Novel Protocol Using a Comprehensive Training ‘N’ Treatment (TNT) Approach Rapidly Reverses Olfactory and Gustatory Dysfunction in Patients with Acute Loss of Taste and Smell Induced by SARS-CoV-2 Infection

{ 'institution': [{'name': 'Research Square'}], 'indexed': {'date-parts': [[2023, 3, 22]], 'date-time': '2023-03-22T05:14:37Z', 'timestamp': 1679462077877}, 'posted': {'date-parts': [[2023, 3, 21]]}, 'group-title': 'In Review', 'reference-count': 51, 'publisher': 'Research Square Platform LLC', 'license': [ { 'start': { 'date-parts': [[2023, 3, 21]], 'date-time': '2023-03-21T00:00:00Z', 'timestamp': 1679356800000}, 'content-version': 'unspecified', 'delay-in-days': 0, 'URL': 'https://creativecommons.org/licenses/by/4.0/'}], 'content-domain': {'domain': [], 'crossmark-restriction': False}, 'accepted': {'date-parts': [[2023, 3, 16]]}, 'abstract': '<jats:title>Abstract</jats:title>\n' ' <jats:p>Infection with SARS-CoV-2 causes COVID-19 and has a well-established set of ' 'clinical symptoms. Olfactory and gustatory dysfunction are among the non-life threatening ' 'sequalae observed with both acute and chronic SARS-CoV-2 infection. This can lead to the loss ' 'of taste and smell and has been observed in large subsets of COVID-19 patients. Although ' 'non-life threatening, loss of taste and smell can contribute to decreased quality of life and ' 'prevent sufficient nutrient intake, which may negatively affect prognosis and recovery. ' 'Despite progress in the treatment of other symptoms caused by COVID-19, there are currently ' 'no standardized treatment protocols to mitigate loss of taste and smell caused by SARS-CoV-2 ' 'infection and most approaches thus far have evaluated sensory training and regimen-based ' 'treatment strategies independently. In this retrospective case series, we demonstrate the ' 'effectiveness of a comprehensive, combined treatment protocol for COVID-19-induced taste and ' 'smell dysfunction using olfactory and gustatory training in combination with vitamins and ' 'supplements, nasal irrigations, nerve stimulation exercises, and anti-inflammatory ' 'prophylaxis. Acutely infected patients with COVID-19-related loss of taste and smell were ' 'given a daily regimen of zinc, vitamin A, B-complex, vitamin D, and alpha lipoic acid in ' 'addition to saline nasal irrigation, fluticasone spray, nerve stimulation exercises, and ' 'repeated olfactory-gustatory training. Triamcinalone paste, theophylline, and prednisone were ' 'included daily with the observation of partial recovery. At two timepoints over approximately ' '20–37 days of treatment, taste and smell scores were quantified based on detection of agents ' 'included on each sensory training panel. Following this novel and comprehensive “Training ‘N’ ' 'Treatment” (TNT) protocol, every patient exhibited a complete recovery of taste and smell. ' 'Given the potential to provide relief to the many people with olfactory and gustatory ' 'dysfunction following SARS-CoV-2 infection, the effectiveness of this protocol warrants ' 'validation in a larger study.</jats:p>', 'DOI': '10.21203/rs.3.rs-2702282/v1', 'type': 'posted-content', 'created': {'date-parts': [[2023, 3, 21]], 'date-time': '2023-03-21T14:12:18Z', 'timestamp': 1679407938000}, 'source': 'Crossref', 'is-referenced-by-count': 0, 'title': 'Novel Protocol Using a Comprehensive Training ‘N’ Treatment (TNT) Approach Rapidly Reverses ' 'Olfactory and Gustatory Dysfunction in Patients with Acute Loss of Taste and Smell Induced by ' 'SARS-CoV-2 Infection', 'prefix': '10.21203', 'author': [ { 'ORCID': 'http://orcid.org/0000-0002-9323-9437', 'authenticated-orcid': False, 'given': 'Nicholas A.', 'family': 'Young', 'sequence': 'first', 'affiliation': [{'name': 'Private Health Management'}]}, { 'ORCID': 'http://orcid.org/0000-0002-9165-0804', 'authenticated-orcid': False, 'given': 'Caralee', 'family': 'Skaggs', 'sequence': 'additional', 'affiliation': [{'name': 'Private Health Management'}]}, { 'ORCID': 'http://orcid.org/0000-0003-2426-4281', 'authenticated-orcid': False, 'given': 'Frances', 'family': 'Tran', 'sequence': 'additional', 'affiliation': [{'name': 'Private Health Management'}]}, { 'ORCID': 'http://orcid.org/0000-0002-9503-9199', 'authenticated-orcid': False, 'given': 'Sara', 'family': 'Murray', 'sequence': 'additional', 'affiliation': [{'name': 'Private Health Management'}]}, { 'ORCID': 'http://orcid.org/0000-0001-5810-4425', 'authenticated-orcid': False, 'given': 'Montana Kay', 'family': 'Lara', 'sequence': 'additional', 'affiliation': [{'name': 'Private Health Management'}]}, { 'ORCID': 'http://orcid.org/0000-0001-7501-3322', 'authenticated-orcid': False, 'given': 'Trevor H.', 'family': 'Wolf', 'sequence': 'additional', 'affiliation': [{'name': 'Private Health Management'}]}, { 'ORCID': 'http://orcid.org/0000-0003-4438-2314', 'authenticated-orcid': False, 'given': 'Tamiem', 'family': 'Popal', 'sequence': 'additional', 'affiliation': [{'name': 'Private Health Management'}]}, { 'ORCID': 'http://orcid.org/0000-0003-0067-5684', 'authenticated-orcid': False, 'given': 'Keighley', 'family': 'Reisenauer', 'sequence': 'additional', 'affiliation': [{'name': 'Private Health Management'}]}, { 'ORCID': 'http://orcid.org/0000-0001-6588-313X', 'authenticated-orcid': False, 'given': 'Nikki', 'family': 'Osgood', 'sequence': 'additional', 'affiliation': [{'name': 'Simon Medical Services'}]}, { 'ORCID': 'http://orcid.org/0000-0003-1762-1914', 'authenticated-orcid': False, 'given': 'Ikeca', 'family': 'Betzner', 'sequence': 'additional', 'affiliation': [{'name': 'Simon Medical Services'}]}, { 'ORCID': 'http://orcid.org/0000-0002-6484-6633', 'authenticated-orcid': False, 'given': 'Gregg', 'family': 'Britt', 'sequence': 'additional', 'affiliation': [{'name': 'Private Health Management'}]}, { 'ORCID': 'http://orcid.org/0000-0003-2362-3641', 'authenticated-orcid': False, 'given': 'Jennifer', 'family': 'Pena', 'sequence': 'additional', 'affiliation': [{'name': 'Private Health Management'}]}, { 'ORCID': 'http://orcid.org/0000-0003-4478-6490', 'authenticated-orcid': False, 'given': 'Eva', 'family': 'Gordon', 'sequence': 'additional', 'affiliation': [{'name': 'Private Health Management'}]}, { 'ORCID': 'http://orcid.org/0000-0003-1090-6626', 'authenticated-orcid': False, 'given': 'Robert', 'family': 'Simon', 'sequence': 'additional', 'affiliation': [ { 'name': 'Private Health Management, Simon Medical Services, Rush ' 'University Medical Center'}]}], 'member': '8761', 'reference': [ { 'key': 'ref1', 'first-page': '103352', 'article-title': 'Olfactory dysfunction as a post-infectious symptom of SARS-CoV-2 ' 'infection', 'volume': '75', 'author': 'Othman BA', 'year': '2022', 'unstructured': 'Othman, B.A., et al., Olfactory dysfunction as a post-infectious symptom ' 'of SARS-CoV-2 infection. 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