Serviço de Otorrinolaringologia e Cirurgia da Cabeça e Pescoço (Otorhinolaryngology and Head & Neck Surgery), Centro Hospitalar Universitário do Porto, Porto, Portugal.
Ann Otol Rhinol Laryngol. 2023 Jun;132(6):657-666. doi: 10.1177/00034894221111093. Epub 2022 Jul 12.
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.
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.
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, < .001; Olfactory training + Topical Corticosteroid showed a mean threshold difference of 4, = .006; Olfactory training + Topical Corticosteroid + Vitamin B complex showed a mean threshold difference of 4.4, = .006; Olfactory training + Intranasal Vitamin A and E showed a mean threshold difference of 4.4, < .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, = .03).
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.
2c (outcomes research).
迄今为止，尚无针对 COVID-19 相关嗅觉功能障碍的非随机、标准化方案的原始研究。主要目的是确定一种新的 COVID-19 后嗅觉障碍治疗方案的疗效，同时评估嗅觉训练中附加治疗的益处。
评估患有长期 COVID-19 后嗅觉障碍的患者。应用基于个体鼻内镜检查结果和患者偏好的非随机方案。患者被分配接受嗅觉训练或嗅觉训练+辅助治疗。参与者在首次就诊和治疗 3 个月后进行嗅觉客观和主观评估，并比较结果。
共纳入 47 例患者。所有组在 3 个月随访时嗅觉阈值均有显著改善，表明方案有效（嗅觉训练组单独治疗的平均阈值差异为 2.9， < .001；嗅觉训练+局部皮质类固醇的平均阈值差异为 4， = .006；嗅觉训练+局部皮质类固醇+维生素 B 复合物的平均阈值差异为 4.4， = .006；嗅觉训练+鼻内维生素 A 和 E 的平均阈值差异为 4.4， < .001）。与接受嗅觉训练+辅助治疗的患者相比，单独进行嗅觉训练的患者嗅觉阈值改善程度较低（嗅觉训练单独治疗的平均改善值为 2.9 ± 2.3，而嗅觉训练+辅助治疗的平均改善值为 4.3 ± 2.458， = .03）。
这是第一项证明治疗 COVID-19 后持续性嗅觉障碍疗效的研究之一。基于内镜检查结果和患者偏好的个性化方法可能是治疗持续性 COVID-19 后嗅觉障碍的有效选择。除嗅觉训练外，还可以考虑辅助治疗，但需要进一步研究以确认其在这种情况下的有效性。
2c（结局研究）。
