Modified Olfactory Training Is an Effective Treatment Method for COVID-19 Induced Parosmia.

OBJECTIVES: Coronavirus disease (COVID-19) infection often causes olfactory dysfunction and parosmia may occur in some patients with olfactory dysfunction. In this study, we retrospectively investigated the effectiveness of modified olfactory training (MOT) for the treatment of COVID-19-induced parosmia. STUDY DESIGN: This study presents results of MOT performed with 12 odors for 36 weeks in patients with olfactory dysfunction following COVID-19 infection. A total of 75 participants were included in the study (mean age 33 years, range 16-60 years). METHODS: The patients were separated into two groups: 1) Treatment group consisted of parosmia patients who received MOT with three sets of four different odors sequentially. 2) Control group consisted of parosmia patients who did not perform any olfactory training. Both groups were matched for age and sex distribution of participants. TDI scores were compared at the time of application and at the end of the 9th month by the Sniffin' Sticks Test. The results of the 0th and 9th months were recorded by applying the parosmia assessment scale to both groups. The results were analyzed statistically, and p < 0.05 was considered significant. RESULTS: When the treatment group and the control group were compared, a significant improvement was observed in both groups at the third, sixth, and ninth month, however the improvement in the treatment group was found to be better than in the control group (P < .001). Extending the treatment from 6 to 9 months in the treatment group was found to be effective in mitigating parosmia complaints and improving discrimination scores (P < .001). CONCLUSION: This study has shown that modified olfactory training is effective in the treatment of parosmia following COVID-19 infection. LEVEL OF EVIDENCE: 3 Laryngoscope, 132:1433-1438, 2022.

Relationship between disease severity and serum IL-6 levels in COVID-19 anosmia.

BACKGROUND: An association between IL-6 levels and cytokine storm syndrome in COVID-19 patients has been suggested. Cases with higher IL-6 levels have more rapid progression and a higher complication rate. On the other hand, COVID-19 cases with anosmia have a milder course of the disease. OBJECTIVE: We aimed to investigate whether there is a relationship between serum IL-6 levels and presence of anosmia in COVID-19 patients. METHODS: Patients with a confirmed diagnosis of COVID-19 based on laboratory (PCR) were stratified into two groups based on presence of olfactory dysfunction (OD). In all cases with and without anosmia; psychophysical test (Sniffin' Sticks test) and a survey on olfactory symptoms were obtained. Threshold (t) - discrimination (d) - identification (i), and total (TDI) scores reflecting olfactory function were calculated. Clinical symptoms, serum IL-6 levels, other laboratory parameters, and chest computed tomography (CT) findings were recorded. RESULTS: A total of 59 patients were included, comprising 23 patients with anosmia and 36 patients without OD based on TDI scores. Patients with anosmia (41.39 ± 15.04) were significantly younger compared to cases without anosmia (52.19 ± 18.50). There was no significant difference between the groups in terms of comorbidities, smoking history, and symptoms including nasal congestion and rhinorrhea. Although serum IL-6 levels of all patients were above normal values (7 pg/mL), patients with anosmia had significantly lower serum IL-6 levels (16.72 ± 14.28 pg/mL) compared to patients without OD (60.95 ± 89.33 pg/mL) (p = 0.026). CONCLUSION: Patients with COVID-19 related anosmia tend to have significantly lower serum levels of IL-6 compared to patients without OD, and the lower IL-6 levels is related to milder course of the disease. With the effect of low cytokine storm and IL-6 level, it may be said that anosmic cases have a milder disease in COVID-19.