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Effectiveness of Corticosteroid Therapy in COVID-19 Induced Olfactory Dysfunction: a systematic review and meta-analysis of Randomized Controlled Trials.
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  • Syed Muhammad Mehdi Zaidi,
  • Shozab Naeem,
  • Muhammad Shuraim Chola,
  • Muhammad Hasan Ashraf,
  • Lamea bint Sahban,
  • Syed Muhammad Ali Masood,
  • Muhammad Saad Choudhry MD,
  • Laiba Naseem,
  • Sabir Ali,
  • Muhammad Rauhaan Ahmed,
  • Muhammad Talha Khan
Syed Muhammad Mehdi Zaidi
Dow University of Health Sciences

Corresponding Author:mehdi.zaidi389@gmail.com

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Shozab Naeem
Dow University of Health Sciences
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Muhammad Shuraim Chola
Dow University of Health Sciences
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Muhammad Hasan Ashraf
Dow University of Health Sciences
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Lamea bint Sahban
Jinnah Sindh Medical University
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Syed Muhammad Ali Masood
Dow University of Health Sciences
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Muhammad Saad Choudhry MD
Dow University of Health Sciences
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Laiba Naseem
Dow University of Health Sciences
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Sabir Ali
Dow University of Health Sciences
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Muhammad Rauhaan Ahmed
Dow University of Health Sciences
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Muhammad Talha Khan
Dow University of Health Sciences
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Abstract

Introduction: Covid-19 has been strongly associated with the loss of smell also known as anosmia. It is one of the first symptoms experienced by patients who encounter covid-19. The condition has been reported to have a detrimental impact on psychological and emotional well-being, physical health, and relationships thus compromising the quality of life. Various reasons have been proposed to justify the cause of anosmia, with apoptosis of olfactory cells and inflammation of the mucosa amongst a few. The following study aims to shed light on the efficacy of intranasal corticosteroids in the treatment of these conditions.  Methods: From their inception to 20 May 2023, a complete search of electronic databases including PubMed, MEDLINE, Scopus, and Cochrane was conducted to look for studies consisting of data regarding short-term or long-term anosmia in COVID-19 patient populations who were treated using intra-nasal corticosteroids.After a rigorous process of study selection, 7 studies were shortlisted and utilized to conduct a meta-analysis. Results: The improvement in the olfactory score at 2 and 4 weeks was statistically higher in the treatment group (Standard Mean Difference [SMD]= 1.01 [0.07, 1.94], p-value= 0.03) as compared to the control group (SMD = 1.25 [0.78, 1.73], P = 0.00004). However, the results in the 4 weeks group were not significant. Similarly, the effect of corticosteroids in patients in whom anosmia lasted for more than 4 weeks also turned out to be insignificant (SMD = 0.51 [-0.12, 1.14], a p-value of 0.11, I2 =78%). According to the subgroup analysis, there were no significant differences in the efficacy of corticosteroids in short and long-term anosmia (RR = 1.26 [0.83, 1.92] and 1.57 [0.04, 70.02], p-value = 0.13).  Conclusion: As per the findings of the meta-analysis, corticosteroids do play a role in the improvement of the olfactory dysfunction caused by COVID-19. However, there was no difference in their efficacy for the treatment of short-term versus long-term anosmia patients.