Affiliation:
1. Department of Anesthesiology and Perioperative Medicine, Shanghai Key Laboratory of Anesthesiology and Brain Functional Modulation, Clinical Research Center for Anesthesiology and Perioperative Medicine, Translational Research Institute of Brain and Brain-Like Intelligence, Shanghai Fourth People’s Hospital, School of Medicine, Tongji University , Shanghai 200434, China
2. Department of Medical Statistics, Tongji University School of Medicine , Shanghai 200092, China
Abstract
Summary
Background
Olfactory and gustatory dysfunctions (OGDs) are key symptoms of coronavirus disease 2019 (COVID-19), which may lead to neurological complications, and lack of effective treatment. This may be because post-disease treatments may be too late to protect the olfactory and gustatory functions.
Aim
To evaluate the effectiveness of early use of saline nasal irrigation (SNI), corticosteroid nasal spray, and saline or chlorhexidine gluconate mouthwash for preventing OGDs in COVID-19.
Design
This study was a double-blind randomized controlled trial.
Methods
The study was conducted from 5 May to 16 June 2022. We recruited patients from three hospitals who were admitted with COVID-19 but without OGDs on the day of admission. Olfactory and gustatory functions were evaluated using the Taste and Smell Survey and the numerical visual analog scale. Participants were randomized to the saline, drug or control groups. The control group received no intervention, saline group received SNI plus saline nasal spray and mouthwash, and the trial group received SNI plus budesonide nasal spray and chlorhexidine gluconate mouthwash. Participants were assessed again on the day of discharge.
Results
A total of 379 patients completed the trial. The prevalence of OGDs was significantly lower in the saline (11.8%, 95% CI, 6.6–19.0%; P < 0.001) and drug (8.3%, 95% CI, 4.1–14.8%; P < 0.001) groups than in the control group (40.0%, 95% CI, 31.8–48.6%). Additionally, both interventions reduced the severity of OGDs.
Conclusions
We demonstrated effective strategies for preventing COVID-19-related OGDs, and the findings may guide early management of severe acute respiratory disease coronavirus 2 (SARS-CoV-2) infection to reduce the incidence of COVID-19-related complications.
Funder
National Natural Science Foundation of China
Shanghai Municipal Committee of Science and Technology for Program of Shanghai Academic
Technology Research Leader
Shanghai Fourth People’s Hospital
School of Medicine
Publisher
Oxford University Press (OUP)