HealthDay News — For patients with COVID-19-related olfactory dysfunction (OD), the clinical benefit of theophylline added to saline nasal irrigation (SNI) is inconclusive, according to a study published online July 7 in JAMA Otolaryngology-Head & Neck Surgery.

Shruti Gupta, MD, from Washington University School of Medicine in St. Louis, and colleagues examined the efficacy and safety of theophylline vs placebo added to SNI for COVID-19-related OD in a phase 2 randomized clinical trial. Participants with OD persisting for 3 to 12 months following COVID-19 infection were recruited and randomly assigned to receive saline sinus rinse kits and bottles of identical-appearing capsules with either 400mg of theophylline (treatment) or 500mg of lactose powder (control; 26 and 25 patients, respectively).

The researchers found that at the end of treatment, at least slight improvement in the Clinical Global Impression Improvement scale was reported by 59% in the theophylline arm compared with 43% in the placebo arm. Between baseline and 6 weeks, the median difference in the University of Pennsylvania Smell Identification Test (UPSIT) change was 3.0 and 0.0 for participants in the theophylline and placebo arms, respectively; the change in UPSIT scores was not significantly different between the groups. A change of 4 or more points in UPSIT scores from baseline to 6 weeks occurred in 50% and 26% of participants in the theophylline and placebo arms, respectively.

“Clinically meaningful benefits in olfactory function for patients with chronic COVID-19-related OD are suggested by subjective assessments but are not definitively demonstrated,” the authors write.

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