Do Intranasal corticosteroids prevent loss of smell/ taste in Covid-19 mediated chronic rhinosinusitis?

Intranasal corticosteroids (INC) appeared protective against the loss in smell and/or taste reported during COVID-19 and did not exacerbate the clinical course of COVID-19 in participants with chronic rhinitis (CR), says an article published in Allergy and Asthma Proceedings.

The therapeutic effects of intranasal corticosteroids on nasal symptoms and the clinical course of coronavirus disease 2019 (COVID-19) in chronic rhinitis patients appear to be unknown. Can Tuzer and colleagues conducted this study to assess the therapeutic effects of INCs on nasal symptoms in participants with CR and COVID-19.

For this study quality of life and nasal symptoms were measured in participants with CR and diagnosed with COVID-19 at four tertiary centers using the 22-item Sino-Nasal Outcome Test (SNOT-22) and the visual analogue scale (VAS), respectively. Nasal symptoms were also measured on the total symptom score-6 (TSS-6) scale in participants with allergic rhinitis. After that, the participants were divided into two groups according to whether or not they used INCs when afflicted with the acute respiratory syndrome, sars syndrome coronavirus 2 (group 1 and group 2, respectively). The participants in Group 2 were separated into two categories based on whether or not they used antihistamines and/or leukotriene receptor antagonists (group 2a and group 2b, respectively). All three groups' scores were compared before and throughout COVID-19.

The key findings of this study were as follow:

1. A total of 71 patients were enrolled (21 in group 1, 24 in group 2a, and 26 in group 2b).

2. When compared to the preCOVID-19 values, the overall SNOT-22 scores grew dramatically in all groups during the infection (p 0.001 in each group).

3. The difference between preCOVID-19 and COVID-19 values, on the other hand, demonstrated a lesser decline in the perceptions of smell and/or taste in group 1 than in groups 2a and 2b (p = 0.015, adjusted p = 0.045; and p = 0.001, adjusted p = 0.002, respectively).

4. Other COVID-19 results, VAS, and TSS-6 ratings did not change significantly across groups (all p > 0.05).

In conclusion, the researchers found that patients with CR who also have COVID-19 can take INCs to successfully avoid decreased taste and/or smell, with no negative influence on COVID-19 clinical outcomes or severity.

Reference: 

Tuzer, C., Karadag, P., Yegit, O., Eyice, D., Oztop, N., Can, A., Demir, S., Coskun, R., Erdogdu Unal, D., Olgac, M., Buyukozturk, S., Colakoglu, B., & Gelincik, A. (2022). Clinical effects of intranasal corticosteroids on nasal symptoms in subjects with chronic rhinitis during COVID-19. In Allergy and Asthma Proceedings (Vol. 43, Issue 2, pp. 106–115). Oceanside Publications Inc. https://doi.org/10.2500/aap.2022.43.210116