Clinical Olfactory Working Group Consensus Statement on the Treatment of Post Infectious Olfactory Dysfunction.

Addison, Alfred B; Wong, Billy; Ahmed, Tanzime; Macchi, Alberto; Konstantinidis, Iordanis; Huart, Caroline; Frasnelli, Johannes; Fjaeldstad, Alexander W; Ramakrishnan, Vijay R; Rombaux, Philippe; Whitcroft, Katherine L; Holbrook, Eric H; Poletti, Sophia C; Hsieh, Julien W; Landis, Basile N; Boardman, James; Welge-Lüssen, Antje; Maru, Devina; Hummel, Thomas; Philpott, Carl M

BACKGROUND Respiratory tract viruses are the second most common cause for olfactory dysfunction. As we learn more about the effects of the severe acute respiratory syndrome coronavirus (SARS-CoV-2), with the recognition that olfactory dysfunction is a key symptom of this disease process, there is now a greater need for evidence-based management for post infectious olfactory dysfunction (PIOD). OBJECTIVE To provide an evidence based practical guide to the management of PIOD (including post-covid cases) for both primary care practitioners and hospital specialists. METHODS A systematic review was performed on the treatment options available for the management of PIOD. The written systematic review was then circulated among the members of the Clinical Olfactory Working Group (COWoG) for their perusal prior to round table expert discussion of the treatment options. The group also undertook a survey to determine their current clinical practice with regards to treatment of PIOD. RESULTS The search resulted in 467 citations from which 107 articles were fully reviewed and analysed for eligibility; 40 citations fulfilled the inclusion criteria, 11 of which were randomised controlled trials. In total, 15 of the articles specifically looked at PIOD whilst the other 25 included other aetiologies for olfactory dysfunction. CONCLUSIONS The COWoG members made an overwhelming recommendation for olfactory training and none recommended monocycline antibiotics. The diagnostic role of oral steroids is discussed and there were some in favour of vitamin A drops. Further research is needed to confirm the place of other therapeutic options.