Persistent COVID-19 parosmia and olfactory loss post olfactory training : randomized clinical trial comparing central and peripheral-acting therapeutics
© 2024. The Author(s)..
PURPOSE: Although COVID-19 anosmia is often transient, patients with persistent olfactory dysfunction (pOD) can experience refractory parosmia and diminished smell. This study evaluated four putative therapies for parosmia in patients with chronic COVID-19 olfactory impairment.
METHODS: After screening nasal endoscopy, 85 patients (49 female, 58%) with pOD and treatment-refractory parosmia were randomized to: (1) ultramicronized palmitoylethanolamide and luteolin + olfactory training (OT) (umPEALUT group, n = 17), (2) alpha-lipoic acid + OT (ALA group, n = 21), (3) umPEALUT + ALA + OT (combination group, n = 28), or 4) olfactory training (OT) alone (control group, n = 23). Olfactory function was assessed at baseline (T0) and 6 months (T1) using a parosmia questionnaire and Sniffin' Sticks test of odor threshold, detection, and identification (TDI). Analyses included one-way ANOVA for numeric data and Chi-Square analyses for nominal data on parosmia.
RESULTS: The umPEALUT group had the largest improvement in TDI scores (21.8 ± 9.4 to 29.7 ± 7.5) followed by the combination group (19.6 ± 6.29 to 27.5 ± 2.7), both p < 0.01. The control and ALA groups had no significant change. Patients in the combination and umPEALUT groups had significantly improved TDI scores compared to ALA and control groups (p < 0.001). Rates of parosmia resolution after 6 months were reported at 96% for combination, 65% for control, 53% for umPEALUT and 29% for ALA (p < 0.001). All treatment regimens were well-tolerated.
CONCLUSIONS: umPEALUT and OT, with or without ALA, was associated with improvement in TDI scores and parosmia, whereas OT alone or OT with ALA were associated with little benefit.
| Medienart: |
E-Artikel |
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| Erscheinungsjahr: |
2024 |
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| Erschienen: |
2024 |
| Enthalten in: |
Zur Gesamtaufnahme - year:2024 |
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| Enthalten in: |
| Sprache: |
Englisch |
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| Beteiligte Personen: |
Cantone, Elena [VerfasserIn] |
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| Links: |
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| Themen: |
Alpha lipoic acid |
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| Anmerkungen: |
Date Revised 16.03.2024 published: Print-Electronic Citation Status Publisher |
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| doi: |
10.1007/s00405-024-08548-6 |
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| funding: |
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| Förderinstitution / Projekttitel: |
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| PPN (Katalog-ID): |
NLM369816889 |
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| 100 | 1 | |a Cantone, Elena |e verfasserin |4 aut | |
| 245 | 1 | 0 | |a Persistent COVID-19 parosmia and olfactory loss post olfactory training |b randomized clinical trial comparing central and peripheral-acting therapeutics |
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| 520 | |a © 2024. The Author(s). | ||
| 520 | |a PURPOSE: Although COVID-19 anosmia is often transient, patients with persistent olfactory dysfunction (pOD) can experience refractory parosmia and diminished smell. This study evaluated four putative therapies for parosmia in patients with chronic COVID-19 olfactory impairment | ||
| 520 | |a METHODS: After screening nasal endoscopy, 85 patients (49 female, 58%) with pOD and treatment-refractory parosmia were randomized to: (1) ultramicronized palmitoylethanolamide and luteolin + olfactory training (OT) (umPEALUT group, n = 17), (2) alpha-lipoic acid + OT (ALA group, n = 21), (3) umPEALUT + ALA + OT (combination group, n = 28), or 4) olfactory training (OT) alone (control group, n = 23). Olfactory function was assessed at baseline (T0) and 6 months (T1) using a parosmia questionnaire and Sniffin' Sticks test of odor threshold, detection, and identification (TDI). Analyses included one-way ANOVA for numeric data and Chi-Square analyses for nominal data on parosmia | ||
| 520 | |a RESULTS: The umPEALUT group had the largest improvement in TDI scores (21.8 ± 9.4 to 29.7 ± 7.5) followed by the combination group (19.6 ± 6.29 to 27.5 ± 2.7), both p < 0.01. The control and ALA groups had no significant change. Patients in the combination and umPEALUT groups had significantly improved TDI scores compared to ALA and control groups (p < 0.001). Rates of parosmia resolution after 6 months were reported at 96% for combination, 65% for control, 53% for umPEALUT and 29% for ALA (p < 0.001). All treatment regimens were well-tolerated | ||
| 520 | |a CONCLUSIONS: umPEALUT and OT, with or without ALA, was associated with improvement in TDI scores and parosmia, whereas OT alone or OT with ALA were associated with little benefit | ||
| 650 | 4 | |a Journal Article | |
| 650 | 4 | |a Alpha lipoic acid | |
| 650 | 4 | |a Anosmia | |
| 650 | 4 | |a Coronavirus long-COVID | |
| 650 | 4 | |a Palmitoylethanolamide | |
| 650 | 4 | |a Parosmia | |
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| 700 | 1 | |a Roccamatisi, Dalila |e verfasserin |4 aut | |
| 700 | 1 | |a La La Mantia, Ignazio |e verfasserin |4 aut | |
| 700 | 1 | |a Brenner, Michael J |e verfasserin |4 aut | |
| 700 | 1 | |a Di Stadio, Arianna |e verfasserin |4 aut | |
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