Comparison of the Healing Effect of Nasal Saline Irrigation with Triamcinolone Acetonide Versus Nasal Saline Irrigation alone in COVID-19 Related Olfactory Dysfunction: A Randomized Controlled Study

Abstract

There is no routinely determined treatment for olfactory dysfunction because of COVID-19. Saline irrigation and nasal corticosteroid treatments are safe and inexpensive methods, and have low side effects. In our study, we argue that saline nasal irrigation and topical corticosteroid treatment can be used in the treatment of patients with olfactory loss in all areas of rhinology. A total of 150 patients who admitted to our clinic with other symptoms or with only acute odor loss, diagnosed with COVID-19 with RT-PCR were divided into 3 equal groups.Fifty patients in Group 1 were not given any extra treatments. The other 50 patients in Group 2 were given saline irrigation for treatment; and the 50 people in Group 3 were given both saline irrigation and nasal steroid spray for treatment. The ''Subjective Olfactory Capability (SOC)'' was used for olfactory function evaluation of patients. Self-Rating Olfactory Score (SROS), and Olfactory Dysfunction Duration (ODD) were recorded on the 1st, 15th and 30th days. SROS of the group receiving Nasal Saline ? Triamcinolone Acetonide treatment on the 30th day was significantly higher than in other groups (p 21-3 = 0.018, p 223 = 0.033). Also, the ODD was significantly reduced in this group compared to other groups (p 21-3 = 0.022, p 223 = 0.028,). Topical triamcinolone treatment was found to be successful in the treatment of olfactory dysfunction due to COVID-19. Nasal steroids, which are both inexpensive and have low side effect profiles, can be used safely in the treatment of patients with olfactory losses.

Efficacy of topical steroids for the treatment of olfactory disorders caused by COVID‐19: A systematic review and meta‐analysis

“… 4 , 12 The outcomes of interest were the post‐treatment olfactory score (2 and 4 weeks after the initiation of treatment were analysed referring to the common analysis time point of the included papers) and percentage of patients with a full recovery. 7 , 10 , 11 , 13 , 14 These outcomes were compared between the treatment (topical steroid) and control groups; the latter were administered either saline or nothing. When the original data were expressed as continuous variables, the meta‐analysis was performed using the standardised mean difference (SMD).…”

“…The data were organised using a standardised format 4,12 . The outcomes of interest were the post‐treatment olfactory score (2 and 4 weeks after the initiation of treatment were analysed referring to the common analysis time point of the included papers) and percentage of patients with a full recovery 7,10,11,13,14 . These outcomes were compared between the treatment (topical steroid) and control groups; the latter were administered either saline or nothing.…”

“… 9 Meanwhile, the effect of topical corticosteroids on olfaction recovery in patients with olfactory impairment caused by COVID‐19 is still controversial. 10 , 11 Despite these clinical controversies, no systematic review of studies examining the effects of topical steroids on olfactory dysfunction in COVID‐19 patients has been published. Therefore, the purpose of this study was to evaluate olfactory recovery and the efficacy of topical steroids for COVID‐19 patients with olfactory dysfunction.…”

“…However, systemic corticosteroid for COVID‐19 patients is not recommended due to the potential for immunosuppression or delayed viral clearance 9 . Meanwhile, the effect of topical corticosteroids on olfaction recovery in patients with olfactory impairment caused by COVID‐19 is still controversial 10,11 . Despite these clinical controversies, no systematic review of studies examining the effects of topical steroids on olfactory dysfunction in COVID‐19 patients has been published.…”

Possible Role of Ivermectin Mucoadhesive Nanosuspension Nasal Spray in Recovery of Post-COVID-19 Anosmia

“… 25 Isotonic NaCl irrigation has no hazard or therapeutic effect on anosmia. 26 Objective and subjective assessments of anosmia recovery were performed for three months follow- up of all included participants at four different times (one week, one month, two months, three months intervals), Figure 1 . The results were recorded in days.…”