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新冠病毒感染后相关嗅觉功能障碍的治疗选择:一项系统综述和荟萃分析

Therapeutic options of post-COVID-19 related olfactory dysfunction: a systematic review and meta-analysis.

作者信息

Asvapoositkul V, Samuthpongtorn J, Aeumjaturapat S, Snidvongs K, Chusakul S, Seresirikachorn K, Kanjanaumporn J

机构信息

Department of Otolaryngology, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.

Department of Anatomy, Faculty of Medicine, Chulalongkorn University, Bangkok, Thailand.

出版信息

Rhinology. 2023 Feb 1;61(1):2-11. doi: 10.4193/Rhin22.221.

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.

摘要

背景

嗅觉功能障碍是新冠病毒感染后的一种典型表现,会影响患者的生活质量。目前,这类患者有多种治疗选择,如口服和鼻内使用皮质类固醇、嗅觉训练、口服维生素矿物质补充剂等。本荟萃分析旨在整合现有证据,以了解与新冠病毒感染相关的持续性嗅觉功能障碍患者当前治疗方法的效果,并评估皮质类固醇附加疗法在嗅觉训练中的可能作用。

方法

对新冠病毒感染后嗅觉功能障碍的当前治疗方法/干预措施进行了系统综述和荟萃分析。汇总数据用于荟萃分析。结果包括主观或客观嗅觉评估、主要和次要不良反应。

结果

本综述纳入了11项研究(1414名参与者),其中6项研究(916名参与者)随后被纳入荟萃分析。从视觉模拟评分(VAS)改善和“嗅觉棒”测试的识别成分来看,鼻内皮质类固醇(INCS)与嗅觉训练(OT)联合治疗并不比OT单一疗法更具优势。此外,与单独使用OT相比,口服皮质类固醇(OCS)与OT联合治疗在改善嗅觉障碍残疾指数(TDI)评分方面没有差异。然而,OT治疗后嗅觉功能有显著改善。

结论

与OT单一疗法相比,INCS + OT或OCS + OT联合疗法在改善嗅觉评分方面没有显著差异。然而,OT治疗后嗅觉功能有所改善。

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