Efficacy of the adjunctive use of photobiomodulation therapy in olfactory disorders in post-COVID-19 patients: A randomized controlled trial

Objectives: Photobiomodulation Therapy (PBMT) is a non-invasive treatment that uses photons from the red to infrared spectrum to modulate cellular processes with anti-inflammatory and regenerative properties. This study aimed to evaluate the use of PBMT applied intranasally in patients with an impai...

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Main Authors: Patricia Costa Oliveira, Luisa Oliveira Correia, Natalia Medeiros Dias Lopes, Gabriel Rodrigues Suassuna, Richard L. Doty, Fabio de Rezende Pinna, Richard Louis Voegels, Marco Aurelio Fornazieri
Format: Article
Language:English
Published: Elsevier 2025-07-01
Series:Brazilian Journal of Otorhinolaryngology
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Online Access:http://www.sciencedirect.com/science/article/pii/S1808869425000266
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Summary:Objectives: Photobiomodulation Therapy (PBMT) is a non-invasive treatment that uses photons from the red to infrared spectrum to modulate cellular processes with anti-inflammatory and regenerative properties. This study aimed to evaluate the use of PBMT applied intranasally in patients with an impaired sense of smell after COVID-19. Methods: This proof-of-concept study was a randomized, placebo-controlled clinical trial that recruited 81 patients with olfactory disorders after SARS-CoV-2 infection (1–12 months), randomly assigned to 3 groups: controls, red light and infrared light exposure groups. PBMT was applied twice a week for five weeks, associated with prednisolone 40 mg for five days and olfactory training for 90 days from the first day of laser application. UPSIT® and subjective chemosensory scores were the outcomes collected before the first session and three months thereafter. Results: Compared to controls, patients undergoing infrared PBMT showed more improvement in UPSIT® scores (+4.6 points, 95% CI: 1.5–7.8, p =  0.004) and a tendency towards reporting a better subjective smell score at the three-month follow-up. Response rates were 26.1% (95% CI: 6.7–45.5), 43.5% (95% CI: 21.6–65.4), and 68% (95% CI: 48.3–87.7) in the control, red and infrared groups, respectively. No major adverse events were reported. Conclusion: Therapy with PBMT in the infrared frequency appears to be a safe option in treating post-COVID olfactory disorders when combined with a five-day use of systemic corticosteroid and 90 days of olfactory training. Level of evidence: 2.
ISSN:1808-8694