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Management of new onset anosmia during the COVID pandemic - BRS Consensus Guidelines
  • +16
  • Claire Hopkins,
  • Mikkel Alanin,
  • Carl Philpott,
  • Philip Harries,
  • Katherine Whitcroft,
  • Ali Qureishi,
  • Shahram Anari,
  • Yujay Ramakrishnan,
  • Anshul Sama,
  • Elgan Davies,
  • Benjamin Stew,
  • Simon Gane,
  • Sean Carrie,
  • Iain Hathorn,
  • Raj Bhalla,
  • Christine Kelly,
  • Nina Hill,
  • Duncan Boak,
  • B. Nirmal Kumar
Claire Hopkins
Guy's Hospital
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Mikkel Alanin
Guy's and Saint Thomas' Hospitals NHS Trust
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Carl Philpott
University of East Anglia, University of East Anglia
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Philip Harries
University Hospital Southampton NHS Foundation Trust
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Katherine Whitcroft
South Yorkshire Deanery
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Ali Qureishi
Oxford University Hospitals NHS Foundation Trust
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Shahram Anari
University Hospitals Birmingham NHS Foundation Trust
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Yujay Ramakrishnan
Nottingham University Hospitals NHS Trust
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Anshul Sama
Nottingham University Hospitals NHS Trust
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Elgan Davies
Spire Regency Hospital, Macclesfield
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Benjamin Stew
University Hospital of Wales Healthcare NHS Trust
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Simon Gane
Royal National Throat Nose and Ear Hospital
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Sean Carrie
The Freeman Hospital and University of Newcastle
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Iain Hathorn
University of Edinburgh
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Raj Bhalla
Central Manchester & Manchester Children's Foundation Trust
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Christine Kelly
AbScent
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Nina Hill
Fifth Sense
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Duncan Boak
Fifth Sense
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B. Nirmal Kumar
WWL NHS FT
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Abstract

Objectives The primary aim of the study is to provide recommendations for the investigation and management of patients with new onset anosmia during the COVID-19 pandemic Design After undertaking a literature review, we used the RAND/UCLA methodology with a multi-step process to reach consensus about treatment options, onward referral imaging. Setting and participants An expert panel consistent of 15 members was assembled. A literature review was undertaken prior to the study and evidence was summarised for the panellists. Main outcome measures The panel undertook a process of ranking and classifying appropriateness of different investigations and treatment options for new onset anosmia during the COVID-19 pandemic. Using a 9-point Likert scale, panellists scored whether a treatment was: Not recommended, optional, or recommended. Consensus was achieved when more than 70% of responses fell into the category defined by the mean. Results Consensus was reached on the majority of statements after 2 rounds of ranking. Disagreement meant no recommendation was made regarding one treatment, using Vitamin A Drops. Alpha lipoic acid was not recommended, olfactory training was recommended for all patients with persistent anosmia of more than 2 weeks duration, and oral steroids, steroid rinses and omega 3 supplements may be considered on an individual basis. Recommendations have been made regarding the need for referral and investigation have been made. Conclusion This study identified the appropriateness of olfactory training, different medical treatment options, referral guidelines and imaging for patients with COVID-19 related anosmia. The guideline may evolve as our experience of COVID-19 develops.

Peer review status:ACCEPTED

21 May 2020Submitted to Clinical Otolaryngology
22 May 2020Submission Checks Completed
22 May 2020Assigned to Editor
01 Jun 2020Review(s) Completed, Editorial Evaluation Pending
05 Jun 2020Reviewer(s) Assigned
10 Jul 2020Editorial Decision: Revise Major
14 Jul 20201st Revision Received
15 Jul 2020Submission Checks Completed
15 Jul 2020Assigned to Editor
16 Jul 2020Reviewer(s) Assigned
26 Jul 2020Review(s) Completed, Editorial Evaluation Pending
17 Aug 2020Editorial Decision: Accept