Systemic corticosteroids in coronavirus disease 2019 (COVID-19)-related smell dysfunction: an international view

Int Forum Allergy Rhinol. 2021 Jul;11(7):1041-1046. doi: 10.1002/alr.22788. Epub 2021 Mar 16.


The frequent association between coronavirus disease 2019 (COVID-19) and olfactory dysfunction is creating an unprecedented demand for a treatment of the olfactory loss. Systemic corticosteroids have been considered as a therapeutic option. However, based on current literature, we call for caution using these treatments in early COVID-19-related olfactory dysfunction because: (1) evidence supporting their usefulness is weak; (2) the rate of spontaneous recovery of COVID-19-related olfactory dysfunction is high; and (3) corticosteroids have well-known potential adverse effects. We encourage randomized placebo-controlled trials investigating the efficacy of systemic steroids in this indication and strongly emphasize to initially consider smell training, which is supported by a robust evidence base and has no known side effects.

Keywords: COVID-19; SARS-CoV-2; corticosteroids; olfaction disorder; smell.

MeSH terms

  • Adrenal Cortex Hormones / pharmacology*
  • COVID-19* / complications
  • COVID-19* / physiopathology
  • Drug-Related Side Effects and Adverse Reactions / diagnosis
  • Drug-Related Side Effects and Adverse Reactions / etiology
  • Drug-Related Side Effects and Adverse Reactions / prevention & control
  • Global Health
  • Humans
  • Medication Therapy Management / standards
  • Medication Therapy Management / statistics & numerical data*
  • Needs Assessment
  • Olfaction Disorders* / drug therapy
  • Olfaction Disorders* / epidemiology
  • Olfaction Disorders* / etiology
  • Olfactory Mucosa / drug effects
  • Olfactory Mucosa / virology
  • Remission, Spontaneous
  • Research Design
  • SARS-CoV-2 / pathogenicity


  • Adrenal Cortex Hormones