Efficacy of pentasodium diethylenetriamine pentaacetate in ameliorating anosmia post COVID-19

Mohamed S Imam; Mohamed H Abdelazim; Ahmed H Abdelazim; Wael F Ismaiel; Mohammed Gamal; Mohammed A S Abourehab; Saleh Alghamdi; Mohamed A Alghamdi; Mohammed M Ghoneim; Samy Elwany

doi:10.1016/j.amjoto.2023.103871

Efficacy of pentasodium diethylenetriamine pentaacetate in ameliorating anosmia post COVID-19

Am J Otolaryngol. 2023 Jul-Aug;44(4):103871. doi: 10.1016/j.amjoto.2023.103871. Epub 2023 Mar 30.

Authors

Affiliations

¹ Pharmacy Practice Department, College of Pharmacy, Shaqra University, Shaqra 11961, Saudi Arabia; Clinical Pharmacy Department, National Cancer Institute, Cairo University, Fom El Khalig Square, Kasr Al-Aini Street, Cairo 11796, Egypt.
² Department of Otolaryngology, Faculty of Medicine, Al-Azhar University, 34518 Damietta, Egypt. Electronic address: mohammedabdelazeem35@yahoo.com.
³ Pharmaceutical Analytical Chemistry Department, Faculty of Pharmacy, Al-Azhar University, 11751 Cairo, Egypt.
⁴ Department of Otolaryngology, Faculty of Medicine, Al-Azhar University, 34518 Damietta, Egypt.
⁵ Pharmaceutical Analytical Chemistry Department, Faculty of Pharmacy, Beni-Suef University, 62514 Beni-Suef, Egypt.
⁶ Department of Pharmaceutics, College of Pharmacy, Umm Al-Qura University, Makkah 21955, Saudi Arabia; Department of Pharmaceutics and Industrial Pharmacy, College of Pharmacy, Minia University, Minia 61519, Egypt.
⁷ Department of Clinical Pharmacy, Faculty of Clinical Pharmacy, Al Baha University, Al Baha, Saudi Arabia.
⁸ Department of Surgery, Division of Otolaryngology, Faculty of Medicine, Albaha University, Albaha City, Saudi Arabia.
⁹ Department of Pharmacy Practice, College of Pharmacy, AlMaarefa University, Ad Diriyah 13713, Saudi Arabia; Pharmacognosy and Medicinal Plants Department, Faculty of Pharmacy, Al-Azhar University, Cairo 11884, Egypt.
¹⁰ Department of Otolaryngology, Faculty of Medicine, Alexandria University, 21500 Alexandria, Egypt.

Abstract

Background: COVID-19 has been frequently demonstrated to be associated with anosmia. Calcium cations are a mainstay in the transmission of odor. One of their documented effects is feedback inhibition. Thus, it has been advocated that reducing the free intranasal calcium cations using topical chelators such as pentasodium diethylenetriamine pentaacetate (DTPA) could lead to restoration of the olfactory function in patients with post-COVID-19 anosmia.

Methodology: This is a randomized controlled trial that investigated the effect of DTPA on post-COVID-19 anosmia. A total of 66 adult patients who had confirmed COVID-19 with associated anosmia that continued beyond three months of being negative for SARS-CoV-2 infection. The included patients were randomly allocated to the control group that received 0.9 % sodium chloride-containing nasal spray or the interventional group that received 2 % DTPA-containing nasal spray at a 1:1 ratio. Before treatment and 30 days post-treatment, the patients' olfactory function was evaluated using Sniffin' Sticks, and quantitative estimation of the calcium cations in the nasal mucus was done using a carbon paste ion-selective electrode test.

Results: Patients in the DTPA-treated group significantly improved compared to the control group in recovery from functional anosmia to hyposmia. Additionally, they showed a significant post-treatment reduction in the calcium concentration compared to the control group.

Conclusion: This study confirmed the efficacy of DTPA in treating post-COVID-19 anosmia.

Keywords: Anosmia; Pentasodium diethylenetriamine pentaacetat; Post-COVID-19.

Publication types

Randomized Controlled Trial

MeSH terms

Adult
Anosmia
COVID-19* / complications
Calcium
Humans
Nasal Sprays
Olfaction Disorders* / complications
Olfaction Disorders* / etiology
Pentetic Acid / pharmacology
SARS-CoV-2
Smell / physiology

Substances

diethylenetriamine
Nasal Sprays
Calcium
Pentetic Acid