Effect of nasal corticosteroid on cacosmia after COVID-19

Background: Olfactory disorders may be an isolated symptom of (COVID-19) infection. Multiple treatment modalities have been attempted to treat them. Objectives: compare the effect of nasal corticosteroid on COVID-19 positive patients aiming to decrease the duration of olfactory qualitative, quantitative and residual abnormalities as cacosmia with those who hadn't taken nasal corticosteroid Patient and methods: This study included 200 patients who presented to the Otorhinolaryngology Department, divided into equal two groups: Group1 (treated group) All patients were given two sprays (50 mcg of mometasone furoate in each spray) in each nostril twice daily (total daily dose of 400 mcg). Group 2 (untreated group) those who weren’t administered nasal corticosteroid or systemic corticosteroid in anosmia treatment. Result: Anosmia in group 1 improved by 61% in the first week,83% in the second week,100 % after one month, and regular follow-up was done for 6 months while in group 2 improvement was 42% in the first week,59% in the second week,73% after one month .In group 2 out of 100 patients 30 patients complained of cacosmia after initial anosmia 3 of them reported improving smell after 1 week then 2 weeks later cacosmia appeared and none of them were improved within the 6 months of follow up with significant p-value between 2 groups <0.001. Conclusion: Cacosmia in the COVID-19 patient must be taken seriously with the trial of different lines of treatment. Nasal corticosteroid is highly recommended in treating anosmia in COVID-19 patients and preventing a high recurrence