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Article: A Pilot Study of Short-Course Oral Vitamin A and Aerosolised Diffuser Olfactory Training for the Treatment of Smell Loss in Long COVID

TitleA Pilot Study of Short-Course Oral Vitamin A and Aerosolised Diffuser Olfactory Training for the Treatment of Smell Loss in Long COVID
Authors
Keywordsaerosolised
anosmia
functional brain network
long COVID
olfactory dysfunction
olfactory training
resting-state fMRI
smell loss
vitamin A
Issue Date30-Jun-2023
PublisherMDPI
Citation
Brain Sciences, 2023, v. 13, n. 7 How to Cite?
Abstract

Background: Olfactory dysfunction (OD) is a common neurosensory manifestation in long COVID. An effective and safe treatment against COVID-19-related OD is needed. Methods: This pilot trial recruited long COVID patients with persistent OD. Participants were randomly assigned to receive short-course (14 days) oral vitamin A (VitA; 25,000 IU per day) and aerosolised diffuser olfactory training (OT) thrice daily (combination), OT alone (standard care), or observation (control) for 4 weeks. The primary outcome was differences in olfactory function by butanol threshold tests (BTT) between baseline and end-of-treatment. Secondary outcomes included smell identification tests (SIT), structural MRI brain, and serial seed-based functional connectivity (FC) analyses in the olfactory cortical network by resting-state functional MRI (rs-fMRI). Results: A total of 24 participants were randomly assigned to receive either combination treatment (n = 10), standard care (n = 9), or control (n = 5). Median OD duration was 157 days (IQR 127-175). Mean baseline BTT score was 2.3 (SD 1.1). At end-of-treatment, mean BTT scores were significantly higher for the combination group than control (p < 0.001, MD = 4.4, 95% CI 1.7 to 7.2) and standard care (p = 0.009) groups. Interval SIT scores increased significantly (p = 0.009) in the combination group. rs-fMRI showed significantly higher FC in the combination group when compared to other groups. At end-of-treatment, positive correlations were found in the increased FC at left inferior frontal gyrus and clinically significant improvements in measured BTT (r = 0.858, p < 0.001) and SIT (r = 0.548, p = 0.042) scores for the combination group. Conclusions: Short-course oral VitA and aerosolised diffuser OT was effective as a combination treatment for persistent OD in long COVID.


Persistent Identifierhttp://hdl.handle.net/10722/331365
ISSN
2023 Impact Factor: 2.7
2023 SCImago Journal Rankings: 0.796
ISI Accession Number ID

 

DC FieldValueLanguage
dc.contributor.authorChung, TWH-
dc.contributor.authorZhang, H-
dc.contributor.authorWong, FKC-
dc.contributor.authorSridhar, S-
dc.contributor.authorLee, TMC-
dc.contributor.authorLeung, GKK-
dc.contributor.authorChan, KH-
dc.contributor.authorLau, KK-
dc.contributor.authorTam, AR-
dc.contributor.authorHo, DTY-
dc.contributor.authorCheng, VCC-
dc.contributor.authorYuen, KY-
dc.contributor.authorHung, IFN-
dc.contributor.authorMak, HKF-
dc.date.accessioned2023-09-21T06:55:06Z-
dc.date.available2023-09-21T06:55:06Z-
dc.date.issued2023-06-30-
dc.identifier.citationBrain Sciences, 2023, v. 13, n. 7-
dc.identifier.issn2076-3425-
dc.identifier.urihttp://hdl.handle.net/10722/331365-
dc.description.abstract<p></p><p>Background: Olfactory dysfunction (OD) is a common neurosensory manifestation in long COVID. An effective and safe treatment against COVID-19-related OD is needed. Methods: This pilot trial recruited long COVID patients with persistent OD. Participants were randomly assigned to receive short-course (14 days) oral vitamin A (VitA; 25,000 IU per day) and aerosolised diffuser olfactory training (OT) thrice daily (combination), OT alone (standard care), or observation (control) for 4 weeks. The primary outcome was differences in olfactory function by butanol threshold tests (BTT) between baseline and end-of-treatment. Secondary outcomes included smell identification tests (SIT), structural MRI brain, and serial seed-based functional connectivity (FC) analyses in the olfactory cortical network by resting-state functional MRI (rs-fMRI). Results: A total of 24 participants were randomly assigned to receive either combination treatment (n = 10), standard care (n = 9), or control (n = 5). Median OD duration was 157 days (IQR 127-175). Mean baseline BTT score was 2.3 (SD 1.1). At end-of-treatment, mean BTT scores were significantly higher for the combination group than control (p < 0.001, MD = 4.4, 95% CI 1.7 to 7.2) and standard care (p = 0.009) groups. Interval SIT scores increased significantly (p = 0.009) in the combination group. rs-fMRI showed significantly higher FC in the combination group when compared to other groups. At end-of-treatment, positive correlations were found in the increased FC at left inferior frontal gyrus and clinically significant improvements in measured BTT (r = 0.858, p < 0.001) and SIT (r = 0.548, p = 0.042) scores for the combination group. Conclusions: Short-course oral VitA and aerosolised diffuser OT was effective as a combination treatment for persistent OD in long COVID.<br></p>-
dc.languageeng-
dc.publisherMDPI-
dc.relation.ispartofBrain Sciences-
dc.rightsThis work is licensed under a Creative Commons Attribution-NonCommercial-NoDerivatives 4.0 International License.-
dc.subjectaerosolised-
dc.subjectanosmia-
dc.subjectfunctional brain network-
dc.subjectlong COVID-
dc.subjectolfactory dysfunction-
dc.subjectolfactory training-
dc.subjectresting-state fMRI-
dc.subjectsmell loss-
dc.subjectvitamin A-
dc.titleA Pilot Study of Short-Course Oral Vitamin A and Aerosolised Diffuser Olfactory Training for the Treatment of Smell Loss in Long COVID-
dc.typeArticle-
dc.identifier.doi10.3390/brainsci13071014-
dc.identifier.scopuseid_2-s2.0-85166433007-
dc.identifier.volume13-
dc.identifier.issue7-
dc.identifier.eissn2076-3425-
dc.identifier.isiWOS:001035241100001-
dc.identifier.issnl2076-3425-

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