Skip to main navigation
Skip notifications
Access to POEMs and Essential Evidence Plus will no longer be included in CMA membership as of Dec. 1, 2023.
Search
Nasal steroid treatment speeds return of smell but not the overall rate of olfactory recovery
Clinical Question
Is a topical corticosteroid effective to restore a lost sense of smell in patients with COVID-19?
Bottom line
Treatment with an inhaled corticosteroid may speed the return of olfactory function but does not affect the overall rate of recovery of one's sense of smell. 1a-
Reference
Study design: Meta-analysis (other)
Funding: Government
Setting: Various (meta-analysis)
Synopsis
The authors searched 5 databases and Google Scholar and identified 4 randomized trials and one prospective study (N = 696 patients) that evaluated the impact of an intranasal steroid on loss of smell (anosmia/hyposmia) following COVID-19 infection. Two investigators independently selected the studies for inclusion. The risk of bias in the randomized studies was high for one of the studies, and the studies used different outcome measures, which the researchers converted into standardized mean differences. There was moderate benefit on olfactory scores at 2 weeks and 4 weeks after treatment with steroid treatment, with substantial heterogeneity among the studies. However, there was no difference in the incidence of full recovery with or without treatment.
Reviewer
Allen F. Shaughnessy, PharmD, MMedEd
Professor of Family Medicine
Tufts University
Boston, MA
Comments
Intranasal steroids
they are likely not recommended in loss of smell from Covid
Full recovery
I want to know more. What does full recovery mean and how does one measure it ?
Nasal steroid treatment speeds return of smell but not the o
The above title and the following statement by the reviewer are misleading. "Treatment with an inhaled corticosteroid may speed the return of olfactory function but does not affect the overall rate of recovery of one's sense of smell. "Speed of return of olfactory function" and "rate of recovery of one's sense of smell" mean the same thing, yet the title and reviewer comments say they are different. These two conclusions obviously cannot both be true. Forced to look up the original manuscript it turns out the latter conclusion is actually meant to convey the overall proportion of patients who regain full olfactory function. The paper is poorly written but so is the review. I'm not using this review or the paper for anything.
Contradictory information.
Quote Title" "NASAL steroid treatment speeds return of smell but not the overall rate of olfactory recovery"
Quote Bottom Line: "Treatment with an INHALED corticosteroid may speed the return of olfactory function but does not affect the overall rate of recovery of one's sense of smell. "
Besides the obvious (underscored) mistake, the two sentences state the exact opposite.