Cochrane ENT: our COVID-19 response

The COVID-19 pandemic has presented enormous challenges for healthcare systems globally. The Cochrane organisation has responded quickly, with a wide range of initiatives including rapid high-priority systematic reviews and a COVID-19 study register. In Cochrane ENT, we have used our team’s skills to deliver targeted evidence to support both healthcare professionals in our field and patients, with fast-tracked systematic reviews on antimicrobial mouthwashes and nasal sprays to prevent infection and on interventions to prevent and treat post-COVID-19 smell loss, plus a curated repository of guidance and evidence to support ENT and audiology practice during the pandemic.

 

Curating guidance and evidence for ENT and audiology practice

 

In April 2020, we used the expertise of our Information Specialist to develop a curated repository of guidance and evidence relevant to the management of patients with ENT, hearing and balance problems during the COVID-19 pandemic. As further evidence has become available, we have expanded and updated this resource, and we will continue to maintain it.

 

Fast-tracked systematic reviews on antimicrobial mouthwashes and nasal sprays to prevent COVID-19 infection

 

As anecdotal evidence began to emerge that healthcare workers were using antimicrobial mouthwashes and nasal sprays to protect themselves and their patients against COVID-19 infection, in collaboration with Cochrane Oral Health we prioritised, registered and fast-tracked three systematic reviews of these interventions for the prevention of COVID-19 infection:

 

 

These reviews are currently (March 2021) being rapidly updated, as data from ongoing studies become available.

 

Rapid, living systematic reviews on post-COVID-19 smell loss/dysfunction – prevention and treatment

 

Olfactory dysfunction – loss or disturbance of smell – is a common and, in some patients, persistent symptom of COVID-19 infection, with the potential to cause significant reduction in quality of life. Cochrane ENT successfully applied to the NIHR themed call - COVID-19: Recovery and Learning and obtained funding to complete Cochrane living systematic reviews on the prevention and treatment of post-COVID-19 olfactory dysfunction/anosmia. In working up the protocols we worked extensively with the patient charities AbScent and Fifth Sense, in particular in the selection and prioritisation of outcome measures. We are very grateful to the more than 400 people who contributed to our surveys: their feedback was invaluable in ensuring that our reviews will focus on the outcomes that matter most to patients. The published protocols are available here:

 

·      Interventions for the treatment of persistent post-COVID-19 olfactory dysfunction

·      Interventions for the prevention of persistent post-COVID-19 olfactory dysfunction

 

First versions of these reviews will follow shortly. As living systematic reviews they will be frequently updated as more data from clinical studies become available. We will also be completing a companion systematic review of ‘Interventions for the treatment of post-viral anosmia’ to capture other evidence that might helpfully inform treatment of patients with this symptom.

 

Our COVID-19 work is highlighted in a recent Cochrane Library supplement (Cochrane ENT in the COVID-19 pandemic: using our expertise and collaborating effectively) and summarised as a Cochrane case study.