Effect of any form of steroids in comparison with that of other medications on the duration of olfactory dysfunction in patients with COVID-19: A systematic review of randomized trials and quasi-experimental studies
Phyo Zin Winn, Thein Hlaing, Kyaw Myo Tun, Seim Lei Lei
PLOS ONE, doi:10.1371/journal.pone.0288285
Background The life quality of about two-thirds of patients with COVID-19 is affected by related olfactory dysfunctions. The negative impact of olfactory dysfunction ranged from the decreased pleasure of eating to impaired quality of life. This research aimed to provide a comprehensive understanding of the effects of corticosteroid treatments by comparing that to other currently available treatments and interventions.
Methods The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) checklist's 27-point checklist was used to conduct this review. PubMed (Public/Publisher MEDLINE), PubMed Central and EMBASE (Excerpta Medica Database) databases were conveniently selected and Boolean search commands were used for a comprehensive literature search. Five core search terms were "effects of treatments", " COVID-19-related olfactory dysfunction", "corticosteroids", "treatments" and "interventions". The reporting qualities of the included studies were appraised using JBI (Joanna Briggs Institute) appraisal tools. The characteristics of the 21 experimental studies with a total sample (of 130,550) were aggregated using frequencies and percentages and presented descriptively. The main interventions and their effects on the duration of the COVID-19-related olfactory dysfunction were narratively analyzed.
Dissemination plan The full dissertation paper will be submitted to the libraries of the University of Bedfordshire, UK and STIMU, Myanmar. A short report of this review will be posted to the public through popular social media: Facebook and Twitter. The key findings of this study will be distributed to the members of the medical profession in Myanmar through the annual medical conference organized and held by the Myanmar Medical Association (MMA). Finally, as an academic research paper, the major processes and key outputs of this systematic review will also be published in the PLOS One, a peer-reviewed open-access scientific journal.
Administrative information The utilization of unauthorized intellectual properties is refrained by the authors. The whole paper is free from copying or stealing the ideas or artworks of other scholars, authors, and professional co-workers. This was the student dissertation work of Dr Phyo Zin Win which has been undertaken for the award of Master of Science in Public Health from the University of Bedfordshire (UK). The co-reviewer and supervisor had the responsibilities for designing the review, undertaking all processes of the systematic review and revising the manuscript together with the principal investigator. Another co-author had the responsibilities for selecting the studies per protocol, extracting the relevant data, and reviewing and editing the manuscript.
Supporting information S1
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'abstract': '<jats:sec id="sec001">\n'
'<jats:title>Background</jats:title>\n'
'<jats:p>The life quality of about two-thirds of patients with COVID-19 is affected by related '
'olfactory dysfunctions. The negative impact of olfactory dysfunction ranged from the '
'decreased pleasure of eating to impaired quality of life. This research aimed to provide a '
'comprehensive understanding of the effects of corticosteroid treatments by comparing that to '
'other currently available treatments and interventions.</jats:p>\n'
'</jats:sec>\n'
'<jats:sec id="sec002">\n'
'<jats:title>Methods</jats:title>\n'
'<jats:p>The Preferred Reporting Items for Systematic Reviews and Meta-Analyses (PRISMA) '
'checklist’s 27-point checklist was used to conduct this review. PubMed (Public/Publisher '
'MEDLINE), PubMed Central and EMBASE (Excerpta Medica Database) databases were conveniently '
'selected and Boolean search commands were used for a comprehensive literature search. Five '
'core search terms were "effects of treatments", " COVID-19-related olfactory dysfunction", '
'"corticosteroids", "treatments" and "interventions". The reporting qualities of the included '
'studies were appraised using JBI (Joanna Briggs Institute) appraisal tools. The '
'characteristics of the 21 experimental studies with a total sample (of 130,550) were '
'aggregated using frequencies and percentages and presented descriptively. The main '
'interventions and their effects on the duration of the COVID-19-related olfactory dysfunction '
'were narratively analyzed.</jats:p>\n'
'</jats:sec>\n'
'<jats:sec id="sec003">\n'
'<jats:title>Results</jats:title>\n'
'<jats:p>Among patients with COVID-19, the normal functions of the olfactory lobe were about '
'23 days earlier to gain with the treatments of fluticasone and triamcinolone acetonide nasal '
'spray compared with that of mometasone furoate nasal spray and oral corticosteroid. The smell '
'loss duration was reduced by fluticasone and triamcinolone acetonide nasal spray 9 days '
'earlier than the inflawell syrup and 16 days earlier than the lavender syrup. The nasal spray '
'of corticosteroids ended the COVID-19-related smell loss symptoms 2 days earlier than the '
'zinc supplementation, about 47 days earlier than carbamazepine treatment and was more '
'effective than palmitoylethanolamide (PEA) and luteolin and omega-3 supplementations and '
'olfactory training. Treatment with oral corticosteroid plus olfactory training significantly '
'improved Threshold, Discrimination and Identification (TDI) scores compared with olfactory '
'training alone. A full dose of the COVID-19 vaccination was not uncertain to reduce the '
'COVID-19-related smell loss duration.</jats:p>\n'
'</jats:sec>\n'
'<jats:sec id="sec004">\n'
'<jats:title>Conclusion</jats:title>\n'
'<jats:p>Corticosteroid treatment is effective in reducing the duration of COVID-19-related '
'smell loss and olfactory training, the basic, essential and effective intervention, should be '
'used as a combination therapy.</jats:p>\n'
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