Hopkins, Claire, Alanin, Mikkel, Philpott, Carl, Harries, Phil, Whitcroft, Katherine, Qureishi, Ali, Anari, Shahram, Ramakrishnan, Yujay, Sama, Anshul, Davies, Elgan, Stew, Ben, Gane, Simon, Carrie, Sean, Hathorn, Iain, Bhalla, Raj, Kelly, Chrissi, Hill, Nina, Boak, Duncan and Nirmal Kumar, B.
(2021)
Management of new onset loss of sense of smell during the COVID-19 pandemic - BRS Consensus Guidelines.
Clinical Otolaryngology, 46 (1).
pp. 16-22.
ISSN 1749-4478
Abstract
OBJECTIVES: The primary aim of the study is to provide recommendations for the investigation and management of patients with new onset loss of sense of smell during the COVID-19 pandemic. DESIGN: After undertaking a literature review, we used the RAND/UCLA methodology with a multi-step process to reach consensus about treatment options, onward referral, and imaging. SETTING AND PARTICIPANTS: An expert panel consisting of 15 members was assembled. A literature review was undertaken prior to the study and evidence was summarised for the panellists. MAIN OUTCOME MEASURES: The panel undertook a process of ranking and classifying appropriateness of different investigations and treatment options for new onset loss of sense of smell during the COVID-19 pandemic. Using a 9-point Likert scale, panellists scored whether a treatment was: Not recommended, optional, or recommended. Consensus was achieved when more than 70% of responses fell into the category defined by the mean. RESULTS: Consensus was reached on the majority of statements after 2 rounds of ranking. Disagreement meant no recommendation was made regarding one treatment, using Vitamin A drops. Alpha-lipoic acid was not recommended, olfactory training was recommended for all patients with persistent loss of sense of smell of more than 2 weeks duration, and oral steroids, steroid rinses, and omega 3 supplements may be considered on an individual basis. Recommendations regarding the need for referral and investigation have been made. CONCLUSION: This study identified the appropriateness of olfactory training, different medical treatment options, referral guidelines and imaging for patients with COVID-19-related loss of sense of smell. The guideline may evolve as our experience of COVID-19 develops.
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