preregistered protocol was submitted and accepted (12.09.22) in the International prospective register of systematic reviews (PROSPERO) with the registration number CRD42022351621.
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Affiliation(s)
- Annelin Espetvedt
- Department of Quality and Health Technology, Faculty of Health Sciences, University of Stavanger, Stavanger, Norway
- SHARE–Centre for Resilience in Healthcare, Faculty of Health Sciences, University of Stavanger, Stavanger, Norway
- The Cognitive and Behavioral Neuroscience Lab, University of Stavanger, Stavanger, Norway
| | - Siri Wiig
- Department of Quality and Health Technology, Faculty of Health Sciences, University of Stavanger, Stavanger, Norway
- SHARE–Centre for Resilience in Healthcare, Faculty of Health Sciences, University of Stavanger, Stavanger, Norway
| | - Kai Victor Myrnes-Hansen
- Department of Quality and Health Technology, Faculty of Health Sciences, University of Stavanger, Stavanger, Norway
- The Norwegian School of Hotel Management, Faculty of Social Sciences, University of Stavanger, Stavanger, Norway
| | - Kolbjørn Kallesten Brønnick
- Department of Quality and Health Technology, Faculty of Health Sciences, University of Stavanger, Stavanger, Norway
- The Cognitive and Behavioral Neuroscience Lab, University of Stavanger, Stavanger, Norway
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Vaira LA, De Riu G, Boscolo-Rizzo P, Hopkins C, Lechien JR. In reference to Intranasal Corticosteroid Treatment on Recovery of Long-Term Olfactory Dysfunction Due to COVID-19. Laryngoscope 2023; 133:E29-E30. [PMID: 36495301 PMCID: PMC9877991 DOI: 10.1002/lary.30505] [Citation(s) in RCA: 1] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/31/2022] [Accepted: 09/06/2022] [Indexed: 12/14/2022]
Abstract
This is a commentary on the article by Hosseinpoor et al. Laryngoscope, 2022
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Affiliation(s)
- Luigi Angelo Vaira
- Maxillofacial Surgery Operative Unit, Department of Medical, Surgical and Experimental Sciences, University of Sassari, Sassari, Italy.,Biomedical Science Department, PhD School of Biomedical Science, University of Sassari, Sassari, Italy
| | - Giacomo De Riu
- Maxillofacial Surgery Operative Unit, Department of Medical, Surgical and Experimental Sciences, University of Sassari, Sassari, Italy
| | - Paolo Boscolo-Rizzo
- Department of Medical, Surgical and Health Sciences, Section of Otolaryngology, University of Trieste, Trieste, Italy
| | - Claire Hopkins
- Department of otorhinolaryngology, King's College, London, UK.,British Rhinological Society, London, UK
| | - Jerome R Lechien
- Department of Anatomy and Experimental Oncology, Mons School of Medicine, UMONS Research Institute for Health Sciences and Technology, University of Mons, Mons, Belgium.,Department of Otolaryngology-Head Neck Surgery, Elsan Polyclinic of Poitiers, Poitiers, France
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Hosseinpoor M, Kabiri M, Bakhshaee M. In response to Intranasal Corticosteroid Treatment on Recovery of Long-Term Olfactory Dysfunction Due to COVID-19. Laryngoscope 2023; 133:E31. [PMID: 36495295 PMCID: PMC9878012 DOI: 10.1002/lary.30506] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/22/2022] [Accepted: 10/25/2022] [Indexed: 12/14/2022]
Affiliation(s)
- Masoumeh Hosseinpoor
- Sinus and Surgical Endoscopic Research Center, Department of Otorhinolaryngology, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Mona Kabiri
- Pharmaceutical nanotechnology Research Center, School of Pharmacy, Mashhad University of Medical Sciences, Mashhad, Iran.,Clinical Research Development Unit, Ghaem Hospital, Faculty of Medicine, Mashhad University of Medical Sciences, Mashhad, Iran
| | - Mehdi Bakhshaee
- Sinus and Surgical Endoscopic Research Center, Department of Otorhinolaryngology, Mashhad University of Medical Sciences, Mashhad, Iran
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Lechien JR, Wajsblat S, Horoi M, Boscolo-Rizzo P, Le Bon SD, Vaira LA, Saussez S. Comparison of prevalence and evolution of COVID-19 olfactory disorders in patients infected by D614 (wild) and B.1.1.7. Alpha variant: a brief report. Eur Arch Otorhinolaryngol 2023; 280:3461-3467. [PMID: 36943439 PMCID: PMC10029791 DOI: 10.1007/s00405-023-07923-z] [Citation(s) in RCA: 4] [Impact Index Per Article: 4.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/12/2023] [Accepted: 03/11/2023] [Indexed: 03/23/2023]
Abstract
OBJECTIVES To investigate the prevalence and the evolution of olfactory disorders (OD) related to coronavirus disease 2019 (COVID-19) in patients infected during the first and the second European waves. METHODS From March 2020 to October 2020, COVID-19 patients with OD were recruited and followed over the 12-month post-infection. The following data were collected: demographic, treatments, vaccination status, and olfactory function. Olfaction was assessed with the Olfactory Disorder Questionnaire (ODQ), and threshold, discrimination, and identification (TDI) test. Outcomes were compared between patients of the first wave (group 1: wild/D614G virus) and the second wave (group 2: B.1.1.7. Alpha variant) at 1-, 3- and 12-month post-infection. RESULTS Sixty patients completed the evaluations accounting for 33 and 27 patients in group 1 and 2, respectively. The 1-month TDI score (23.7 ± 5.3) was significantly lower in group 2 compared to group 1 (29.8 ± 8.7; p = 0.017). Proportion of normosmic patients at 1-month post-infection was significantly higher in group 1 compared to group 2 (p = 0.009). TDI scores only significantly increased from 1- to 3-month post-infection in anosmic and hyposmic patients. Focusing on There was a negative association between the 1-month ODQ and the 1-month TDI (rs = - 0.493; p = 0.012). ODQ was a significant predictor of TDI scores at 3- and 12-month post-infection. The 12-month prevalence of parosmia was 60.6% in group 1 and 42.4% in group 2, respectively. There was no significant influence of oral corticosteroid treatment, adherence to an olfactory training and vaccination status on the olfactory outcomes. CONCLUSIONS Patients of the second wave (Alpha B.1.1.7. variant) reported significant higher proportion of psychophysical test abnormalities at 1-month post-infection than patients infected during the first wave (D614G virus).
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Affiliation(s)
- Jerome R Lechien
- Department of Otolaryngology, Polyclinic of Poitiers, Elsan, Poitiers, France.
- Division of Laryngology and, Bronchoesophagology, EpiCURA Hospital, Faculty of Medicine, UMONS Research Institute for Health Sciences and Technology, University of Mons (UMons), Mons, Belgium.
- Department of Human Anatomy and Experimental Oncology, Faculty of Medicine, UMONS Research Institute for Health Sciences and Technology, University of Mons (UMons), Mons, Belgium.
- Department of Otorhinolaryngology and Head and Neck Surgery, CHU Saint-Pierre, Brussels, Belgium.
- Department of Otorhinolaryngology and Head and Neck Surgery, School of Medicine, Foch Hospital, UFR Simone Veil, Université Versailles Saint-Quentin-en-Yvelines (Paris Saclay University), Paris, France.
| | - Shannon Wajsblat
- Department of Otorhinolaryngology and Head and Neck Surgery, CHU Saint-Pierre, Brussels, Belgium
| | - Mihaela Horoi
- Department of Otorhinolaryngology and Head and Neck Surgery, CHU Saint-Pierre, Brussels, Belgium
| | - Paolo Boscolo-Rizzo
- Department of Medical, Surgical and Health Sciences, Section of Otolaryngology, University of Trieste, Trieste, Italy
| | - Serge D Le Bon
- Department of Otorhinolaryngology and Head and Neck Surgery, CHU de Genève, Geneva, Suisse
| | - Luigi A Vaira
- Maxillofacial Surgery Operative Unit, Department of Medicine, Surgery and Pharmacy, University of Sassari, 07100, Sassari, Italy
- Biomedical Science Department, PhD School of Biomedical Science, University of Sassari, 07100, Sassari, Italy
| | - Sven Saussez
- Division of Laryngology and, Bronchoesophagology, EpiCURA Hospital, Faculty of Medicine, UMONS Research Institute for Health Sciences and Technology, University of Mons (UMons), Mons, Belgium
- Department of Otorhinolaryngology and Head and Neck Surgery, CHU Saint-Pierre, Brussels, Belgium
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12
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Asvapoositkul V, Samuthpongtorn J, Aeumjaturapat S, Snidvongs K, Chusakul S, Seresirikachorn K, Kanjanaumporn J. Therapeutic options of post-COVID-19 related olfactory dysfunction: a systematic review and meta-analysis. Rhinology 2023; 61:2-11. [PMID: 36173148 DOI: 10.4193/rhin22.221] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 02/02/2023]
Abstract
BACKGROUND Olfactory dysfunction is a typical post-COVID-19 presentation, affecting patients' quality of life. There are currently multiple treatment options in this group of patients such as oral and intranasal corticosteroids, olfactory training, oral vitamin-mineral supplementation, amongst others. This meta-analysis aims to consolidate existing evidence for current therapies in patients with persistent olfactory dysfunction related to COVID-19 infection and evaluate the possible role of corticosteroid add-on therapy in olfactory training. METHODOLOGY A systematic review and meta-analysis to study current treatments/interventions for olfactory dysfunction in post-COVID-19 infection were conducted. Data were pooled for the meta-analysis. The outcomes include subjective or objective olfactory assessment major and minor adverse reactions. RESULTS Eleven studies (1414 participants) were included in this review, with six studies (916 participants) then assessed for the meta-analysis. Combined treatment of intranasal corticosteroid (INCS) with olfactory training (OT) has no benefit over OT monotherapy from both a VAS score improvement and identification component of Sniffin' Sticks test standpoint. In addition, there were no differences in improvement of TDI score between combined oral corticosteroid (OCS) with OT therapy compared to OT alone. Olfactory function was, however, significantly improved after OT. CONCLUSION There were no significant differences in the improvement of olfactory scores in combination INCS+OT or OCS+OT therapies compared to OT monotherapy. However, there is improvement in olfactory function after OT.
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Affiliation(s)
- V Asvapoositkul
- Department of Otolaryngology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - J Samuthpongtorn
- Department of Anatomy, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand
| | - S Aeumjaturapat
- Department of Otolaryngology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand; Endoscopic Nasal and Sinus Surgery Excellence Center, King Chulalongkorn Memorial Hospital, Bangkok, Thailand
| | - K Snidvongs
- Department of Otolaryngology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand; Endoscopic Nasal and Sinus Surgery Excellence Center, King Chulalongkorn Memorial Hospital, Bangkok, Thailand
| | - S Chusakul
- Department of Otolaryngology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand; Endoscopic Nasal and Sinus Surgery Excellence Center, King Chulalongkorn Memorial Hospital, Bangkok, Thailand
| | - K Seresirikachorn
- Department of Otolaryngology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand; Endoscopic Nasal and Sinus Surgery Excellence Center, King Chulalongkorn Memorial Hospital, Bangkok, Thailand
| | - J Kanjanaumporn
- Department of Otolaryngology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand; Endoscopic Nasal and Sinus Surgery Excellence Center, King Chulalongkorn Memorial Hospital, Bangkok, Thailand
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13
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Saussez S, Vaira LA, De Riu G, Lechien JR. Therapies for COVID-19-Related Persistent Olfactory Disorders: One of the Good Fruits of the Pandemic. Pathogens 2023; 12:pathogens12010072. [PMID: 36678420 PMCID: PMC9865084 DOI: 10.3390/pathogens12010072] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/22/2022] [Revised: 12/27/2022] [Accepted: 12/27/2022] [Indexed: 01/04/2023] Open
Abstract
At the beginning of 2021, the scientific community realized the burden of COVID-19-related persistent olfactory disorders (ODs). The percentage of those infected with COVID-19 who developed severe and persistent ODs [1-3] with devastating effects on their quality of life was 5 to 40% [4,5].
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Affiliation(s)
- Sven Saussez
- Department of Human and Experimental Oncology, Faculty of Medicine UMONS Research Institute for Health Sciences and Technology, University of Mons (UMons), B7000 Mons, Belgium
- Correspondence: (S.S.); (L.A.V.); Tel.: +32-485-716-053 (S.S.); +39-340-1846168 (L.A.V.)
| | - Luigi Angelo Vaira
- Maxillofacial Surgery Operative Unit, Department of Medicine, Surgery and Pharmacy, University of Sassari, 07100 Sassari, Italy
- Biomedical Science Department, PhD School of Biomedical Science, University of Sassari, 07100 Sassari, Italy
- Correspondence: (S.S.); (L.A.V.); Tel.: +32-485-716-053 (S.S.); +39-340-1846168 (L.A.V.)
| | - Giacomo De Riu
- Maxillofacial Surgery Operative Unit, Department of Medicine, Surgery and Pharmacy, University of Sassari, 07100 Sassari, Italy
| | - Jérome R. Lechien
- Department of Human and Experimental Oncology, Faculty of Medicine UMONS Research Institute for Health Sciences and Technology, University of Mons (UMons), B7000 Mons, Belgium
- Department of Otolaryngology-Head Neck Surgery, Elsan Polyclinic of Poitiers, 86000 Poitiers, France
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14
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Gary JB, Gallagher L, Joseph PV, Reed D, Gudis DA, Overdevest JB. Qualitative Olfactory Dysfunction and COVID-19: An Evidence-Based Review with Recommendations for the Clinician. Am J Rhinol Allergy 2023; 37:95-101. [PMID: 35957578 PMCID: PMC9379596 DOI: 10.1177/19458924221120117] [Citation(s) in RCA: 17] [Impact Index Per Article: 17.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Abstract
BACKGROUND Nearly 40% of patients who experience smell loss during SARS-CoV-2 infection may develop qualitative olfactory dysfunction, most commonly parosmia. Our evidence-based review summarizes the evolving literature and offers recommendations for the clinician on the management of patients experiencing parosmia associated with COVID-19. METHODS We performed a systematic search using independent queries in PubMed, Embase, Ovid, and Cochrane databases, then categorized articles according to themes that emerged regarding epidemiology, effect on quality of life, disease progression, prognosis, pathophysiology, diagnosis, and treatment of parosmia. RESULTS We identified 123 unique references meeting eligibility and performed title and abstract review with 2 independent reviewers, with 74 articles undergoing full-text review. An inductive approach to thematic development provided 7 central themes regarding qualitative olfactory dysfunction following COVID-19. CONCLUSIONS While other respiratory viruses are known to cause qualitative olfactory disturbances, the incidence of parosmia following COVID-19 is notable, and correlates negatively with age. The presence of parosmia predicts persistent quantitative olfactory dysfunction. Onset can occur months after infection, and symptoms may persist for well over 7 months. Affected patients report increased anxiety and decreased quality of life. Structured olfactory training with essential oils is the preferred treatment, where parosmia predicts recovery of aspects of quantitative smell loss when undergoing training. There is limited evidence that nasal corticosteroids may accelerate recovery of olfactory function. Patients should be prepared for the possibility that symptoms may persist for years, and providers should guide them to resources for coping with their psychosocial burden.
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Affiliation(s)
- Joseph B. Gary
- Vagelos College of Physicians and
Surgeons, Columbia University, New York, NY, USA
| | - Liam Gallagher
- Vagelos College of Physicians and
Surgeons, Columbia University, New York, NY, USA
| | - Paule V. Joseph
- National Institute on Alcohol Abuse and
Alcoholism, Bethesda, MD, USA
- National Institute of Nursing Research,
Bethesda, MD, USA
| | - Danielle Reed
- Monell Chemical Senses
Center, Philadelphia, PA, USA
| | - David A. Gudis
- Vagelos College of Physicians and
Surgeons, Columbia University, New York, NY, USA
- Department of Otolaryngology–Head and
Neck Surgery, Columbia University Irving Medical
Center, New York–Presbyterian Hospital, New York, NY, USA
| | - Jonathan B. Overdevest
- Vagelos College of Physicians and
Surgeons, Columbia University, New York, NY, USA
- Department of Otolaryngology–Head and
Neck Surgery, Columbia University Irving Medical
Center, New York–Presbyterian Hospital, New York, NY, USA
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15
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Vaira LA, Lechien JR, De Riu G, Saussez S. The Trajectories of Olfactory Dysfunction from the First to the Omicron Wave: Are We Getting over it? Pathogens 2022; 12:pathogens12010010. [PMID: 36678358 PMCID: PMC9863251 DOI: 10.3390/pathogens12010010] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/17/2022] [Accepted: 12/20/2022] [Indexed: 12/24/2022] Open
Abstract
It has now been two years since the publication in Pathogens of our European multicenter study on the prevalence of olfactory dysfunctions (OD) during COVID-19 [...].
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Affiliation(s)
- Luigi Angelo Vaira
- Maxillofacial Surgery Operative Unit, Department of Medicine, Surgery and Pharmacy, University of Sassari, 07100 Sassari, Italy
- Biomedical Science Department, PhD School of Biomedical Science, University of Sassari, 07100 Sassari, Italy
- Correspondence: ; Tel.: +39-3401846168
| | - Jérome R. Lechien
- Department of Human and Experimental Oncology, Faculty of Medicine UMONS Research Institute for Health Sciences and Technology, University of Mons (UMons), B7000 Mons, Belgium
- Department of Otolaryngology-Head Neck Surgery, Elsan Polyclinic of Poitiers, 86000 Poitiers, France
| | - Giacomo De Riu
- Maxillofacial Surgery Operative Unit, Department of Medicine, Surgery and Pharmacy, University of Sassari, 07100 Sassari, Italy
| | - Sven Saussez
- Department of Human and Experimental Oncology, Faculty of Medicine UMONS Research Institute for Health Sciences and Technology, University of Mons (UMons), B7000 Mons, Belgium
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Vaira LA, Deiana G, Maglitto F, Salzano G. Post-Viral Olfactory Loss: What We Learned from the SARS-CoV-2 Pandemic. LIFE (BASEL, SWITZERLAND) 2022; 12:life12111868. [PMID: 36431003 PMCID: PMC9696542 DOI: 10.3390/life12111868] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Subscribe] [Scholar Register] [Received: 11/10/2022] [Accepted: 11/11/2022] [Indexed: 11/16/2022]
Abstract
Viral infections have always been one of the most frequent causes of persistent olfactory dysfunctions accounting for 18% to 45% of all cases [...].
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Affiliation(s)
- Luigi Angelo Vaira
- Maxillofacial Surgery Operative Unit, Department of Medicine, Surgery and Pharmacy, University of Sassari, 07100 Sassari, Italy
- Biomedical Science Department, PhD School of Biomedical Science, University of Sassari, 07100 Sassari, Italy
- Correspondence: ; Tel.: +39-3401846168
| | - Giovanna Deiana
- Biomedical Science Department, PhD School of Biomedical Science, University of Sassari, 07100 Sassari, Italy
- Direction, Hygiene and Hospital Infection Control Operative Unit, University Hospital of Sassari, 07100 Sassari, Italy
| | - Fabio Maglitto
- Maxillofacial Surgery Operative Unit, University Hospital of Naples “Federico II”, 80131 Naples, Italy
| | - Giovanni Salzano
- Maxillofacial Surgery Operative Unit, University Hospital of Naples “Federico II”, 80131 Naples, Italy
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17
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Hosseinpoor M, Kabiri M, Rajati Haghi M, Ghadam Soltani T, Rezaei A, Faghfouri A, Poustchian Gholkhatmi Z, Bakhshaee M. Intranasal Corticosteroid Treatment on Recovery of Long-Term Olfactory Dysfunction Due to COVID-19. Laryngoscope 2022; 132:2209-2216. [PMID: 36054369 PMCID: PMC9538270 DOI: 10.1002/lary.30353] [Citation(s) in RCA: 14] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/26/2022] [Revised: 07/13/2022] [Accepted: 08/02/2022] [Indexed: 12/13/2022]
Abstract
BACKGROUND AND AIMS Olfactory dysfunction is a recognized manifestation in patients infected with Coronavirus Disease 2019 (COVID-19). This investigation aimed to assess the effect of mometasone furoate intranasal spray on the improvement of smell dysfunction in post-COVID-19 patients. MATERIALS AND METHODS This randomized placebo-controlled trial included 80 non-hospitalized adult patients who had persistent anosmia or severe microsmia for more than 4 weeks due to COVID-19 infection. The participants were randomly allocated to the intervention or placebo group to receive mometasone furoate nasal spray or sodium chloride intranasal spray during 4 weeks of follow-up, respectively. The patients' olfactory dysfunction was assessed in terms of visual analog scale (VAS), and smell test score according to the modified version of the University of Pennsylvania smell identification test for the Iranian population. RESULTS A total of 70 participants completed the follow-up period and were analyzed in this study. By comparing the olfactory scores including smell test and VAS scores, no significant differences were found between case and control groups at baseline, 2, and 4 weeks intervals. However, the change of both olfactory scores at pre to post-treatment intervals and 2-4 weeks was significantly higher in the mometasone group relative to the placebo group. At post-treatment, the frequency of anosmia was 22.9% reduced in the case group compared to the control group. CONCLUSION Overall, there was no significant difference in olfactory dysfunction between the two groups during follow-up. However, based on the significant between-group difference in terms of olfactory scores changes, it seems that the nasal corticosteroids may be a positive effect on the recovery process of patients who received more than 2 weeks. LEVEL OF EVIDENCE 2 Laryngoscope, 132:2209-2216, 2022.
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Affiliation(s)
- Masoumeh Hosseinpoor
- Sinus and Surgical Endoscopic Research CenterMashhad University of Medical SciencesMashhadIran
| | - Mona Kabiri
- Clinical Research Development Unit, Ghaem Hospital, Faculty of MedicineMashhad University of Medical SciencesMashhadIran
| | - Mohsen Rajati Haghi
- Department of Otorhinolaryngology, Sinus and Surgical Endoscopic Research CenterMashhad University of Medical SciencesMashhadIran
| | | | - Alireza Rezaei
- Department of Pathology, Mashhad BranchIslamic Azad University of Medical SciencesMashhadIran
| | - Atiyeh Faghfouri
- Student Research Committee, Faculty of MedicineMashhad University of Medical SciencesMashhadIran
| | | | - Mehdi Bakhshaee
- Department of Otorhinolaryngology, Sinus and Surgical Endoscopic Research CenterMashhad University of Medical SciencesMashhadIran
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18
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Lechien JR, Vaira LA, Saussez S. Effectiveness of olfactory training in COVID-19 patients with olfactory dysfunction: a prospective study. Eur Arch Otorhinolaryngol 2022; 280:1255-1263. [PMID: 36153785 PMCID: PMC9510568 DOI: 10.1007/s00405-022-07665-4] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2022] [Accepted: 09/16/2022] [Indexed: 02/07/2023]
Abstract
OBJECTIVES To investigate effectiveness of olfactory training (OT) in COVID-19 patients with persistent olfactory dysfunction (OD). METHODS From March 2020 to March 2022, COVID-19 patients with OD were prospectively followed in three European medical centers for a period of 18 months. A standardized OT protocol were recommended to patients. Patient-reported outcome questionnaires and psychophysical evaluations were used to evaluate olfaction at baseline, 6, 12, and 18 months after the start of OT. The evolution of olfactory outcome was compared according to the adherence to the OT protocol. RESULTS Fifty-seven patients completed the evaluations. Thirty-two patients fully adhered to the OT, while 25 did not adhere. The psychophysical scores significantly improved from baseline to 6-month post-infection in both groups. In the OT group, the psychophysical scores continued to significantly improve from 6 to 12 months after the start of OT (p = 0.032). The mean duration of OT was 15.4 weeks. The mean delay of patient recovery perception was comparable between groups (27.4 weeks). The occurrence of cacosmia (35.1%) and parosmia (43.9%) throughout the follow-up period was comparable between groups. There proportion of phantosmia was higher in training (34.4%) compared with no-OT (16.0%; p = 0.007) group. The baseline Sniffin'Sticks tests was positively associated with the 6-month Sniffin'Sticks tests (rs = 0.685; p < 0.001) and negatively associated with the time of recovery (rs = - 0.369; p = 0.034). CONCLUSIONS The adherence to an OT protocol was associated with better mid-term improvement of psychophysical scores. Future large-cohort randomized-controlled studies are needed to confirm the effectiveness of OT in COVID-19 patients.
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Affiliation(s)
- Jerome R. Lechien
- Department of Otolaryngology, Polyclinic of Poitiers, Elsan, Poitiers, France ,grid.8364.90000 0001 2184 581XDepartment of Human Anatomy and Experimental Oncology, Faculty of Medicine, UMONS Research Institute for Health Sciences and Technology, University of Mons (UMons), Mons, Belgium ,grid.12832.3a0000 0001 2323 0229Department of Otorhinolaryngology and Head and Neck Surgery, Foch Hospital, School of Medicine, UFR Simone Veil, Université Versailles Saint-Quentin-en-Yvelines (Paris Saclay University), Paris, France ,grid.490660.dDepartment of Otorhinolaryngology and Head and Neck Surgery, EpiCURA Hospital, Baudour, Belgium
| | - Luigi A. Vaira
- grid.11450.310000 0001 2097 9138Maxillofacial Surgery Operative Unit, Department of Medical, Surgical and Experimental Sciences, University of Sassari, Sassari, Italy ,grid.11450.310000 0001 2097 9138Biomedical Science Department, PhD School of Biomedical Science, University of Sassari, Sassari, Italy
| | - Sven Saussez
- grid.8364.90000 0001 2184 581XDepartment of Human Anatomy and Experimental Oncology, Faculty of Medicine, UMONS Research Institute for Health Sciences and Technology, University of Mons (UMons), Mons, Belgium ,grid.490660.dDepartment of Otorhinolaryngology and Head and Neck Surgery, EpiCURA Hospital, Baudour, Belgium
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19
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Dysosmia in Recovered COVID-19 Patients. J Craniofac Surg 2022; 34:843-844. [PMID: 36136915 PMCID: PMC10128425 DOI: 10.1097/scs.0000000000009008] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/26/2022] Open
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20
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O'Byrne L, Webster KE, MacKeith S, Philpott C, Hopkins C, Burton MJ. Interventions for the treatment of persistent post-COVID-19 olfactory dysfunction. Cochrane Database Syst Rev 2022; 9:CD013876. [PMID: 36062970 PMCID: PMC9443431 DOI: 10.1002/14651858.cd013876.pub3] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/23/2022]
Abstract
BACKGROUND Olfactory dysfunction is a common consequence of COVID-19 infection and persistent symptoms can have a profound impact on quality of life. At present there is little guidance on how best to treat this condition. A variety of interventions have been suggested to promote recovery, including medication and olfactory training. However, it is uncertain whether any intervention is of benefit. This is an update of the 2021 review with one additional study added. OBJECTIVES: 1) To evaluate the benefits and harms of any intervention versus no treatment for people with persisting olfactory dysfunction due to COVID-19 infection. 2) To keep the evidence up-to-date, using a living systematic review approach. SEARCH METHODS: The Cochrane ENT Information Specialist searched the Cochrane ENT Register; Central Register of Controlled Trials (CENTRAL); Ovid MEDLINE; Ovid Embase; Web of Science; ClinicalTrials.gov; ICTRP and additional sources for published and unpublished trials. The date of the latest search was 20 October 2021. SELECTION CRITERIA: We included randomised controlled trials (RCTs) in people with COVID-19 related olfactory disturbance that had persisted for at least four weeks. We included any intervention compared to no treatment or placebo. DATA COLLECTION AND ANALYSIS: We used standard Cochrane methods. Our primary outcomes were the recovery of sense of smell, disease-related quality of life and serious adverse effects. Secondary outcomes were the change in sense of smell, general quality of life, prevalence of parosmia and other adverse effects (including nosebleeds/bloody discharge). We used GRADE to assess the certainty of the evidence for each outcome. MAIN RESULTS We included two studies with 30 participants. The studies evaluated the following interventions: systemic corticosteroids plus intranasal corticosteroid/mucolytic/decongestant and palmitoylethanolamide plus luteolin. Systemic corticosteroids plus intranasal corticosteroid/mucolytic/decongestant compared to no intervention We included a single RCT with 18 participants who had anosmia for at least 30 days following COVID-19 infection. Participants received a 15-day course of oral corticosteroids combined with nasal irrigation (consisting of an intranasal corticosteroid/mucolytic/decongestant solution) or no intervention. Psychophysical testing was used to assess olfactory function at 40 days. This is a single, small study and for all outcomes the certainty of evidence was very low. We are unable to draw meaningful conclusions from the numerical results. Palmitoylethanolamide plus luteolin compared to no intervention We included a single RCT with 12 participants who had anosmia or hyposmia for at least 90 days following COVID-19 infection. Participants received a 30-day course of palmitoylethanolamide and luteolin or no intervention. Psychophysical testing was used to assess olfactory function at 30 days. This is a single, small study and for all outcomes the certainty of evidence was very low. We are unable to draw meaningful conclusions from the numerical results. AUTHORS' CONCLUSIONS There is very limited evidence available on the efficacy and harms of treatments for persistent olfactory dysfunction following COVID-19 infection. However, we have identified a number of ongoing trials in this area. As this is a living systematic review we will update the data regularly, as new results become available.
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Affiliation(s)
- Lisa O'Byrne
- Department of Otolaryngology Head and Neck Surgery, St Vincent's University Hospital, Dublin 4, Ireland
| | - Katie E Webster
- Cochrane ENT, Nuffield Department of Surgical Sciences, University of Oxford, Oxford, UK
| | - Samuel MacKeith
- Oxford University Hospitals NHS Foundation Trust, Oxford, UK
| | - Carl Philpott
- Department of Medicine, Norwich Medical School, University of East Anglia, Norwich, UK
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21
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Webster KE, O'Byrne L, MacKeith S, Philpott C, Hopkins C, Burton MJ. Interventions for the prevention of persistent post-COVID-19 olfactory dysfunction. Cochrane Database Syst Rev 2022; 9:CD013877. [PMID: 36063364 PMCID: PMC9443936 DOI: 10.1002/14651858.cd013877.pub3] [Citation(s) in RCA: 3] [Impact Index Per Article: 1.5] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
BACKGROUND Loss of olfactory function is well recognised as a symptom of COVID-19 infection, and the pandemic has resulted in a large number of individuals with abnormalities in their sense of smell. For many, the condition is temporary and resolves within two to four weeks. However, in a significant minority the symptoms persist. At present, it is not known whether early intervention with any form of treatment (such as medication or olfactory training) can promote recovery and prevent persisting olfactory disturbance. This is an update of the 2021 review with four studies added. OBJECTIVES 1) To evaluate the benefits and harms of any intervention versus no treatment for people with acute olfactory dysfunction due to COVID-19 infection. 2) To keep the evidence up-to-date, using a living systematic review approach. SEARCH METHODS: The Cochrane ENT Information Specialist searched the Cochrane ENT Register; Central Register of Controlled Trials (CENTRAL); Ovid MEDLINE; Ovid Embase; Web of Science; ClinicalTrials.gov; ICTRP and additional sources for published and unpublished trials. The date of the latest search was 20 October 2021. SELECTION CRITERIA We included randomised controlled trials (RCTs) in people with COVID-19 related olfactory disturbance, which had been present for less than four weeks. We included any intervention compared to no treatment or placebo. DATA COLLECTION AND ANALYSIS: We used standard Cochrane methods. Our primary outcomes were the presence of normal olfactory function, serious adverse effects and change in sense of smell. Secondary outcomes were the prevalence of parosmia, change in sense of taste, disease-related quality of life and other adverse effects (including nosebleeds/bloody discharge). We used GRADE to assess the certainty of the evidence for each outcome. MAIN RESULTS: We included five studies with 691 participants. The studies evaluated the following interventions: intranasal corticosteroid sprays, intranasal corticosteroid drops, intranasal hypertonic saline and zinc sulphate. Intranasal corticosteroid spray compared to no intervention/placebo We included three studies with 288 participants who had olfactory dysfunction for less than four weeks following COVID-19. Presence of normal olfactory function The evidence is very uncertain about the effect of intranasal corticosteroid spray on both self-rated recovery of olfactory function and recovery of olfactory function using psychophysical tests at up to four weeks follow-up (self-rated: risk ratio (RR) 1.19, 95% confidence interval (CI) 0.85 to 1.68; 1 study; 100 participants; psychophysical testing: RR 2.3, 95% CI 1.16 to 4.63; 1 study; 77 participants; very low-certainty evidence). Change in sense of smell The evidence is also very uncertain about the effect of intranasal corticosteroid spray on self-rated change in the sense of smell (at less than 4 weeks: mean difference (MD) 0.5 points lower, 95% CI 1.38 lower to 0.38 higher; 1 study; 77 participants; at > 4 weeks to 3 months: MD 2.4 points higher, 95% CI 1.32 higher to 3.48 higher; 1 study; 100 participants; very low-certainty evidence, rated on a scale of 1 to 10, higher scores mean better olfactory function). Intranasal corticosteroids may make little or no difference to the change in sense of smell when assessed with psychophysical testing (MD 0.2 points, 95% CI 2.06 points lower to 2.06 points higher; 1 study; 77 participants; low-certainty evidence, 0- to 24-point scale, higher scores mean better olfactory function). Serious adverse effects The authors of one study reported no adverse effects, but their intention to collect these data was not pre-specified so we are uncertain if these were systematically sought and identified. The remaining two studies did not report on adverse effects. Intranasal corticosteroid drops compared to no intervention/placebo We included one study with 248 participants who had olfactory dysfunction for ≤ 15 days following COVID-19. Presence of normal olfactory function Intranasal corticosteroid drops may make little or no difference to self-rated recovery at > 4 weeks to 3 months (RR 1.00, 95% CI 0.89 to 1.11; 1 study; 248 participants; low-certainty evidence). No other outcomes were assessed by this study. Data on the use of hypertonic saline nasal irrigation and the use of zinc sulphate to prevent persistent olfactory dysfunction are included in the full text of the review. AUTHORS' CONCLUSIONS There is very limited evidence available on the efficacy and harms of treatments for preventing persistent olfactory dysfunction following COVID-19 infection. However, we have identified a number of ongoing trials in this area. As this is a living systematic review we will update the data regularly, as new results become available.
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Affiliation(s)
- Katie E Webster
- Cochrane ENT, Nuffield Department of Surgical Sciences, University of Oxford, Oxford, UK
| | - Lisa O'Byrne
- Department of Otolaryngology Head and Neck Surgery, St Vincent's University Hospital, Dublin 4, Ireland
| | - Samuel MacKeith
- Oxford University Hospitals NHS Foundation Trust, Oxford, UK
| | - Carl Philpott
- Department of Medicine, Norwich Medical School, University of East Anglia, Norwich, UK
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22
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Nag AK, Saltagi AK, Saltagi MZ, Wu AW, Higgins TS, Knisely A, Ting JY, Illing EA. Management of Post-Infectious Anosmia and Hyposmia: A Systematic Review. Ann Otol Rhinol Laryngol 2022:34894221118186. [PMID: 35959948 DOI: 10.1177/00034894221118186] [Citation(s) in RCA: 4] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/15/2022]
Abstract
BACKGROUND Anosmia and hyposmia significantly affect patients' quality of life and have many etiologies, including trauma, inflammatory conditions including chronic rhinosinusitis, neoplasm, and viral infections, such as rhinovirus and SARS-CoV-2. OBJECTIVE Our purpose was to establish whether a consensus exists regarding optimal management of olfactory dysfunction and to provide insight into the treatment of anosmia in the current climate of increased prevalence secondary to COVID-19. Thus, we aimed to systematically review the literature on the management of non-Chronic-rhinosinusitis- related anosmia/hyposmia. METHODS PubMed, EMBASE, and Cochrane databases were searched for articles published since January 1990 using terms combined with Medical Subject Headings (MeSH). We included articles evaluating management of anosmia and hyposmia written in the English language, with original data, a minimum of 3 months of follow-up except for COVID-related studies, at least 2 patients, and well-defined and measurable outcomes. RESULTS A total of 3013 unique titles were returned upon the initial search. Of these, 297 abstracts were examined, yielding 19 full texts meeting inclusion criteria (8 with level 1 evidence, 3 with level 2, 1 with level 3, and 7 with level 4). The studies included a total of 1522 subjects, with follow up ranging from 3 to 72 months, with an exception for COVID related studies. Endpoints were based on clinically significant improvements of olfactory functions as measured through validated smell tests. Treatments with the most robust data were intranasal corticosteroids and olfactory training. CONCLUSION The literature on the treatment of anosmia and hyposmia includes randomized trials showing the efficacy of a few modalities. While further research is needed to expand therapeutic options for this debilitating condition, the current literature supports the use of olfactory training and topical corticosteroids.
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Affiliation(s)
- Amit K Nag
- Department of Otolaryngology-Head and Neck Surgery, Cleveland Clinic Foundation, Cleveland, OH, USA
| | - Abdul K Saltagi
- Indiana University School of Medicine, Indianapolis, IN, USA
| | - Mohamad Z Saltagi
- Indiana University School of Medicine, Indianapolis, IN, USA.,Department of Otolaryngology-Head and Neck Surgery, Indiana University Health, Indianapolis, IN, USA
| | - Arthur W Wu
- Cedars-Sinai Division of Otolaryngology, Los Angeles, CA, USA
| | - Thomas S Higgins
- Department of Otolaryngology-Head and Neck Surgery, University of Louisville, Louisville, KY, USA.,Kentuckiana Ear, Nose & Throat, Louisville, KY, USA
| | - Anna Knisely
- Department of Otolaryngology, Head and Neck Surgery, Swedish Medical Center, Seattle, WA, USA
| | - Jonathan Y Ting
- Indiana University School of Medicine, Indianapolis, IN, USA.,Department of Otolaryngology-Head and Neck Surgery, Indiana University Health, Indianapolis, IN, USA
| | - Elisa A Illing
- Indiana University School of Medicine, Indianapolis, IN, USA.,Department of Otolaryngology-Head and Neck Surgery, Indiana University Health, Indianapolis, IN, USA
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23
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SARS-CoV-2 Infection (COVID-19) and Rhinologic Manifestation: Narrative Review. J Pers Med 2022; 12:jpm12081234. [PMID: 36013183 PMCID: PMC9409980 DOI: 10.3390/jpm12081234] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/07/2022] [Revised: 07/24/2022] [Accepted: 07/25/2022] [Indexed: 01/08/2023] Open
Abstract
Patients with severe pneumonia of unknown etiology presented in December 2019 in Wuhan, China. A novel coronavirus, severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), was isolated from the respiratory tracts of these patients. The World Health Organization (WHO) defined respiratory diseases due to SARS-CoV-2 infection as coronavirus disease 2019 (COVID-19). Many researchers have reported that the nasal cavity is an important initial route for SARS-CoV-2 infection and that the spike protein of this virus binds to angiotensin-converting enzyme 2 (ACE2) on epithelial cell surfaces. Therefore, COVID-19 is thought to significantly affect nasal symptoms and various rhinological diseases. In this review, we summarize the association between COVID-19 and various rhinological diseases, such as olfactory dysfunction, rhinosinusitis, and allergic rhinitis.
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24
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Sousa FAD, Machado AS, da Costa JC, Silva AC, Pinto AN, Coutinho MB, Meireles L, Sousa CAE. Tailored Approach for Persistent Olfactory Dysfunction After SARS-CoV-2 Infection: A Pilot Study. Ann Otol Rhinol Laryngol 2022; 132:657-666. [PMID: 35822286 DOI: 10.1177/00034894221111093] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/17/2022]
Abstract
OBJECTIVE So far, no original studies explored non-randomized, standardized protocols for COVID-19 associated olfactory dysfunction. The main objective was to determine the efficacy of a new protocol for post-COVID olfactopathy while assessing the benefit of adding adjuvant therapies to olfactory training. METHODS Patients suffering from long-lasting post-COVID-19 olfactory dysfunction were evaluated. A non-randomized protocol based on individual nasal endoscopy findings and patient's preferences was applied. Patients were assigned for olfactory training alone or olfactory training + adjuvant therapy. Participants performed olfactory objective and subjective evaluations at first consultation and 3 months after treatment, and results were compared. RESULTS A total of 47 patients were enrolled. All groups showed significant improvement in olfactory thresholds at 3-month follow-up suggesting protocol effectiveness (olfactory training group alone showed a mean threshold difference of 2.9, P < .001; Olfactory training + Topical Corticosteroid showed a mean threshold difference of 4, P = .006; Olfactory training + Topical Corticosteroid + Vitamin B complex showed a mean threshold difference of 4.4, P = .006; Olfactory training + Intranasal Vitamin A and E showed a mean threshold difference of 4.4, P < .001). Olfactory training alone showed lower mean olfactory threshold improvement, when compared to patients undergoing olfactory training + adjuvant therapy (olfactory training alone mean improvement 2.9 ± 2.3 vs olfactory training + adjuvants mean improvement 4.3 ± 2.458, P = .03). CONCLUSIONS This is one of the first studies to demonstrate results in the treatment of post-COVID-19 persistent olfactory impairment. A customized approach based on endoscopy findings and patient's preferences may be a valid option for the management of persistent post-COVID-19 olfactory disorder. Adjuvant therapy could be considered in addition to olfactory training, but further studies are needed in order to confirm their effectiveness in this setting. LEVEL OF EVIDENCE 2c (outcomes research).
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Affiliation(s)
- Francisco Alves de Sousa
- Serviço de Otorrinolaringologia e Cirurgia da Cabeça e Pescoço (Otorhinolaryngology and Head & Neck Surgery), Centro Hospitalar Universitário do Porto, Porto, Portugal
| | - André Sousa Machado
- Serviço de Otorrinolaringologia e Cirurgia da Cabeça e Pescoço (Otorhinolaryngology and Head & Neck Surgery), Centro Hospitalar Universitário do Porto, Porto, Portugal
| | - Joana Carvalho da Costa
- Serviço de Otorrinolaringologia e Cirurgia da Cabeça e Pescoço (Otorhinolaryngology and Head & Neck Surgery), Centro Hospitalar Universitário do Porto, Porto, Portugal
| | - Ana Costa Silva
- Serviço de Otorrinolaringologia e Cirurgia da Cabeça e Pescoço (Otorhinolaryngology and Head & Neck Surgery), Centro Hospitalar Universitário do Porto, Porto, Portugal
| | - Ana Nóbrega Pinto
- Serviço de Otorrinolaringologia e Cirurgia da Cabeça e Pescoço (Otorhinolaryngology and Head & Neck Surgery), Centro Hospitalar Universitário do Porto, Porto, Portugal
| | - Miguel Bebiano Coutinho
- Serviço de Otorrinolaringologia e Cirurgia da Cabeça e Pescoço (Otorhinolaryngology and Head & Neck Surgery), Centro Hospitalar Universitário do Porto, Porto, Portugal
| | - Luís Meireles
- Serviço de Otorrinolaringologia e Cirurgia da Cabeça e Pescoço (Otorhinolaryngology and Head & Neck Surgery), Centro Hospitalar Universitário do Porto, Porto, Portugal
| | - Cecília Almeida E Sousa
- Serviço de Otorrinolaringologia e Cirurgia da Cabeça e Pescoço (Otorhinolaryngology and Head & Neck Surgery), Centro Hospitalar Universitário do Porto, Porto, Portugal
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25
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Vandersteen C, Payne M, Dumas LÉ, Cancian É, Plonka A, D’Andréa G, Chirio D, Demonchy É, Risso K, Askenazy-Gittard F, Savoldelli C, Guevara N, Robert P, Castillo L, Manera V, Gros A. Olfactory Training in Post-COVID-19 Persistent Olfactory Disorders: Value Normalization for Threshold but Not Identification. J Clin Med 2022; 11:jcm11123275. [PMID: 35743346 PMCID: PMC9224948 DOI: 10.3390/jcm11123275] [Citation(s) in RCA: 7] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/02/2022] [Revised: 05/27/2022] [Accepted: 06/05/2022] [Indexed: 02/04/2023] Open
Abstract
(1) Background: Persistent post-viral olfactory disorders (PPVOD) are estimated at 30% of patients one year after COVID-19 infection. No treatment is, to date, significantly effective on PPVOD with the exception of olfactory training (OT). The main objective of this work was to evaluate OT efficiency on post-COVID-19 PPVOD. (2) Methods: Consecutive patients consulting to the ENT department with post-COVID-19 PPVOD were included after completing clinical examination, the complete Sniffin’ Stick Test (TDI), the short version of the Questionnaire of olfactory disorders and the SF-36. Patients were trained to practice a self-olfactory training with a dedicated olfactory training kit twice a day for 6 months before returning to undergo the same assessments. (3) Results: Forty-three patients were included and performed 3.5 months of OT in average. We observed a significant TDI score improvement, increasing from 24.7 (±8.9) before the OT to 30.9 (±9.8) (p < 0.001). Based on normative data, a significant increase in the number of normosmic participants was observed only for the threshold values (p < 0.001). Specific and general olfaction-related quality of life improved after the OT. (4) Conclusions: Olfactory function appeared to improve only in peripheral aspects of post-COVID-19 PPVOD after OT. Future controlled studies must be performed to confirm the OT role and justify new therapeutic strategies that may focus on the central aspects of post-COVID-19 PPVOD.
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Affiliation(s)
- Clair Vandersteen
- Institut Universitaire de la Face et du Cou, Centre Hospitalier Universitaire, Université Côte d’Azur, 31 Avenue de Valombrose, 06100 Nice, France; (É.C.); (G.D.); (C.S.); (N.G.); (L.C.)
- Laboratoire CoBTeK, Université Côte d’Azur, 06100 Nice, France; (M.P.); (L.-É.D.); (A.P.); (F.A.-G.); (P.R.); (V.M.); (A.G.)
- Correspondence: ; Tel.: +33-4-9203-1705
| | - Magali Payne
- Laboratoire CoBTeK, Université Côte d’Azur, 06100 Nice, France; (M.P.); (L.-É.D.); (A.P.); (F.A.-G.); (P.R.); (V.M.); (A.G.)
- Département d’Orthophonie de Nice (DON), UFR Médecine, Université Côte d’Azur, 06107 Nice, France
| | - Louise-Émilie Dumas
- Laboratoire CoBTeK, Université Côte d’Azur, 06100 Nice, France; (M.P.); (L.-É.D.); (A.P.); (F.A.-G.); (P.R.); (V.M.); (A.G.)
- Hôpitaux Pédiatriques de Nice CHU-LENVAL, Centre Hospitalier Universitaire, Université Côte d’Azur, 57 Avenue de la Californie, 06200 Nice, France
| | - Élisa Cancian
- Institut Universitaire de la Face et du Cou, Centre Hospitalier Universitaire, Université Côte d’Azur, 31 Avenue de Valombrose, 06100 Nice, France; (É.C.); (G.D.); (C.S.); (N.G.); (L.C.)
| | - Alexandra Plonka
- Laboratoire CoBTeK, Université Côte d’Azur, 06100 Nice, France; (M.P.); (L.-É.D.); (A.P.); (F.A.-G.); (P.R.); (V.M.); (A.G.)
- Institut NeuroMod, INRIA Centre de Recherche Sophia Antipolis, Université Côte d’Azur, 2004 Route des Lucioles, 06902 Valbonne, France
- Service Clinique Gériatrique du Cerveau et du Mouvement, Centre Hospitalier Universitaire de Nice, 06000 Nice, France
| | - Grégoire D’Andréa
- Institut Universitaire de la Face et du Cou, Centre Hospitalier Universitaire, Université Côte d’Azur, 31 Avenue de Valombrose, 06100 Nice, France; (É.C.); (G.D.); (C.S.); (N.G.); (L.C.)
| | - David Chirio
- Département de Médecine Infectiologique, Hôpital de l’archet, Centre Hospitalier Universitaire, Université Côte d’Azur, 151 Route de Saint-Antoine, 06200 Nice, France; (D.C.); (É.D.); (K.R.)
| | - Élisa Demonchy
- Département de Médecine Infectiologique, Hôpital de l’archet, Centre Hospitalier Universitaire, Université Côte d’Azur, 151 Route de Saint-Antoine, 06200 Nice, France; (D.C.); (É.D.); (K.R.)
| | - Karine Risso
- Département de Médecine Infectiologique, Hôpital de l’archet, Centre Hospitalier Universitaire, Université Côte d’Azur, 151 Route de Saint-Antoine, 06200 Nice, France; (D.C.); (É.D.); (K.R.)
| | - Florence Askenazy-Gittard
- Laboratoire CoBTeK, Université Côte d’Azur, 06100 Nice, France; (M.P.); (L.-É.D.); (A.P.); (F.A.-G.); (P.R.); (V.M.); (A.G.)
- Hôpitaux Pédiatriques de Nice CHU-LENVAL, Centre Hospitalier Universitaire, Université Côte d’Azur, 57 Avenue de la Californie, 06200 Nice, France
| | - Charles Savoldelli
- Institut Universitaire de la Face et du Cou, Centre Hospitalier Universitaire, Université Côte d’Azur, 31 Avenue de Valombrose, 06100 Nice, France; (É.C.); (G.D.); (C.S.); (N.G.); (L.C.)
| | - Nicolas Guevara
- Institut Universitaire de la Face et du Cou, Centre Hospitalier Universitaire, Université Côte d’Azur, 31 Avenue de Valombrose, 06100 Nice, France; (É.C.); (G.D.); (C.S.); (N.G.); (L.C.)
| | - Philippe Robert
- Laboratoire CoBTeK, Université Côte d’Azur, 06100 Nice, France; (M.P.); (L.-É.D.); (A.P.); (F.A.-G.); (P.R.); (V.M.); (A.G.)
- Département d’Orthophonie de Nice (DON), UFR Médecine, Université Côte d’Azur, 06107 Nice, France
- Service Clinique Gériatrique du Cerveau et du Mouvement, Centre Hospitalier Universitaire de Nice, 06000 Nice, France
| | - Laurent Castillo
- Institut Universitaire de la Face et du Cou, Centre Hospitalier Universitaire, Université Côte d’Azur, 31 Avenue de Valombrose, 06100 Nice, France; (É.C.); (G.D.); (C.S.); (N.G.); (L.C.)
| | - Valeria Manera
- Laboratoire CoBTeK, Université Côte d’Azur, 06100 Nice, France; (M.P.); (L.-É.D.); (A.P.); (F.A.-G.); (P.R.); (V.M.); (A.G.)
- Département d’Orthophonie de Nice (DON), UFR Médecine, Université Côte d’Azur, 06107 Nice, France
| | - Auriane Gros
- Laboratoire CoBTeK, Université Côte d’Azur, 06100 Nice, France; (M.P.); (L.-É.D.); (A.P.); (F.A.-G.); (P.R.); (V.M.); (A.G.)
- Département d’Orthophonie de Nice (DON), UFR Médecine, Université Côte d’Azur, 06107 Nice, France
- Service Clinique Gériatrique du Cerveau et du Mouvement, Centre Hospitalier Universitaire de Nice, 06000 Nice, France
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Kim DH, Kim SW, Kang M, Hwang SH. Efficacy of topical steroids for the treatment of olfactory disorders caused by COVID-19: A systematic review and meta-analysis. Clin Otolaryngol 2022; 47:509-515. [PMID: 35352483 PMCID: PMC9111649 DOI: 10.1111/coa.13933] [Citation(s) in RCA: 13] [Impact Index Per Article: 6.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/17/2021] [Revised: 01/16/2022] [Accepted: 01/30/2022] [Indexed: 11/29/2022]
Abstract
Objectives The aim of this study was to assess the effect of topical steroids on acute‐onset olfactory dysfunction in patients infected with COVID‐19. Design and Setting Systematic review and meta‐analysis of cohort studies. Participants Patients infected with COVID‐19. Main outcome measures PubMed, Embase, the Web of Science, SCOPUS, Cochrane database and Google Scholar were searched for articles up to September 2021. We analysed studies comparing the improvement of olfactory dysfunction between topical steroid treatment and control groups (placebo or no treatment). In addition, we performed a subgroup analysis by study type. Results The improvement of olfactory score at 2 (standardised mean difference [SMD] = 0.7272, 95% confidence interval = [0.3851, 1.0692], p < .0001, I2 = 62.1%) and 4 weeks post‐treatment (SMD = 1.0440 [0.6777, 1.4102], p < .0001, I2 = 61.2%) was statistically greater in the treatment than control group. However, there was no significant difference (odds ratio [OR] = 1.4345 [0.9525, 2.1604], p = .0842, I2 = 45.4%) in the incidence of fully recovery from anosmia/hyposmia between the treatment and control groups. In subgroup analysis, there were no significant differences in the improvement of olfactory score at 4 weeks post‐treatment (OR = 0.6177 [0.1309, 1.1045] vs. 0.1720 [0.8002, 1.5438], p = .0761) or the incidence of full recovery from anosmia/hyposmia (OR = 1.8478 [0.6092, 5.6053] vs. 1.3784 [0.8872, 2.1414], p = .8038) between randomised and non‐randomised controlled trials. Conclusions Although this meta‐analysis found that topical steroids improved the acute‐onset olfactory dysfunction caused by COVID‐19, there was no difference in the rate of full olfactory recovery between treated and control patients.
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Affiliation(s)
- Do Hyun Kim
- Department of Otolaryngology-Head and Neck Surgery, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Sung Won Kim
- Department of Otolaryngology-Head and Neck Surgery, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Minju Kang
- Department of Otolaryngology-Head and Neck Surgery, Seoul St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
| | - Se Hwan Hwang
- Department of Otolaryngology-Head and Neck Surgery, Bucheon St. Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea
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Gamil Y, Ismail RM, Abdou A, Shabaan AA, Hamed MG. Association between Administration of Systemic Corticosteroids and the Recovery of Olfactory and/or Gustatory Functions in Patients with COVID-19: A Prospective Cohort Study. Open Access Maced J Med Sci 2022. [DOI: 10.3889/oamjms.2022.8599] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/05/2022] Open
Abstract
AIM: This study is a prospective cohort study aimed to assess the effect of systemic corticosteroids administration time in the recovery of gustatory and olfactory sensations dysfunction (ageusia and anosmia) in COVID-19 patients.
MATERIALS AND METHODS: Sixty-seven COVID-19 patients with symptoms of ageusia and anosmia were recruited (that their COVID infection was confirmed using polymerase chain reaction). Daily 10 mg of systemic corticosteroids were prescribed in the 1st week and then reduced to 5 mg in the 2nd week to all the patients to observe taste and smell sensation recovery. All data were recorded and then analyzed. Patients were then grouped into two groups (early and late groups) according to the duration of their taste and smell dysfunction.
RESULTS: Regression analysis showed that early corticosteroid administration resulted in a significant decrease in recovery time of ageusia and anosmia (0.27 [0.2–0.35], p < 0.001). Patients in the early administration group (<1 week) showed faster improvement in regaining taste and smell functions than in the late administration group (>1 week) with significant difference (p < 0.001).
CONCLUSIONS: The use of systemic corticosteroids in early phases of covid-19 infection help in faster recovery of ageusia and anosmia.
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The Effects of Persistent Olfactory and Gustatory Dysfunctions on Quality of Life in Long-COVID-19 Patients. Life (Basel) 2022; 12:life12020141. [PMID: 35207429 PMCID: PMC8878431 DOI: 10.3390/life12020141] [Citation(s) in RCA: 37] [Impact Index Per Article: 18.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/19/2021] [Revised: 12/26/2021] [Accepted: 01/17/2022] [Indexed: 12/12/2022] Open
Abstract
(1) Background: Persistent olfactory (POD) and gustatory (PGD) dysfunctions are one of the most frequent symptoms of long-Coronavirus Disease 2019 but their effect on the quality of life (QoL) of patients is still largely unexplored. (2) Methods: An online survey was administered to individuals who reported to have had SARS-CoV-2 infection at least 6 months prior with persisting COVID-19 symptoms (using the COVID symptom index), including ratings of POD and PGD, and their physical (PCS) and mental (MCS) components of quality of life were assessed using the standardized short form 12 questionnaire (SF-12). (3) Results: Responses from 431 unique individuals were included in the analyses. The most frequent persistent symptoms were: fatigue (185 cases, 42.9%), olfactory dysfunction (127 cases, 29.5%), gustatory dysfunction (96 cases, 22.3%) and muscle pain (83 cases, 19.3%). Respondents who reported persisting muscle pain, joint pain, fatigue, headache, gastrointestinal disturbances, and dyspnea had significantly worse PCS. Those experiencing persistent fatigue and dyspnea also showed significantly lower MCS. Respondents reporting POD or PGD showed significantly worse QoL, but only pertaining to the MCS. Multiple regressions predicted MCS based on olfactory and marginally on gustatory ratings, but not PCS. Age significantly affected the prediction of PCS but not MCS, and gender and temporal distance from the COVID-19 diagnosis had no effect. (4) Conclusions: POD and PGD are frequent symptoms of the long-COVID-19 syndrome and significantly reduce QoL, specifically in the mental health component. This evidence should stimulate the establishment of appropriate infrastructure to support individuals with persistent CD, while research on effective therapies scales up.
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30
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Treatment and Prognosis of COVID-19 Associated Olfactory and Gustatory Dysfunctions. J Pers Med 2021; 11:jpm11101037. [PMID: 34683178 PMCID: PMC8539133 DOI: 10.3390/jpm11101037] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/18/2021] [Revised: 09/14/2021] [Accepted: 10/14/2021] [Indexed: 01/08/2023] Open
Abstract
Olfactory and gustatory dysfunctions are important initial symptoms of coronavirus disease 2019 (COVID-19). However, the treatment modality for these conditions has yet to be clearly established. Therefore, most physicians have been administering empirical treatments for COVID-19-associated olfactory dysfunction, including topical or systemic steroid supplementation and olfactory training. In this literature review, we summarize the clinical course and effects of various treatments currently being conducted in patients with COVID-19-associated olfactory and gustatory dysfunctions.
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Saussez S, Sharma S, Thiriard A, Olislagers V, Vu Duc I, Le Bon SD, Khalife M, Hans S, De Riu G, Hopkins C, Lechien JR, Vaira LA, Marchant A. Predictive factors of smell recovery in a clinical series of 288 coronavirus disease 2019 patients with olfactory dysfunction. Eur J Neurol 2021; 28:3702-3711. [PMID: 34157187 PMCID: PMC8444937 DOI: 10.1111/ene.14994] [Citation(s) in RCA: 34] [Impact Index Per Article: 11.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/25/2021] [Revised: 06/16/2021] [Accepted: 06/17/2021] [Indexed: 12/11/2022]
Abstract
BACKGROUND AND PURPOSE The aim was to evaluate potential predictive factors of smell recovery in a clinical series of 288 patients presenting olfactory dysfunction (OD) related to coronavirus disease 2019 (COVID-19). Potential correlations were sought between epidemiological, clinical and immunological characteristics of patients and the persistence of OD at 60 days. METHODS COVID-19 positive patients presenting OD were prospectively recruited from three European hospitals. Baseline clinical and olfactory evaluations were performed within the first 2 weeks after OD onset and repeated at 30 and 60 days. In a subgroup of patients, anti-severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) antibodies were measured in serum, saliva and nasal secretions at 60 days. RESULTS A total of 288 COVID-19 patients with OD were included in the study. Two weeks after the onset of the loss of smell, 52.4% of patients had OD on psychophysical tests, including 113 cases (39.2%) of anosmia and 38 cases (13.2%) of hyposmia. At 60-day follow-up, 25.4% of the patients presented persistent OD. There was no significant correlation between sex, age, viral load on nasopharyngeal swab or COVID-19 severity and poor olfactory outcome. In a subgroup of 63 patients, it was demonstrated that patients with poor olfactory outcomes at 60 days had lower levels of salivary and nasal immunoglobulin G (IgG) and IgG1, but similar levels of antibodies in the serum. CONCLUSIONS No clinical markers predicted the evolution of OD at 60 days. Patients with poor olfactory outcome at 60 days had lower saliva and nasal antibodies, suggesting a role for local immune responses in the persistence of COVID-19 related OD.
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Affiliation(s)
- Sven Saussez
- COVID-19 Task Force of the Young-Otolaryngologists of the International Federations of Oto-rhino-laryngological Societies (YO-IFOS), Paris, France.,Department of Human Anatomy and Experimental Oncology, Faculty of Medicine, UMONS Research Institute for Health Sciences and Technology, University of Mons (UMons), Mons, Belgium.,Department of Otorhinolaryngology and Head and Neck Surgery, CHU de Bruxelles, CHU Saint-Pierre, School of Medicine, Université Libre de Bruxelles, Brussels, Belgium.,Department of Otorhinolaryngology and Head and Neck Surgery, EpiCURA Hospital, Baudour, Belgium
| | - Shilpee Sharma
- Institute for Medical Immunology, Université libre de Bruxelles, Charleroi, Belgium
| | - Anaïs Thiriard
- Institute for Medical Immunology, Université libre de Bruxelles, Charleroi, Belgium
| | - Véronique Olislagers
- Institute for Medical Immunology, Université libre de Bruxelles, Charleroi, Belgium
| | - Inès Vu Duc
- Institute for Medical Immunology, Université libre de Bruxelles, Charleroi, Belgium
| | - Serge-D Le Bon
- Department of Otorhinolaryngology and Head and Neck Surgery, CHU de Bruxelles, CHU Saint-Pierre, School of Medicine, Université Libre de Bruxelles, Brussels, Belgium
| | - Mohamad Khalife
- Department of Otorhinolaryngology and Head and Neck Surgery, EpiCURA Hospital, Baudour, Belgium
| | - Stephane Hans
- Department of Otolaryngology and Head and Neck Surgery, Foch Hospital, School of Medicine, UFR Simone Veil, Université Versailles Saint-Quentin-en-Yvelines (Paris Saclay University), Paris, France
| | - Giacomo De Riu
- Maxillofacial Surgery Unit, Department of Medical, Surgical and Experimental Sciences, University of Sassari, Sassari, Italy
| | - Claire Hopkins
- Guy's and St Thomas NHS Foundation Trust, London, UK.,British Rhinological Society (President), London, UK
| | - Jerome R Lechien
- COVID-19 Task Force of the Young-Otolaryngologists of the International Federations of Oto-rhino-laryngological Societies (YO-IFOS), Paris, France.,Department of Otorhinolaryngology and Head and Neck Surgery, CHU de Bruxelles, CHU Saint-Pierre, School of Medicine, Université Libre de Bruxelles, Brussels, Belgium.,Department of Otolaryngology and Head and Neck Surgery, Foch Hospital, School of Medicine, UFR Simone Veil, Université Versailles Saint-Quentin-en-Yvelines (Paris Saclay University), Paris, France
| | - Luigi A Vaira
- Maxillofacial Surgery Unit, Department of Medical, Surgical and Experimental Sciences, University of Sassari, Sassari, Italy.,Biomedical Science PhD School, Biomedical Science Department, University of Sassari, Sassari, Italy
| | - Arnaud Marchant
- Institute for Medical Immunology, Université libre de Bruxelles, Charleroi, Belgium
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