tetano
Editor, Senior Moderator
Pathogens
. 2021 Jun 4;10(6):698.
doi: 10.3390/pathogens10060698.
Short-Term Efficacy and Safety of Oral and Nasal Corticosteroids in COVID-19 Patients with Olfactory Dysfunction: A European Multicenter Study
Sven Saussez[SUP] 1 2 3 4 [/SUP], Luigi Angelo Vaira[SUP] 1 5 6 [/SUP], Carlos M Chiesa-Estomba[SUP] 1 7 [/SUP], Serge-D Le Bon[SUP] 1 4 [/SUP], Mihaela Horoi[SUP] 1 4 [/SUP], Giovanna Deiana[SUP] 8 [/SUP], Marzia Petrocelli[SUP] 9 [/SUP], Philippe Boelpaep[SUP] 2 [/SUP], Giovanni Salzano[SUP] 5 10 [/SUP], Mohamad Khalife[SUP] 1 4 [/SUP], Stephane Hans[SUP] 1 11 [/SUP], Giacomo De Riu[SUP] 1 5 [/SUP], Claire Hopkins[SUP] 12 13 [/SUP], Jerome R Lechien[SUP] 1 2 11 [/SUP]
Affiliations
Abstract
Background: The objective of this study was to investigate the efficacy and safety of early administration of oral corticosteroids (OC) or nasal corticosteroids (NC) as an add-on to olfactory training (OT) versus OT alone in patients with olfactory dysfunction (OD) related to coronavirus disease 2019 (COVID-19). Methods: Patients with a positive diagnosis of COVID-19 and OD were prospectively recruited from March 22 to December 15, 2020 from 4 European hospitals. Patients had confirmed OD on psychophysical testing. All patients undertook OT, with add-on 10 days of OC (group 1: OC + OT), or 1 month of NC (group 2: NC + OT) or olfactory training alone (group 3: OT). Olfactory evaluations (Sniffin'Sticks tests) were carried out at the time of inclusion, 1 and 2 months after the start of the therapeutic course. Results: A total of 152 hyposmic or anosmic patients completed the study. Group 1, 2 and 3 included 59, 22 and 71 patients, respectively and all patient groups were comparable regarding baseline Sniffin'Sticks tests. The median Sniffin'Sticks test values significantly improved from pre- to post-intervention in all groups. The increase of Sniffin'Sticks test values was higher in group 1 (OC + OT) compared with groups 2 and 3 (p < 0.001) at one month after treatment but did not remain so at 2 months. Groups 1, 2 and 3, respectively, presented parosmia in 20/71 (28.2%), 9/22 (40.9%) and 42/71 (59.2%) patients. This difference was statistically significant between group 1 and 3 (p < 0.001). There were no patients with a worsening of the disease or an increase of the severity of the COVID-19 symptoms. Conclusions: The use of OCs in patients with OD related to mild COVID-19 is generally well-tolerated without any case of deterioration of symptoms. OC is associated with greater improvement in psychophysical olfactory evaluations at 1-month post-treatment but there was no difference at 2 months. Parosmia may be reduced following treatment with OC and NC. On the basis of these preliminary results, it is possible to state that considering the 2 months efficacy of OC and NC with respect to the OT alone and the risk-benefit ratio, the benefit to start a specific treatment of COVID-19 related OD cannot be demonstrated and there is a need for a randomised controlled trial to assess this further.
Keywords: COVID-19; SARS-CoV-2; anosmia; olfactory; smell; treatment.
. 2021 Jun 4;10(6):698.
doi: 10.3390/pathogens10060698.
Short-Term Efficacy and Safety of Oral and Nasal Corticosteroids in COVID-19 Patients with Olfactory Dysfunction: A European Multicenter Study
Sven Saussez[SUP] 1 2 3 4 [/SUP], Luigi Angelo Vaira[SUP] 1 5 6 [/SUP], Carlos M Chiesa-Estomba[SUP] 1 7 [/SUP], Serge-D Le Bon[SUP] 1 4 [/SUP], Mihaela Horoi[SUP] 1 4 [/SUP], Giovanna Deiana[SUP] 8 [/SUP], Marzia Petrocelli[SUP] 9 [/SUP], Philippe Boelpaep[SUP] 2 [/SUP], Giovanni Salzano[SUP] 5 10 [/SUP], Mohamad Khalife[SUP] 1 4 [/SUP], Stephane Hans[SUP] 1 11 [/SUP], Giacomo De Riu[SUP] 1 5 [/SUP], Claire Hopkins[SUP] 12 13 [/SUP], Jerome R Lechien[SUP] 1 2 11 [/SUP]
Affiliations
- PMID: 34199734
- DOI: 10.3390/pathogens10060698
Abstract
Background: The objective of this study was to investigate the efficacy and safety of early administration of oral corticosteroids (OC) or nasal corticosteroids (NC) as an add-on to olfactory training (OT) versus OT alone in patients with olfactory dysfunction (OD) related to coronavirus disease 2019 (COVID-19). Methods: Patients with a positive diagnosis of COVID-19 and OD were prospectively recruited from March 22 to December 15, 2020 from 4 European hospitals. Patients had confirmed OD on psychophysical testing. All patients undertook OT, with add-on 10 days of OC (group 1: OC + OT), or 1 month of NC (group 2: NC + OT) or olfactory training alone (group 3: OT). Olfactory evaluations (Sniffin'Sticks tests) were carried out at the time of inclusion, 1 and 2 months after the start of the therapeutic course. Results: A total of 152 hyposmic or anosmic patients completed the study. Group 1, 2 and 3 included 59, 22 and 71 patients, respectively and all patient groups were comparable regarding baseline Sniffin'Sticks tests. The median Sniffin'Sticks test values significantly improved from pre- to post-intervention in all groups. The increase of Sniffin'Sticks test values was higher in group 1 (OC + OT) compared with groups 2 and 3 (p < 0.001) at one month after treatment but did not remain so at 2 months. Groups 1, 2 and 3, respectively, presented parosmia in 20/71 (28.2%), 9/22 (40.9%) and 42/71 (59.2%) patients. This difference was statistically significant between group 1 and 3 (p < 0.001). There were no patients with a worsening of the disease or an increase of the severity of the COVID-19 symptoms. Conclusions: The use of OCs in patients with OD related to mild COVID-19 is generally well-tolerated without any case of deterioration of symptoms. OC is associated with greater improvement in psychophysical olfactory evaluations at 1-month post-treatment but there was no difference at 2 months. Parosmia may be reduced following treatment with OC and NC. On the basis of these preliminary results, it is possible to state that considering the 2 months efficacy of OC and NC with respect to the OT alone and the risk-benefit ratio, the benefit to start a specific treatment of COVID-19 related OD cannot be demonstrated and there is a need for a randomised controlled trial to assess this further.
Keywords: COVID-19; SARS-CoV-2; anosmia; olfactory; smell; treatment.