Management of Persistent COVID-19-Related Olfactory Dysfunction in the United Kingdom: A National Survey of Rhinology Practice, Prognosis and Treatments

Introduction: The UK management of persistent COVID-19 olfactory dysfunction (C19OD) remains unclear. The magnitude of the problem is also unknown. Objectives: To quantify the prevalence of persistent C19OD, evaluate management practices, and track patient outcomes from referral to discharge. Methods: A nationwide online survey of UK rhinology clinicians examined clinical assessment, treatment, follow-up, referral patterns and prevalence. Responses were analysed descriptively. Results: Sixty-eight percent of clinicians responded. Most patients with persistent C19OD were managed in general Otolaryngology clinics (60.9%), with limited access to specialist smell services (8.7%). Formal olfactory testing was uncommon (15.8%) and nearly half of clinicians performed no structured assessment. Smell training and intranasal corticosteroids were the most frequent treatments. 62% of treated patients continued to have persistent C19OD and were discharged home without a further treatment plan. Conclusion: UK Management of persistent C19OD remains inconsistent with only 15.8% being formally tested for their smell loss. 62% of treated patients remained symptomatic with persistent C19OD and subsequently discharged home without a treatment plan. Improved access to standardised tertiary referral centres is recommended enabling better access to novel treatments.