Clinical Olfactory Working Group consensus statement on the treatment of postinfectious olfactory dysfunction
Clinical Olfactory Working Group consensus statement on the treatment of postinfectious olfactory dysfunction
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DOI：
10.1016/j.jaci.2020.12.641
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发表时间：
2021-05-05
影响因子：
14.2
通讯作者：
Philpott, Carl M.
中科院分区：
文献类型：
--
作者：
Addison, Alfred B.;Wong, Billy;Philpott, Carl M.
背景：呼吸道病毒是嗅觉功能障碍的第二大常见原因。随着我们对严重急性呼吸综合征冠状病毒2 （SARS-CoV-2）的影响了解得越来越多，并认识到嗅觉功能障碍是该疾病过程的一个关键症状，因此比以往任何时候都更需要以证据为基础的感染后嗅觉功能障碍（PIOD）管理。目的：我们的目的是为初级保健医生和医院专家提供基于证据的PIOD管理指南（包括2019冠状病毒后病例）。方法：对可用于PIOD管理的治疗方案进行系统回顾。然后，在圆桌专家讨论治疗方案之前，书面系统评价在临床嗅觉工作组成员中分发，供他们仔细阅读。该小组还进行了一项调查，以确定他们目前在治疗PIOD方面的临床实践。结果：检索结果为467条引用，其中107篇文章被全面审查并分析其合格性；40篇文献符合纳入标准，其中11篇为随机对照试验。总共有15篇文章专门研究了PIOD，而其他25篇文章包括了嗅觉功能障碍的其他病因。结论：临床嗅觉工作组成员对嗅觉训练提出了压倒性的建议；没有人推荐单环素类抗生素。讨论了口服类固醇的诊断作用；一些小组成员支持维生素A滴剂。需要进一步的研究来确认其他治疗选择的地位。[J] .中华过敏症杂志，2011;47:1509 - 1509。
Background: Respiratory tract viruses are the second most common cause of olfactory dysfunction. As we learn more about the effects of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), with the recognition that olfactory dysfunction is a key symptom of this disease process, there is a greater need than ever for evidence-based management of postinfectious olfactory dysfunction (PIOD).Objective: Our aim was to provide an evidence-based practical guide to the management of PIOD (including post-coronavirus 2019 cases) for both primary care practitioners and hospital specialists.Methods: A systematic review of the treatment options available for the management of PIOD was performed. The written systematic review was then circulated among the members of the Clinical Olfactory Working Group for their perusal before roundtable expert discussion of the treatment options. The group also undertook a survey to determine their current clinical practice with regard to treatment of PIOD. Results: The search resulted in 467 citations, of which 107 articles were fully reviewed and analyzed for eligibility; 40 citations fulfilled the inclusion criteria, 11 of which were randomized controlled trials. In total, 15 of the articles specifically looked at PIOD whereas the other 25 included other etiologies for olfactory dysfunction.Conclusions: The Clinical Olfactory Working Group members made an overwhelming recommendation for olfactory training; none recommended monocycline antibiotics. The diagnostic role of oral steroids was discussed; some group members were in favor of vitamin A drops. Further research is needed to confirm the place of other therapeutic options. (J Allergy Clin Immunol 2021;147:1704-19.)