The COVANOS trial – insight into post-COVID olfactory  dysfunction and the role of smell training

Lechner, Matt; Liu, J.; Counsell, Nicholas; Gillespie, D.; Chandrasekharan, Deepak; Ta, N.H.; Jumani, K.; Gupta, R.; Rao-Merugumala, S.; Rocke, John; Williams, C.; Tetteh, A.; Amnolsingh, R.; Khwaja, Sadie; Batterham, Rachel L.; Yan, Carol H.; Treibel, T.A.; Moon, James; Woods, J.; Brunton, R.; Boardman, J.; Paun, Santdeep; Eynon-Lewis, Nicholas; Kumar, B.N.; Jayaraj, Samuel; Hopkins, Claire; Philpott, Carl; Lund, Valerie J.

doi:10.4193/rhin21.470

Cited by 20 publications

(16 citation statements)

References 29 publications

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“…Based on pre-COVID-19 studies, various treatment regimes have been recommended [ 9 , 10 ]: olfactory training [ 11 ], topical administration of vitamin A [ 12 ], omega-3 supplementation [ 13 ], and topical [ 14 ] and systemic corticosteroids [ 15 ]. A positive effect of some of these treatments was possibly recently confirmed for COVID-19-associated smell loss: two studies found a positive effect of olfactory training [ 16 , 17 ]. Hernandez et al showed that omega-3 supplementation improves the olfactory threshold [ 18 ].…”

Section: Introductionmentioning

confidence: 93%

Topical Administration of Mometasone Is Not Helpful in Post-COVID-19 Olfactory Dysfunction

Hintschich

Dietz

Haehner

et al. 2022

Life

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Persistent olfactory dysfunction is a major concern post-COVID-19, affecting up to 5% of all patients. Different therapeutic options, including mometasone nasal spray, have been recommended, only some of which have been validated for post-COVID-19 olfactory dysfunction. In this study we psychophysically assessed the effect of intranasally applied mometasone furoate on the recovery of olfaction. The spray was applied with a long applicator so that the olfactory cleft could be reached effectively. After olfactory dysfunction had been confirmed psychophysically using Sniffin’ Sticks, patients were randomly assigned to two different treatment arms: the study group (n = 40) underwent olfactory training and intranasal administration of mometasone furoate twice daily, whereas the control group (n = 46) performed olfactory training only. After a study duration of three months, psychophysical testing of olfaction was repeated using Sniffin’ Sticks. We found no benefit of an additional topical administration of mometasone furoate compared to olfactory training alone. These results psychophysically confirm two previous studies which were based on patients’ subjective self-ratings. Our findings are in contrast to current recommendations for the management of olfactory dysfunction post-COVID-19, which might have to be adapted accordingly.

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Section: Introductionmentioning

confidence: 93%

Topical Administration of Mometasone Is Not Helpful in Post-COVID-19 Olfactory Dysfunction

Hintschich

Dietz

Haehner

et al. 2022

Life

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show abstract

“…The strongest evidence for the treatment of COVID‐19 OD recommends olfactory training. 7 , 8 , 9 , 10 , 11 Other proposed therapies based on prepandemic evidence involve the use of topical intranasal medications 12 , 13 , 14 and oral anti‐inflammatory/neuroprotective agents. 15 , 16 , 17 , 18 However, the efficacy remains moderate at best among all current proposed therapeutics.…”

Section: Introductionmentioning

confidence: 99%

Use of platelet‐rich plasma for COVID‐19–related olfactory loss: a randomized controlled trial

Yan

Jang

Lin

et al. 2022

Int Forum Allergy Rhinol

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Introduction The current study evaluated the use of platelet‐rich plasma (PRP), an autologous blood product with supraphysiologic concentrations of growth factors, in the treatment of prolonged coronavirus disease 2019 (COVID‐19)–related smell loss. Methods This multi‐institutional, randomized controlled trial recruited patients with COVID‐19 who had objectively measured smell loss (University of Pennsylvania Smell Identification Test [UPSIT] ≤ 33) between 6 and 12 months. Patients were randomized to three intranasal injections of either PRP or sterile saline into their olfactory clefts. The primary outcome measure was change in Sniffin’ Sticks score (threshold, discrimination, and identification [TDI]) from baseline. The secondary end point measures included responder rate (achievement of a clinically significant improvement, ≥5.5 points TDI), change in individual TDI olfaction scores, and change in subjective olfaction via a visual analog scale. Results A total of 35 patients were recruited and 26 completed the study. PRP treatment resulted in a 3.67‐point (95% CI: 0.05–7.29, p = 0.047) greater improvement in olfaction compared with the placebo group at 3 months and a higher response rate (57.1% vs 8.3%, odds ratio 12.5 [95% exact bootstrap confidence interval, 2.2–116.7]). There was a greater improvement in smell discrimination following PRP treatment compared with placebo but no difference in smell identification or threshold. There was no difference in subjective scores between PRP and placebo. No adverse effects were reported. Conclusion Olfactory function following COVID‐19 can improve spontaneously after 6 months and can improve to a greater extent with PRP injection. These data build on the promise of PRP to be a safe potential treatment option for patients with COVID‐19–related smell loss, and larger‐powered studies will help further assess its efficacy.

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“…33 Post-Covid long-term anosmi-parosmia (over 1 year) can be seen as a long-term effect of Covid. 34 For the proper management of this condition, the literature needs…”

Section: Konstantinidis Et Al Applied Classical Olfactory Training Fo...mentioning

confidence: 99%

Management of post-COVID olfactory disorder: Is olfactory training effective on recovery of olfactory mucosal function?

Demir

Sizer

SIRMA>

2022

Mucosa

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BACKGROUND: The number of patients presenting with sudden onset and persistant anosmia and other olfactory disorders, which is a finding related to coronavirus disease has been increased considerably. In this study, we aimed to evaluate the efficacy of olfactory training in patients with persistent anosmia after Covid-19 infection. METHODS: Forty-six patients who applied for sudden loss of smell after Covid-19 infection and still had olfactory disorders were included in the study. Odor threshold and odor identification tests were performed on the patients before the treatment. As olfactory training, 4 scent bottles included the following groups: phenyl ethyl alcohol, eucalyptol group, citronellal group and eugenol group were given to patients and patients instructed to sniff the odors twice a day, for 5 seconds each, when they woke up in the morning and before they went to sleep and make a daily check that they applied the treatment. Patients who continued the training for 12 weeks were re-evaluated with the odor threshold test and odor identification test. RESULTS: The pre-training mean olfactory threshold score of the patients was 1.65±1.74, and the post-training mean olfactory threshold score was 3.89±2.73. It was observed that the olfactory threshold scores increased significantly after the olfactory training (p

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The COVANOS trial – insight into post-COVID olfactory dysfunction and the role of smell training

Cited by 20 publications

References 29 publications

Topical Administration of Mometasone Is Not Helpful in Post-COVID-19 Olfactory Dysfunction

Topical Administration of Mometasone Is Not Helpful in Post-COVID-19 Olfactory Dysfunction

Use of platelet‐rich plasma for COVID‐19–related olfactory loss: a randomized controlled trial

Management of post-COVID olfactory disorder: Is olfactory training effective on recovery of olfactory mucosal function?

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