tetano
Editor, Senior Moderator
Eur Arch Otorhinolaryngol
. 2024 Mar 16.
doi: 10.1007/s00405-024-08548-6. Online ahead of print. Persistent COVID-19 parosmia and olfactory loss post olfactory training: randomized clinical trial comparing central and peripheral-acting therapeutics
Elena Cantone[SUP] #[/SUP][SUP] 1 [/SUP], Luca D'Ascanio[SUP] 2 [/SUP], Pietro De Luca[SUP] 3 [/SUP], Dalila Roccamatisi[SUP] 4 [/SUP], Ignazio La La Mantia[SUP] 5 [/SUP], Michael J Brenner[SUP] 6 [/SUP], Arianna Di Stadio[SUP] #[/SUP][SUP] 7 8 [/SUP]
Affiliations
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 (T[SUB]0[/SUB]) and 6 months (T[SUB]1[/SUB]) 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.
Keywords: Alpha lipoic acid; Anosmia; Coronavirus long-COVID; Palmitoylethanolamide; Parosmia.
. 2024 Mar 16.
doi: 10.1007/s00405-024-08548-6. Online ahead of print. Persistent COVID-19 parosmia and olfactory loss post olfactory training: randomized clinical trial comparing central and peripheral-acting therapeutics
Elena Cantone[SUP] #[/SUP][SUP] 1 [/SUP], Luca D'Ascanio[SUP] 2 [/SUP], Pietro De Luca[SUP] 3 [/SUP], Dalila Roccamatisi[SUP] 4 [/SUP], Ignazio La La Mantia[SUP] 5 [/SUP], Michael J Brenner[SUP] 6 [/SUP], Arianna Di Stadio[SUP] #[/SUP][SUP] 7 8 [/SUP]
Affiliations
- PMID: 38492007
- DOI: 10.1007/s00405-024-08548-6
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 (T[SUB]0[/SUB]) and 6 months (T[SUB]1[/SUB]) 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.
Keywords: Alpha lipoic acid; Anosmia; Coronavirus long-COVID; Palmitoylethanolamide; Parosmia.