Does anyone remember COVID? It seems that what happened between 2019 and 2021 is all but forgotten about. Aside from it cropping up on news feeds occasionally and a few out-of-date automated phone messages that start off with ‘During the current unprecedented pandemic....’, the events of the past few years seem to have slipped from our collective memories. There are still, however, patients we see with the sequelae of coronavirus infection. Within the remit of otolaryngology services, patients with loss of their sense of smell due to COVID (as well as other causes) are still referred for an opinion. The Editors’ Choice this issue is a relatively simple study using intranasal sodium gluconate solution versus placebo in confirmed COVID-19 patients with anosmia, aiming to assess improvement in participant’s olfaction. The results show there was a statistically significant improvement in the sense of smell in the treatment group - albeit a mild benefit. Any improvement is without doubt beneficial to those with anosmia, as anyone who has had a significant upper respiratory tract infection can attest to, when everything you eat tastes like cardboard! This is a development that is potentially the first step to helping this group of patients, as well as others with anosmia or hyposmia due to other causes. As always, thanks to our reviewers for their hard work and contributions!
Nazia Munir and Hannah Cooper
This study looks at the concept that the level of calcium in the microenvironment of the olfactory cleft can affect the level of olfactory dysfunction. Using sodium gluconate (a chelating agent which forms a stable chelate metal complex) intranasally, the authors sought to find out if it improves smell in 50 patients all with confirmed COVID-19 infection and anosmia on Sniffin Sticks testing. Patients were randomised into one of two groups, and received either the sodium gluconate solution or a placebo (0.9% sodium chloride), for one month duration. Outcomes in terms of Sniffin Sticks score and calcium levels in nasal secretions were then recorded. The results show that 80% of patients treated with sodium gluconate had an improvement in their smell function from anosmia to hyposmia, and there was a trend of lower calcium levels in the same group, and the results were statistically significant. The sodium chloride group demonstrated no such improvements. The main side effects were nasal discharge or mild burning sensations, and the authors reflect that the benefits were only a mild improvement in smell function in those who perceived a benefit, however this is an exciting development for patients with smell loss post COVID-19 infection and perhaps other modalities of smell loss.