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Título

Efficacy of the photobiomodulation therapy on recovery of olfactory and gustatory dysfunction in patients with long-covid-19. A serie of cases

Resumo

INTRODUCTION: Smell and taste disorders are frequent symptoms during acute COVID-19 and may persist long after the resolution of the initial phase. Many studies have reported persistence of these symptoms more than 6 months after the onset, with female patients more likely to report persistent symptoms. Photobiomodulation Therapy (PBMT) represents a new and emerging therapeutic modality for the treatment of olfactory impairment after COVID-19, as it is able to modulate inflammatory processes and improve tissue healing in general. OBJECTIVES: Report a series of cases using PBMT for the management of COVID-19-related olfactory and taste impairment. METHODS: Six females (average: 46,6 years ± 13,7) and one male patient were seen at the post-COVID-19 Outpatient Clinic of a University Hospital in Rio de Janeiro, Brazil, from march to December 2021. COVID-19 infection was confirmed by biomolecular assay (RTPCR) and all patients had anosmia and ageusia since infection. Data about the exact initiation and duration of all signs and symptoms related to COVID-19 was collected. Olfactory and gustatory function was evaluated separately using visual analog scales (VAS) ranging from 0 (normal smell/taste) to 10 (complete anosmia/ ageusia). Scale was applied at the first clinical appointment (baseline) and after the end of the treatment. Two questions related to quality of life were applied before and after treatment. An intranasal PBMT protocol was applied using Laser DUO® (MM Optics Ltda São Carlos, SP, Brazil) at 660 nm, on contact mode, with 100 mW of power, and 8J of energy in each nasal mucosa and 6J in ten points of the tongue. A total of sixteen laser sessions, twice a week and with a 48-hour interval were done. The paired t test was used to compare the pre- and post-treatment VAS means. RESULTS: All patients completed the protocol (16 sessions). On average, the olfactory and gustatory VAS scale scores after treatment (media =3,66, standard error =0,55; media =8,09, stand error = 0,85 respectively) was lower than the pre-treatment score (media =8,00, stand error = 0,85; media =3,50, stand error = 0,42 respectively), t (5)= 6,50, p < 0,01; t (5) = 5,89, p<0,01. Patients also reported an improvement in quality of life after treatment. CONCLUSION: Given the lack of information about the available treatments for olfactory and gustatory dysfunctions in patients with long-term covid, PMB appears to be a promising therapeutic modality.

Palavras Chave

COVID-19. Photobiomodulation Therapy. Anosmia. Ageusia