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85% of COVID-19 patients and are often some Material and Methods
of the earliest and most specific indicators Sample enrollment and evaluation
of infection . Although initially assumed as Patients who attended the Otorhinolaryngology
3
transient by many authors it is now known Department's smell and taste clinic at Centro
4,5
that about 15% of infected patients do not Hospitalar Universitário de Santo António
recover for several months . Then, many were evaluated for eligibility. Data related
5,6
COVID-19 patients may experience long-term to anamnesis and physical examination
changes in their smell and taste perception, was collected according to the institutional
which adds to the ongoing burden of protocol described elsewhere .
1
long COVID-19 . Certainly, this underlooked The inclusion criteria were: age ≥18 years, abrupt
7
“olfactory pandemic” persists nowadays and onset of olfactory impairment coincident with
calls to be combated. With the former in mind, SARSCoV-2 infection verified by nasal swab
unravelling treatment solutions for long-lasting and Polymerase Chain Reaction technique
olfactory impairment has never seemed more (PCR), subjective persistence of pCIOD ≥
urgent. Various therapeutic modalities have 12 months, objective olfactory perception
1
been suggested to treat persistent COVID-19 threshold (OPT) ≤ 7 at the time of PRP
induced olfactory dysfunction (pCIOD) . These injection, having performed olfactory training
1,8
include topical nasal corticosteroids, intranasal and adjuvant therapy without achieving
vitamin A + E , vitamin B complex tablets, substantial improvement (measured by at
among others . Nevertheless, besides olfactory least two consecutive 3 months apart OPT
1
training, no adjuvant therapy has unequivocally evaluations) and cognitive ability to sign
shown benefit . Recently, a novel approach informed consent. Exclusion criteria were
1,8
for treating persistent olfactory dysfunction as follows: Chronic rhinosinusitis, history of
has been described : injection of platelet rich head trauma with loss of consciousness,
plasma (PRP) into the olfactory mucosa 9,10 . documented pre-existing olfactory
PRP is an autologous blood product dysfunction before COVID-19, pregnancy,
containing supraphysiologic levels of growth previous neurosurgery or endoscopic nasal
factors and cytokines 11,12 . It has been shown surgery, known olfactory bulb lesions on
to promote tissue regeneration and repair imaging, known neurologic disease (Parkinson's,
and has been medically used in various Dementia, Epilepsy), major psychiatric disease,
clinical scenarios, such as in osteoarticular inability to tolerate nasal endoscopy, known
pathology, skin rejuvenation, wound healing, platelet or coagulation disorders, undergoing
and hair regrowth 11,12 . PRP injection was anti-inflammatory or anticoagulant therapy,
proposed as a potential new therapy for and concurrent pathology presumably needing
olfactory dysfunction treatment in 2019, when anti-inflammatory treatment in the next 30 days
Yan et al brought the first pilot study with following injection.
preliminary promising results . The same A visual analog scale (VAS) was used to
9
group published the first randomized trial on subjectively assess olfactory impairment on
PRP application in late 2022, with favorable a scale from 0 to 10, with participants asked
results The main objective of this work is to to rate their satisfaction with their smell
10.
describe the resulting olfactory outcomes of and taste function (10 indicating a return to
pCIOD patients submitted to PRP injection normal). This measurement was taken at
while addressing any possible ensuing three time points: immediately before the
complications. A distinctive, customized injection, one month after, and three months
protocol was developed at the smell and taste after the injection. The olfactory perception
consultation of Centro Hospitalar Universitário threshold (OPT) was measured in the same
de Santo António, and its implementation is time points by means of Burghart Sniffin'
outlined as follows. Sticks n-butanol threshold test with 16 levels
346 Revista Portuguesa de Otorrinolaringologia - Cirurgia de Cabeça e Pescoço
