Olfactory Training in Post-COVID-19 Persistent Olfactory Disorders: Value Normalization for Threshold but Not Identification

Vandersteen, Clair; Payne, Magali; Dumas, L.; Cancian, Elisa; Plonka, Alexandra; D’Andréa, Gregoire; Chirio, David; Demonchy, Élisa; Risso, Karine; Askénazy, Florence; Savoldelli, Charles; Guevara, N.; Robert, Philippe; Castillo, L.; Manera, Valéria; Gros, Auriane

doi:10.3390/jcm11123275

Cited by 14 publications

(20 citation statements)

References 64 publications

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“…To date, there are only a few studies investigating the efficacy of olfactory training in the treatment of post-COVID-19 persistent OD. A recent study by Vandersteen and colleagues [24] reported a significant clinical recovery after OT in patients with COVID-19-related persistent OD. Their cohort was comprised of forty-three patients with a mean OD duration of 5.8 ± 3.2 months.…”

Section: Discussionmentioning

confidence: 93%

“…Regarding the effectiveness of OT across three different olfactory abilities-smell identification, discrimination, and threshold-several meta-analyses [10,11,20] reported a great variance in the improvement of these subscores. In patients with post-COVID-19 persistent OD who performed OT, Vandersteen and colleagues [24] observed a significant T and I improvement, followed by a non-significant D improvement. Our study, however, produced a significant increase in the mean values of all subsets of the Sniffin' Sticks test after the COT.…”

Section: Discussionmentioning

confidence: 96%

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Effects of classical olfactory training in patients with COVID-19-related persistent loss of smell

Yaylacı

Azak

Önal

et al. 2022

Eur Arch Otorhinolaryngol

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Purpose The management of post-COVID-19 persistent olfactory dysfunction (OD) is uncertain. Currently, olfactory training is the only evidence-based therapy for post-viral OD. In this study, we evaluated the effectiveness of classical olfactory training (COT) in the treatment of post-COVID-19 persistent OD. Materials and methods Patients with persistent OD after COVID-19 were assessed using the Sniffin' Sticks test. Fifty-one patients were then divided into two groups based on personal preference: the COT group (n = 31) included subjects who performed COT over 12 weeks, and the control group (n = 20) included subjects who did not receive any treatment. After the exclusion of eight patients, the olfactory performances of 43 patients were re-evaluated and compared to the baseline values.Results A significantly higher proportion of patients in the COT group improved their olfactory scores above the clinically important difference compared to the control group (40% versus 6%) (p = 0.014). The subjective smell improvement by COT was independent of age, gender, OD duration, presence of parosmia, or the initial olfactory score (all p > 0.05). Conclusion Twelve weeks of COT appears to increase the olfactory sensitivity in patients with persistent OD following COVID-19.

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Section: Discussionmentioning

confidence: 93%

Section: Discussionmentioning

confidence: 96%

Effects of classical olfactory training in patients with COVID-19-related persistent loss of smell

Yaylacı

Azak

Önal

et al. 2022

Eur Arch Otorhinolaryngol

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“… 16 17 Contrary to the findings of our study, a recent report indicated that the C19OD patient group included a high percentage of women. 18 19 20 Heo et al reported that patients who recovered were mostly women ( P =0.001) who were significantly younger ( P = 0.048). 20 Considering that the average duration of symptoms in the C19OD patient group who visited our hospital was more than four months, selection bias may have occurred because of the high proportion of men who did not recover from the symptoms.…”

Section: Discussionmentioning

confidence: 99%

“…Hummel et al 6 reported a significant effect only on the T-score after olfactory training, and Sorokowska et al 8 reported significant effects on the D, I, and TDI total scores, excluding the T-score. Vandersteen et al 19 reported a significant increase in the T score and decrease in the D score after olfactory training in patients with C19OD, suggesting the need for a study on the etiology of the central abnormality of C19OD. Although there are differences among papers on the exact effect of olfactory training, olfactory training was introduced as a good treatment method without side effects even in C19OD.…”

Section: Discussionmentioning

confidence: 99%

Comparative Analysis of Olfactory and Gustatory Function of Patients With COVID-19 Olfactory Dysfunction and Non-COVID-19 Postinfectious Olfactory Dysfunction

Jung,

Choi,

Jang

et al. 2023

J Korean Med Sci

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Background Coronavirus disease 2019 (COVID-19) is known to have a high incidence of loss of smell and taste. However, studies in the early stages of the COVID-19 pandemic have evaluated these symptoms using subjective surveys and simple olfactory tests only. Hence, we compared the olfactory and gustatory characteristics of patient groups with COVID-19 olfactory dysfunction (C19OD) and non-COVID-19 postinfectious olfactory dysfunction (PIOD) using an objective olfactory test and evaluated the significance of olfactory training in both patient groups. Methods We retrospectively analyzed the medical records of 14 patients with a decreased sense of smell after having positive COVID-19 polymerase chain reaction results, and 56 patients with PIOD with no history of confirmed COVID-19. Participants were evaluated using the Korean version of the Sniffin’ stick (KVSS) II, and chemical gustometry and olfactory training was assessed during their first visit. Olfactory training was then re-evaluated after an average of 8 (± 6) weeks. Results The average age of participants in the C19OD group was lower than in those in the non-COVID-19 PIOD group. The proportion of men in the C19OD group was higher than in the non-COVID-19 PIOD group. At baseline assessment, the C19OD group had better olfactory and gustatory functions. After olfactory training, the non-COVID-19 PIOD patient group showed a significant increase in all KVSS II Total, T, D, and I scores, but there was a non-significant increase in all scores in the C19OD group. Conclusion The C19OD group had better olfactory and gustatory function than the non-COVID-19 PIOD group at the initial assessment. After olfactory training, there was an increase in olfactory function test scores in both groups. Olfactory training may be helpful in C19OD, as in non-COVID-19 PIOD.

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“… 17 , 18 A positive effect of olfactory training (OT) on the recovery from post-infectious olfactory disorders has already been shown in studies. 19 - 21 This study aims to compare these two therapeutic approaches to the treatment of persistent olfactory dysfunction. Most data on loss of smell rely on the evaluation of orthonasal olfactory performance.…”

Section: Introductionmentioning

confidence: 99%

Treatment of Olfactory Disorders After SARS – CoViD 2 Virus Infection

Schmidt¹,

Azar²,

Goektas³

2023

Ear Nose Throat J

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Objective The benefit of a nasal corticosteroid in the treatment of persistent post-infectious smell disorders is not as clear in previous studies as is assumed for olfactory training. This study would therefore like to describe the treatment strategies using the example of a persistent olfactory dysfunction as a result of a proven infection with SARS-CoViD-2-virus. Methods Twenty patients (average age of 33.9 ± 11.9 years) with hyposmia were included in this study from December 2020 to July 2021. Every second patient received additionally a nasal corticosteroid. The two resulting randomized groups of equal size were screened with the TDI test, a 20-item taste powder test for the assessment of retronasal olfaction and otorhinolaryngological examination. The patients were asked to train twice daily using a standardized odor training kit and followed up after 2 months and 3 months, respectively. Results We documented a significant overall improvement in olfactory ability over the investigation period in both groups. While the TDI score steadily increased on average under the combination therapy, the rise under olfactory training alone was initially steeper. This short-term interaction effect over mean two months was not statistically significant. According to Cohen, however, a moderate effect (eta 2 = 0.055, Cohen`s d = 0.5) can still be assumed. This effect could be explained by a possibly higher compliance at the beginning of the sole olfactory training due to the lack of further drug treatment offers. When the training intensity decreases, the recovery of the sense of smell stagnates. Adjunctive therapy ultimately outweighs this short-term benefit. Conclusions The results reinforce the recommendation of early and consistent olfactory training on patients with dysosmia due to COVID-19. For continuous improvement of the sense of smell, an accompanying topical treatment seems at least to be worth consideration. The results should be optimized with larger cohorts and using new objective olfactometric methods.

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Olfactory Training in Post-COVID-19 Persistent Olfactory Disorders: Value Normalization for Threshold but Not Identification

Cited by 14 publications

References 64 publications

Effects of classical olfactory training in patients with COVID-19-related persistent loss of smell

Effects of classical olfactory training in patients with COVID-19-related persistent loss of smell

Comparative Analysis of Olfactory and Gustatory Function of Patients With COVID-19 Olfactory Dysfunction and Non-COVID-19 Postinfectious Olfactory Dysfunction

Treatment of Olfactory Disorders After SARS – CoViD 2 Virus Infection

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