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Therapeutic effects of olfactory training and systemic vitamin A in patients with COVID-19-related olfactory dysfunction: a double-blinded randomized controlled clinical trial

Taheri et al., Brazilian Journal of Otorhinolaryngology, doi:10.1016/j.bjorl.2024.101451
Jun 2024  
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0 0.5 1 1.5 2+ Recovery, 12 months 38% Improvement Relative Risk Recovery, 3 months 43% Anosmia, 12 months 67% Anosmia, 3 months 86% Anosmia/severe hyposmia.. 89% Anosmia/severe hypo.. (b) 89% Vitamin A  Taheri et al.  LATE TREATMENT  DB RCT Is late treatment with vitamin A beneficial for COVID-19? Double-blind RCT 60 patients in Iran (March 2020 - March 2021) Improved recovery with vitamin A (not stat. sig., p=0.53) c19early.org Taheri et al., Brazilian J. Otorhinola.., Jun 2024 Favors vitamin A Favors control
Vitamin A for COVID-19
41st treatment shown to reduce risk in June 2023
 
*, now known with p = 0.021 from 14 studies.
Lower risk for recovery and cases.
No treatment is 100% effective. Protocols combine complementary and synergistic treatments. * >10% efficacy in meta analysis with ≥3 clinical studies.
4,200+ studies for 70+ treatments. c19early.org
RCT 90 outpatients with post-COVID-19 anosmia showing significant improvements in smell alterations with olfactory training after 3 and 12 months. Adding oral vitamin A to olfactory training resulted in higher rates of improvement, but the difference was not statistically significant.
risk of no recovery, 37.5% lower, RR 0.62, p = 0.53, treatment 5 of 30 (16.7%), control 8 of 30 (26.7%), NNT 10.0, 12 months.
risk of no recovery, 42.9% lower, RR 0.57, p = 0.51, treatment 4 of 30 (13.3%), control 7 of 30 (23.3%), NNT 10.0, 3 months.
risk of anosmia, 66.7% lower, RR 0.33, p = 1.00, treatment 0 of 30 (0.0%), control 1 of 30 (3.3%), NNT 30, relative risk is not 0 because of continuity correction due to zero events (with reciprocal of the contrasting arm), 12 months.
risk of anosmia, 85.7% lower, RR 0.14, p = 0.24, treatment 0 of 30 (0.0%), control 3 of 30 (10.0%), NNT 10.0, relative risk is not 0 because of continuity correction due to zero events (with reciprocal of the contrasting arm), 3 months.
risk of anosmia/severe hyposmia, 88.9% lower, RR 0.11, p = 0.11, treatment 0 of 30 (0.0%), control 4 of 30 (13.3%), NNT 7.5, relative risk is not 0 because of continuity correction due to zero events (with reciprocal of the contrasting arm), 12 months.
risk of anosmia/severe hyposmia, 88.9% lower, RR 0.11, p = 0.11, treatment 0 of 30 (0.0%), control 4 of 30 (13.3%), NNT 7.5, relative risk is not 0 because of continuity correction due to zero events (with reciprocal of the contrasting arm), 3 months.
Effect extraction follows pre-specified rules prioritizing more serious outcomes. Submit updates
Taheri et al., 3 Jun 2024, Double Blind Randomized Controlled Trial, placebo-controlled, Iran, peer-reviewed, 6 authors, study period March 2020 - March 2021, post-COVID anosmia. Contact: aborey110@gmail.com.
This PaperVitamin AAll
Therapeutic effects of olfactory training and systemic vitamin A in patients with COVID-19-related olfactory dysfunction: a double-blinded randomized controlled clinical trial
Abolfazl Taheri, Maryam Naderi, Nematollah Jonaidi Jafari, Hamid Emadi Koochak, Mohsen Saberi Esfeedvajani, Reyhaneh Abolghasemi
Brazilian Journal of Otorhinolaryngology, doi:10.1016/j.bjorl.2024.101451
Three-months olfactory training is effective to treat the COVID-19-related anosmia. • Daily oral vitamin A did not lead to better results in improving anosmia. • The intervention time was important in the final olfactory status of the patients.
Authors' contributions Dr. A. T is the main manager. He had the main rule in the of conceptualization and investigation in the research. Dr. M. N had the main role in data curation and writing the original draft of the manuscript. Dr. M. S helped in formal analysis. Dr. N. J. J and Dr. H. E. K were the project consultants and helped in methodology and data curation. Dr. R. A helped in validation, reviewing, and editing the manuscript. Conflicts of interest The authors declare no conflicts of interest. Declarations Consent for publication: Not applicable.
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Late treatment
is less effective
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