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

Braz J Otorhinolaryngol. 2025 Jul-Aug;91(4):101583. doi: 10.1016/j.bjorl.2025.101583. Epub 2025 Mar 26.

Abstract

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.

Keywords: COVID-19; Laser therapy; Olfactory disorders; Photobiomodulation; Smell.

Publication types

  • Randomized Controlled Trial

MeSH terms

  • Adult
  • Aged
  • COVID-19* / complications
  • Combined Modality Therapy
  • Female
  • Humans
  • Low-Level Light Therapy* / methods
  • Male
  • Middle Aged
  • Olfaction Disorders* / etiology
  • Olfaction Disorders* / radiotherapy
  • Olfaction Disorders* / therapy
  • Prednisolone / therapeutic use
  • SARS-CoV-2
  • Treatment Outcome

Substances

  • Prednisolone