Management of new onset anosmia during the COVID pandemic - BRS
Consensus Guidelines
Abstract
Objectives The primary aim of the study is to provide recommendations
for the investigation and management of patients with new onset anosmia
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 imaging.
Setting and participants An expert panel consistent 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 anosmia
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 anosmia of
more than 2 weeks duration, and oral steroids, steroid rinses and omega
3 supplements may be considered on an individual basis. Recommendations
have been made 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 anosmia. The
guideline may evolve as our experience of COVID-19 develops.