Oliveira Patricia Costa, Correia Luisa Oliveira, Lopes Natalia Medeiros Dias, Suassuna Gabriel Rodrigues, Doty Richard L, Pinna Fabio de Rezende, Voegels Richard Louis, Fornazieri Marco Aurelio
Universidade Estadual de Londrina, Londrina, PR, Brazil.
Pontifícia Universidade Católica do Paraná, Londrina, PR, Brazil.
Braz J Otorhinolaryngol. 2025 Mar 26;91(4):101583. doi: 10.1016/j.bjorl.2025.101583.
Photobiomodulation Therapy (PBMT) is a non-invasive treatment that uses photons from the red to infrared spectrum to modulate cellular processes with anti-inflammatory and regenerative properties. This study aimed to evaluate the use of PBMT applied intranasally in patients with an impaired sense of smell after COVID-19.
This proof-of-concept study was a randomized, placebo-controlled clinical trial that recruited 81 patients with olfactory disorders after SARS-CoV-2 infection (1-12 months), randomly assigned to 3 groups: controls, red light and infrared light exposure groups. PBMT was applied twice a week for five weeks, associated with prednisolone 40 mg for five days and olfactory training for 90 days from the first day of laser application. UPSIT® and subjective chemosensory scores were the outcomes collected before the first session and three months thereafter.
Compared to controls, patients undergoing infrared PBMT showed more improvement in UPSIT® scores (+4.6 points, 95% CI: 1.5-7.8, p = 0.004) and a tendency towards reporting a better subjective smell score at the three-month follow-up. Response rates were 26.1% (95% CI: 6.7-45.5), 43.5% (95% CI: 21.6-65.4), and 68% (95% CI: 48.3-87.7) in the control, red and infrared groups, respectively. No major adverse events were reported.
Therapy with PBMT in the infrared frequency appears to be a safe option in treating post-COVID olfactory disorders when combined with a five-day use of systemic corticosteroid and 90 days of olfactory training.
光生物调节疗法（PBMT）是一种非侵入性治疗方法，它利用从红色到红外光谱的光子来调节具有抗炎和再生特性的细胞过程。本研究旨在评估经鼻应用PBMT对新冠病毒感染后嗅觉减退患者的疗效。
这项概念验证研究是一项随机、安慰剂对照临床试验，招募了81名感染SARS-CoV-2后（1至12个月）患有嗅觉障碍的患者，随机分为3组：对照组、红光照射组和红外光照射组。PBMT每周应用两次，持续五周，从激光应用的第一天起，联合使用40毫克泼尼松龙五天，并进行90天的嗅觉训练。UPSIT®评分和主观化学感觉评分是在第一次治疗前及此后三个月收集的结果。
与对照组相比，接受红外PBMT治疗的患者在UPSIT®评分上有更大改善（提高4.6分，95%置信区间：1.5 - 7.8，p = 0.004），并且在三个月随访时报告主观嗅觉评分更好的趋势。对照组、红光组和红外组的有效率分别为26.1%（95%置信区间：6.7 - 45.5）、43.5%（95%置信区间：21.6 - 65.4）和68%（95%置信区间：48.3 - 87.7）。未报告重大不良事件。
当与为期五天的全身用皮质类固醇和90天的嗅觉训练联合使用时，红外频率的PBMT治疗似乎是治疗新冠后嗅觉障碍的一种安全选择。
