Department of Otorhinolaryngology, Head and Neck Surgery, University Hospitals Leuven, Leuven, Belgium.
Department of Otorhinolaryngology, Kantonsspital St.Gallen, St. Gallen, Switzerland.
Curr Allergy Asthma Rep. 2024 Oct 31;25(1):2. doi: 10.1007/s11882-024-01182-6.
COVID -19 associated olfactory dysfunction is widespread, yet effective treatment strategies remain unclear. This article aims to provide a comprehensive systematic review of therapeutic approaches and offers evidence-based recommendations for their clinical application.
A living Cochrane review, with rigorous inclusion criteria, has so far included 2 studies with a low certainty of evidence. In this systematic review we list clinical data of 36 randomised controlled trials (RCTs) and non-randomised studies published between Jan 1, 2020 and Nov 19, 2023 regarding treatment options for COVID-19 associated olfactory dysfunction. Nine treatment groups were analysed, including olfactory training, local and systemic corticosteroids, platelet-rich plasma (PRP), calcium chelators, vitamin supplements including palmitoylethanolamide with luteolin, insulin, gabapentin and cerebrolysin. Primary objective was the effect of the studied treatments on the delta olfactory function score (OFS) for objective/psychophysical testing. Treatments such as PRP and calcium chelators demonstrated significant improvements on OFS, whereas olfactory training and corticosteroids did not show notable efficacy for COVID-19 associated olfactory dysfunction.
COVID-19 相关嗅觉功能障碍广泛存在，但有效的治疗策略仍不清楚。本文旨在对治疗方法进行全面系统的综述，并为其临床应用提供循证建议。
一项严格纳入标准的Cochrane 综述，迄今为止仅包括 2 项低确定性证据的研究。在这项系统综述中，我们列出了 2020 年 1 月 1 日至 2023 年 11 月 19 日期间发表的关于 COVID-19 相关嗅觉功能障碍治疗选择的 36 项随机对照试验（RCT）和非随机研究的临床数据。分析了 9 个治疗组，包括嗅觉训练、局部和全身皮质类固醇、富含血小板的血浆（PRP）、钙螯合剂、维生素补充剂（包括棕榈酰乙醇酰胺和叶黄素）、胰岛素、加巴喷丁和脑活素。主要目标是研究治疗对客观/心理物理测试的 delta 嗅觉功能评分（OFS）的影响。PRP 和钙螯合剂等治疗方法在 OFS 上显示出显著改善，而嗅觉训练和皮质类固醇对 COVID-19 相关嗅觉功能障碍没有明显疗效。
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