Budesonide falls short of improving hyposmia related to COVID-19

Local intranasal treatment with budesonide does not appear to be effective for persistent hyposmia in patients with nonsevere COVID-19, according to a study.

The study included 123 patients (average age 40 years, 32.5 percent male) with a SARS-CoV-2 infection and presenting an isolated hyposmia persisting 30 days after symptom onset.

The patients were randomly allocated to either the experimental (n=62) or control (n=61) group. The experimental group received budesonide and physiological saline nasal irrigations administered via three syringes of 20 mL in each nasal cavity in the morning and evening for 30 days. The control group, on the other hand, received a similar protocol without budesonide.

Two patients in the experimental group met the primary endpoint of improvement of more than two points on the ODORATEST score after 30 days of treatment, whereas none in the control group did. The between-group difference was not significant (p=0.5).

Questionnaire data showed no difference in the olfactory capacities between the treatment groups, including the ODORATEST global score (p>0.9), detection sub-score (p=0.8) and identification sub-score (p=0.8), after 30 days of treatment.

The findings lend support to the hypothesis that cellular damage is already occurring 1 month after the onset of infection, and that the use of an anti-inflammatory does not modify the course of olfactory impairment.