Platelet-rich plasma for the treatment of COVID-19 related olfactory dysfunction: a systematic review

INTRODUCTION

Olfactory Dysfunction (OD) is a prevalent issue with a significant number of cases attributed to COVID-19. This systematic review aimed to evaluate the effectiveness of platelet-rich plasma (PRP) in the treatment of COVID-19 related OD, including anosmia, hyposmia, and parosmia.

METHODS

A comprehensive literature search was conducted using Medline, Scopus, Directory of Open Access Journals (DOAJ), and Google Scholar from inception until December 22, 2022. The eligibility criteria were confirmed COVID-19 patients with OD, whether it was measured objectively and/or subjectively, who received PRP treatment. The study followed a pre-specified protocol registered in PROSPERO (ID: CRD42023386803) and adhered to PRISMA guidelines.

RESULTS

Four studies that enrolled 233 patients were included. The degree of improvement was assessed using threshold-discrimination-identification (TDI) scores at baseline and 1 and 2 months after PRP injection. Parosmia was assessed using the Visual Analog Scale (VAS) scores. Treatment of OD with PRP injections resulted in variable degrees of improvement. However, PRP injections can be considered safe, effective, and promising therapeutic options, as revealed by pooled studies.

CONCLUSIONS

This systematic review indicated that PRP may be an effective treatment for COVID-19 related OD. However, additional large-scale studies are required to further investigate PRP efficacy in the treatment of OD following COVID-19.

Prevalence of Asymptomatic Deep Vein Thrombosis in Preoperative State of Spine Surgeries

BACKGROUND

Deep venous thrombosis (DVT) is considered the most common cause of preventable death among hospitalized patients. A few studies have investigated the risk of venous thromboembolic events in patients undergoing elective spine surgery and reported varying incidences. We aim to assess the incidence of preoperative lower limb DVT in patients with lumbar degenerative disease undergoing elective surgery.

METHODS

This is a retrospective review of prospectively collected data on adult patients with lumbar degenerative spine diseases (lumbar stenosis [LST], lumbar spondylolisthesis [SPL], or lumbar disc herniation) who were scheduled for operative management. Each patient underwent a preoperative lower limb venous Duplex (LLVD). Incidence of DVT, risk factors, and clinical course of patients were reported.

RESULTS

Forty-nine patients (32 females; 65%) were included. All patients were diagnosed clinically and radiologically with lumbar degenerative diseases; LST (44.9%), SPL (36.7%), and lumbar disc herniation (18.4%), requiring surgical management. Three patients (6.1%) were found to have positive DVT studies, leading to the cancellation or rescheduling of their procedures (P < 0.01). These included 1 patient with LST (P = 0.045) and 2 patients with SPL (P = 0.006). Among patients with LST and SPL, higher disability (modified Rankin scale ≥3) was significantly associated with positive LLVD (P = 0.035).

CONCLUSION

Patients with LST or SPL with higher preoperative disability scores were at higher risk to have preoperative DVT. Further research is needed to evaluate the feasibility and value of preoperative LLVD to detect DVT in patients planned for lumbar degenerative surgery.