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Web-application guided bimodal olfactory training for COVID-19 patients: a randomized trial

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C. Vandersteen - M. Payne - C. Becker - S. Bernier - A. Derreumaux - N. Guevara - L. Castillo - A. Plonka - V. Manera - X. Fernandez - A. Gros

DOI: 10.4193/Rhin24.273

BACKGROUND: Many Post-Acute COVID-19 Syndrome (PACS) patients continue to experience persistent dysosmia up to two years post-pandemic. Cognitive and semantic memory functions, along with olfactory associative areas, may be affected in PACS without olfactory recovery. Visual-olfactory bimodal olfactory training may stimulate these areas. This study evaluates the olfactory recovery using a new bi-modal training kit, MaMadeleine™, assisted by a web application. METHODOLOGY: A prospective randomised study (Nov 2021–June 2022) included PACS patients aged ≥14 with post-infectious olfactory dysfunction. Patients were randomized for two months of simple (A) or semantic (B) visual-olfactory training. Evaluations included clinical assessments, Sniffin’ Sticks Tests, and quality-of-life questionnaires. Adherence to treatment was monitored via the web application. RESULTS: We
included 83 patients, on average 13±5.6 months after COVID-19. Olfactory training using MaMadeleine™ led to subjective orthoand retro-nasal olfactory improvement in 79.4% (n=58) and 58.9% (n=43) of patients, respectively, with Sniffin’ Sticks Test scores
increasing from 26.5±7.5 to 29.1±7.4. Both groups saw a 20% decrease in parosmia and phantosmia. No significant differences in recovery were observed between groups, although exploratory findings in a small subgroup (n=10) with semantic memory
impairment suggest a possible benefit of bimodal training, warranting further investigation. Quality of life improved significantly in both groups. Adherence was better in group B than in group A. CONCLUSIONS: MaMadeleine™ training improves subjective olfactory function, psychophysical test results, and quality of life in PACS patients with olfactory dysfunction. Multimodal training enhances adherence. Further studies are needed in semantic memory-impaired patients.

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