Olfactory Training and Visual Stimulation Assisted by a Web-Application for Patients With Persistent Olfactory Dysfunction After SARS-CoV-2 Infection

Abstract IntroductionWe aimed to quantify the benefit of olfactory training and visual stimulation assisted by a dedicated web application for patients who experienced olfactory dysfunction for ≥1 month after Sars-Cov-2 infection and compared it with published cohorts of spontaneous recoveries.Materials and MethodsWe performed a prospective observational study. Participants performed olfactory training and visual stimulation assisted by a dedicated web-application. Improvement was defined as a 2-point increase on a 10-point, self-assessed olfactory visual analogue scale.ResultsIn total, 1155 patients were assessable. Improvement was observed in patients who trained 4 weeks and 4 to 8 weeks with high concentration oils in 63.0% (58/92) and 72.9% (137/188) respectively, whereas in historical cohorts, a spontaneous improvement was observed in 7% to 27% without training respectively (p<.001). The benefit was observed regardless of the duration of the olfactory dysfunction. No or mild toxicity was reported by 86.6% (662/764) of patients. Severe toxicity leading to stop training was reported in 0.5% of patients.ConclusionsOlfactory training and visual stimulation assisted by a dedicated web application seems to accelerate olfactive improvement in persistent olfactory dysfunction following SARS-CoV-2 infection, especially after 30 days of olfactory training. Maximal duration of training appeared to be 8 weeks.

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Olfactory training and visual stimulation assisted by web-application in patients with persistent olfactory dysfunction after SARS-CoV-2 infection: observational study. (Preprint)

10.2196/preprints.29583 ◽

2021 ◽

Author(s):

Fabrice Denis ◽

Anne-Lise Septans ◽

Lea Periers ◽

Jean-Michel Maillard ◽

Florian Legoff ◽

...

Keyword(s):

Web Application ◽

Primary Outcome ◽

Visual Stimulation ◽

Real Life ◽

Olfactory Dysfunction ◽

High Concentration ◽

Real Life Data ◽

The Mean ◽

Mean Time ◽

Olfactory Training

BACKGROUND Persistent olfactory dysfunction (OD) is a significant complication of SARS-CoV-2 infection. Olfactory training (OT) using aromatic oils are recommended to improve olfactory recovery, but quantitative data are missing. OBJECTIVE We aimed to quantify the benefit of OT associated with visual stimulation assisted by a dedicated web-application on patients with 1-month or more OD. METHODS We performed an observational real-life data-based study on a cohort of patients with at least 1-month persistent OD included between 1/30/21 and 3/26/2021. Analysis was performed after a 4-weeks mean time of OT and at least 500 patients assessable for primary outcome. Participants exposed themselves twice daily to odors from four high concentration oils and visual stimulation assisted by a dedicated web-application. Improvement was defined as a 2/10 points increase on self-assessed olfactory visual analogue scale. RESULTS 548 were assessable for primary outcome assessment. The mean baseline self-assessed olfactory score was 1.9/10 (SD 1.7) and increase to 4.6 (SD 2.8) beyond a mean time of olfactory training of 27.7 days (SD 17.2). Olfactory training was associated with at least 2-points increase in 64.2% (n=352). The rate of patients with improvement was higher in patients having trained for more than 28 days versus patients having trained for less than 28 days (72.2% vs 59.0% respectively, p=.002). The benefit was observed regardless of the duration of the OD. CONCLUSIONS OT associated with visual stimulation assisted by a dedicated web-application was associated with significant improvement in olfaction, especially if OT duration was superior to 28 days. CLINICALTRIAL NCT04806880

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Olfactory training and visual stimulation assisted by web-application in patients with persistent olfactory dysfunction after SARS-CoV-2 infection: observational study.

10.1101/2021.05.13.21257176 ◽

2021 ◽

Author(s):

Fabrice Denis ◽

Anne-Lise Septans ◽

Lea Periers ◽

Jean-Michel Maillard ◽

Florian Legoff ◽

...

Keyword(s):

Web Application ◽

Primary Outcome ◽

Visual Stimulation ◽

Real Life ◽

Olfactory Dysfunction ◽

High Concentration ◽

Real Life Data ◽

The Mean ◽

Mean Time ◽

Olfactory Training

Background: Persistent olfactory dysfunction (OD) is a significant complication of SARS-CoV-2 infection. Olfactory training (OT) using aromatic oils are recommended to improve olfactory recovery, but quantitative data are missing. Objective: We aimed to quantify the benefit of OT associated with visual stimulation assisted by a dedicated web-application on patients with 1-month or more OD. Methods: We performed an observational real-life data-based study on a cohort of patients with at least 1-month persistent OD included between 1/30/21 and 3/26/2021. Analysis was performed after a 4-weeks mean time of OT and at least 500 patients assessable for primary outcome. Participants exposed themselves twice daily to odors from four high concentration oils and visual stimulation assisted by a dedicated web-application. Improvement was defined as a 2/10 points increase on self-assessed olfactory visual analogue scale. Results: 548 were assessable for primary outcome assessment. The mean baseline self-assessed olfactory score was 1.9/10 (SD 1.7) and increase to 4.6 (SD 2.8) beyond a mean time of olfactory training of 27.7 days (SD 17.2). Olfactory training was associated with at least 2-points increase in 64.2% (n=352). The rate of patients with improvement was higher in patients having trained for more than 28 days versus patients having trained for less than 28 days (72.2% vs 59.0% respectively, p=.002). The kinetic of improvement was 8 days faster in hyposmic than in anosmic patients (p<.001). The benefit was observed regardless of the duration of the OD. Conclusions: OT associated with visual stimulation assisted by a dedicated web-application was associated with significant improvement in olfaction, especially if OT duration was superior to 28 days.

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Correction: Olfactory Training and Visual Stimulation Assisted by a Web Application for Patients With Persistent Olfactory Dysfunction After SARS-CoV-2 Infection: Observational Study

Journal of Medical Internet Research ◽

10.2196/32120 ◽

2021 ◽

Vol 23 (7) ◽

pp. e32120

Author(s):

Fabrice Denis ◽

Anne-Lise Septans ◽

Lea Periers ◽

Jean-Michel Maillard ◽

Florian Legoff ◽

...

Keyword(s):

Observational Study ◽

Web Application ◽

Visual Stimulation ◽

Olfactory Dysfunction ◽

Olfactory Training

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Olfactory training and visual stimulation assisted by web-application in patients with persistent olfactory dysfunction after SARS-CoV-2 infection: observational study. (Preprint)

Journal of Medical Internet Research ◽

10.2196/29583 ◽

2021 ◽

Author(s):

Fabrice Denis ◽

Anne-Lise Septans ◽

Lea Periers ◽

Jean-Michel Maillard ◽

Florian Legoff ◽

...

Keyword(s):

Observational Study ◽

Web Application ◽

Visual Stimulation ◽

Olfactory Dysfunction ◽

Olfactory Training

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Correction: Olfactory Training and Visual Stimulation Assisted by a Web Application for Patients With Persistent Olfactory Dysfunction After SARS-CoV-2 Infection: Observational Study (Preprint)

10.2196/preprints.32120 ◽

2021 ◽

Author(s):

Fabrice Denis ◽

Anne-Lise Septans ◽

Lea Periers ◽

Jean-Michel Maillard ◽

Florian Legoff ◽

...

Keyword(s):

Observational Study ◽

Web Application ◽

Visual Stimulation ◽

Olfactory Dysfunction ◽

Olfactory Training

UNSTRUCTURED REMOVE

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Postinfectious Olfactory Dysfunction: Oral Steroids and Olfactory Training versus Olfactory Training Alone: Is There any Benefit from Steroids?

ORL ◽

10.1159/000516316 ◽

2021 ◽

pp. 1-8

Author(s):

Sotiria Genetzaki ◽

Evangelia Tsakiropoulou ◽

Vasilios Nikolaidis ◽

Konstantinos Markou ◽

Iordanis Konstantinidis

Keyword(s):

Olfactory Dysfunction ◽

Olfactory Function ◽

Line Treatment ◽

First Line ◽

Olfactory Testing ◽

Significant Difference ◽

Oral Steroids ◽

Group A ◽

Olfactory Training ◽

First Line Treatment

Introduction: There are limited treatment options for postinfectious olfactory dysfunction (PIOD). Olfactory training has recently been used in clinical practice, but no medical treatment is widely accepted. Although there is weak evidence for their value, some physicians use oral corticosteroids as first-line treatment. The aim of this study was to compare combined oral methylprednisolone and olfactory training with olfactory training alone in the management of PIOD. Methods: This prospective cohort study included 131 patients with PIOD over a 2-year period before the COVID-19 pandemic. Seventy-eight patients who were treated with oral methylprednisolone and olfactory training (group A) were compared with 53 patients who were treated with olfactory training only (group B). Olfactory function was evaluated with “Sniffin’ Sticks” at baseline and 2, 8, and 16 weeks after initial assessment. Patients who improved after steroid treatment underwent magnetic resonance imaging of the paranasal sinuses, skin prick tests, lung spirometry, and sputum eosinophil assessment. Results: Oral steroids improved 19.23% of patients (n = 15) of group A. History, clinical evaluation, imaging, and laboratory tests identified an inflammatory background in half of them (n = 8). The remaining 7 had no findings of nasal inflammation, and all had a short history of olfactory dysfunction. Both groups significantly improved in olfactory testing results at the end of the olfactory training scheme without significant difference between them. Conclusions: The percentage of improved patients after oral methylprednisolone was relatively low to suggest it as first-line treatment. Half of the improved patients had an underlying upper airway inflammatory condition not related to the infection that caused the acute loss of olfactory function.

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An Emerging Problem of Shisha Smoking among High School Students in Ethiopia

International Journal of Environmental Research and Public Health ◽

10.3390/ijerph18137023 ◽

2021 ◽

Vol 18 (13) ◽

pp. 7023

Author(s):

Selamawit Hirpa ◽

Andrew Fogarty ◽

Adamu Addissie ◽

Linda Bauld ◽

Thomas Frese ◽

...

Keyword(s):

High School ◽

High School Students ◽

Smokeless Tobacco ◽

Addis Ababa ◽

Capital City ◽

School Level ◽

Cluster Sampling ◽

High Concentration ◽

School Students ◽

Study Participants

Shisha smoking is also known as hookah, water pipe, goza, and nargile. Shisha use among the young is increasing globally. Shisha smoke results in a high concentration of carbon monoxide, tar, nicotine, and heavy metals which can be toxic to humans, especially with chronic exposure. This study aims to determine the prevalence and risk factors of shisha smoking among in-school adolescents in Ethiopia. Four regional states in Ethiopia (Oromia, Amhara, Southern Nations, Nationalities, and Peoples’ Region, Tigray) and the capital city (Addis Ababa) were the study areas. A two-stage cluster sampling approach was employed to produce a representative sample. From the sampling frames in the study areas, 36 high schools were selected randomly. A multi-level logistic regression analysis was used to account for cluster-specific random effects, the effect of individuals’, and school-level variables for ever-use of shisha. A total of 3355 secondary school grade 9 and 10 students aged between 13 and 22 years took part in this study. A total of 86 (2.6%) and 20 (0.6%) of the study participants, reported that they had ever smoked or were current smokers of shisha, respectively. Of all study participants, 38.6% perceived shisha as less harmful than cigarettes and 48.5% reported that they do not know which was more harmful to health. Students were more likely to ever use shisha if they had friend/s who smoke shisha (AOR = 16.8, 95% CI: 6.4–44.3), ever smoked cigarettes (AOR = 8.2, 95% CI: 3.4–19.8), ever used khat (AOR = 4.2, 95% CI: 1.9–10.4), ever used marijuana (AOR = 3.9, 95% CI: 1.4–11.1), ever used smokeless tobacco (AOR = 3.1 95% CI: 1.1–8.4), and students had received income from their parents (AOR = 3.1 CI: 1.1–8.8). Prevalence of ever and current use of shisha among high school students is low in Ethiopia compared to many countries in Africa. The majority of adolescents perceived shisha as less harmful to health than cigarette smoking. Health education about the harmful effects of shisha should be delivered to adolescents, along with information on other substances like khat, cigarettes, marijuana, and smokeless tobacco to prevent initiation of substance use.

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Olfactory Training Using Heavy and Light Weight Molecule Odors

Perception ◽

10.1177/0301006616672881 ◽

2016 ◽

Vol 46 (3-4) ◽

pp. 343-351 ◽

Cited By ~ 11

Author(s):

Sophia C. Poletti ◽

Elisabeth Michel ◽

Thomas Hummel

Keyword(s):

Molecular Weight ◽

Olfactory Dysfunction ◽

Light Weight ◽

Short Term ◽

Olfactory Loss ◽

Short Term Exposure ◽

Before And After ◽

Phenyl Ethyl Alcohol ◽

A Prospective Study ◽

Olfactory Training

Background Repeated short-term exposure to odors is known to improve olfaction in patients with acquired olfactory dysfunction. The aim was to find out whether differences in molecular weight of odors used for olfactory training influences olfaction. We hypothesized a greater improvement following training with light weight molecule (LWM) odors. Methods A prospective study was performed in patients with posttraumatic (PTOL) and postviral olfactory loss (PVOL). Olfactory training was performed over a period of 5 months. One group ( n = 48) used four odors containing heavy weight molecules (HWM; >150 g/mol) and another ( n = 48) containing LWM (<150 g/mol). Olfaction was tested before and after the training using the Sniffin’ Sticks test. Results Olfactory training was associated with olfactory improvement, with the improvement in PVOL patients being three times greater than that seen in the PTOL group. Compared with LWM training, HWM training was associated with a significantly greater improvement in Phenyl Ethyl Alcohol (PEA) threshold scores in PVOL patients; however, no such improvement could be shown for other subtests or in PTOL patients. Conclusion Overall, training was associated with olfactory improvement. With the exception of threshold scores in PVOL, there were no significant differences between LWM and HWM groups.

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Combination of sintilimab, anlotinib and pegaspargase "sandwich" with radiotherapy in localized natural killer/T cell lymphoma: A multicenter, phase 2 study.

Journal of Clinical Oncology ◽

10.1200/jco.2021.39.15_suppl.7537 ◽

2021 ◽

Vol 39 (15_suppl) ◽

pp. 7537-7537

Author(s):

Zhiming Li ◽

Peng Sun ◽

Yu Wang ◽

Hang Yang ◽

Yajun Li ◽

...

Keyword(s):

T Cell ◽

Cell Lymphoma ◽

Risk Group ◽

T Cell Lymphoma ◽

Severe Toxicity ◽

Phase 2 ◽

Newly Diagnosed ◽

Phase 2 Study ◽

Tumor Types ◽

Mild Toxicity

7537 Background: NK/T-cell lymphoma (NKTL) is a rare and distinct subtype NHL. Most newly diagnosed NKTL cases were localized-stage. For localized NKTL, RT alone is inadequate due to high systemic failure rate. Chemoradiation has been increasingly applied. However, current chemotherapy (CT) regimens have severe toxicity and infection, which reduce the completion of RT and patients’ medical compliance. Therefore, novel regimens with mild toxicity are needed. Sintilimab, a fully human anti-PD-1 monoclonal antibody, has showed encouraging antitumor efficacy in pts with r/r NKTL. Anlotinib, a multiple-targeted TKI that mainly blocks VEGF/VEGFR pathway, has been approved for several solid tumor types in china. Anti-angiogenesis therapy could improve efficacy of ICI in multiple tumor types. This multicenter, single-arm, phase 2 study aims to evaluate the efficacy and safety of sandwich chemoradiotion of sintilimab combined with anlotinib and pegaspargase (PEG-ASP) in newly diagnosed localized NKTL pts. Methods: Patients with pathologically confirmed previously untreated stage NKTL were enrolled. All enrolled patients received 3 cycles of sintilimab (200mg D1 ivdrip) combined with anlotinib (12mg po D1-14) and PEG-ASP (2500U/m2 D1) every 3 weeks followed by RT, then received additional 3 cycles of combination therapy as described above. The primary endpoint was overall response rate (ORR) by LUGANO 2014 criteria. Results: A total of 39 pts were enrolled, and 24 pts eligible for response evaluation (70.8% men; median age, 46 y [range 20-64]; 58.3% stage). According to PINK-E system, 8 pts (33.3%) were identified as intermediate risk group and 16 patients were low risk group. 23 of 24 patients completed protocol-specified therapeutic schemes, one patient discontinued the study after the second cycle due to disease progression. ORR was 95.8% (23/24, 95%CI: 76.9%-84.1%). Surprisingly, all the responded patients achieved CR, while 66.7% (16/24, 95%CI: 44.7%-83.6%) patients achieved CR after the second cycle. Median PFS and OS have not been reached. 1-year OS and PFS was 100% and 95.8%, respectively. All grade TRAEs occurred in 84.6% of all enrolled patients and 92.1% were grade 1-2. The most common TRAE was lymphocytopenia (9.9%). Of note, grade 3-4 hematological toxicity was reported in only one patient (4.2%). All AEs were resolved after symptomatic treatment, without systematic corticosteroid intervention. Conclusions: Sintilimab combined with anlotinib and PEG-ASP upfront and after radiotherapy was effective and could be well tolerated in localized NKTL, achieving promising CRR and rapid and long-term remission with mild toxicity. Further investigation of survival outcome is warranted. Clinical trial information: NCT03936452.

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