ABSTRACT
Background: Olfactory dysfunction (OD) is a common symptom of Corona Virus Disease 2019 (COVID-19). It is defined as the reduced or distorted ability to smell during sniffing (orthonasal olfaction) and represents one of the early symptoms in the clinical course of COVID-19 infection. A large online questionnaire-based survey has shown that some post-COVID-19 patients had no improvement 1 month after discharge from the hospital. Objective: To explore the efficacy of acupuncture for OD in COVID-19 infected patients and to determine whether acupuncture could have benefits over sham acupuncture for OD in post-COVID-19 patients. Methods: This is a single-blind, randomized controlled, cross-over trial. We plan to recruit 40 post-COVID-19 patients with smell loss or smell distortions lasting for more than 1 month. Qualified patients will be randomly allocated to the intervention group (real acupuncture) or the control group (sham acupuncture) at a 1:1 ratio. Each patient will receive 8 sessions of treatment over 4 weeks (Cycle 1) and a 2-week follow-up. After the follow-up, the control group will be subjected to real acupuncture for another 4 weeks (Cycle 2), and the real acupuncture group will undergo the 4-week sham acupuncture. The primary outcomes will be the score changes on the questionnaire of olfactory functioning and olfaction-related quality of life at week 6, 8, 12, and 14 from the baseline. The secondary outcomes will be the changes in the olfactory test score at week 6 and 12 from the baseline measured by using the Traditional Chinese version of the University of Pennsylvania Smell Identification Test (UPSIT-TC). Discussion: The results of this trial will help to determine the effectiveness of acupuncture for OD in post-COVID-19 patients. This may provide a new treatment option for patients.
ABSTRACT
Introduction: Measuring pediatric odor detection in a COVID-19-impacted context is important. Our goal was to determine whether the Pediatric Smell Wheel (PSW) can be used effectively in this clinical setting. Method(s): Consecutive patients at a pediatric otolaryngology clinic who were aged 5-17 years were recruited. Demographics including gender, race, use of nasal topical medications, previous nasal surgery, and previous COVID-19 infection were collected. Each child performed a test of their sense of smell using the PSW (Sensonics International) under direct supervision, and scores were compared. Result(s): Forty-three children were included;mean age was 9.1 years (95% CI, 8.0-10.1);19 (44.2%) were female and 24 (55.8%) male. Thirteen (30.2%) used nasal sprays, 10 (23.2%) had undergone adenoidectomy, and 4 (9.3%) had other nasal surgery. Twenty (46.5%) had a previous COVID-19 infection. Mean and median PSW score out of 11 was 7 (95% CI, 6.4-7.7), ranging from 2 to 10. There was no significant difference in scores based on age, gender, race, use of nasal topicals, previous nasal surgery, or previous COVID-19 infection. Children were able to perform the task as directed. Percentage correct for each odorant on the PSW ranged from 86% for identifying the onion scent to 27.9% for identifying the popcorn scent. Cronbach alpha was 0.54, and deleting any individual item did not improve it above 0.57, indicating low internal consistency of the PSW. Conclusion(s): During the COVID-19 pandemic, children performed more poorly identifying odors on the PSW than previously reported. The reliability of the PSW may not be adequate in today's context.