Though most patients recover within 4 weeks, it is reported that up to ~ 46% of patients still have olfactory disorders after 6 months and 20–60% after a year. Olfactory disorders are a common early feature in COVID-19, occurring in about two of every three patients.
This trial is registered on the ISRCTN registry with trial ID ISRCTN70794078. Therefore, we recommend not prescribing prednisolone for patients with persistent olfactory disorders after COVID-19. This trial shows that prednisolone does not improve olfactory function after COVID-19. Furthermore, on secondary outcomes, we obtained no differences between groups. There was similar improvement on olfactory function in both groups after 12 weeks. Median TDI score on SST was 26.8 (IQR 23.6-29.3) in the placebo group and 28.8 (IQR 24.0-30.9) in the prednisolone group, with a median difference of - 1.5 (-3.0 to 0.25). No difference in olfactory function between groups was obtained after 12 weeks. Resultsīetween November 2021 and February 2022, we included 115 eligible patients, randomly assigned to the treatment ( n = 58) or placebo group ( n = 57). The CONSORT 2010 guideline was performed. Secondary outcomes were objective gustatory function assessed by the Taste Strip Test (TST) and subjective self-reported outcomes on questionnaires about olfactory, gustatory and trigeminal function, quality of life, and nasal symptoms. The primary outcome was the objective olfactory function on Sniffin’ Sticks Test (SST) 12 weeks after the start of treatment, measured in Threshold-Discrimination-Identification (TDI) score. In addition, all patients performed olfactory training. The treatment group received oral prednisolone 40 mg once daily for 10 days and the placebo group received matching placebo. Patients were included if they were > 18 years old and if they had persistent (> 4 weeks) olfactory disorders within 12 weeks after a confirmed COVID-19 test. We performed a randomized, double-blind, placebo-controlled, single-centered trial in the Netherlands. Hence, we aimed to determine the efficacy of a short oral prednisolone treatment on patients with persistent olfactory disorders after COVID-19. Prednisolone has been suggested as a treatment for olfactory disorders after COVID-19, but evidence is scarce.
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