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.
- Klíčová slova
- COVID-19, SARS-CoV-2, corticosteroids, olfaction disorder, smell,
- MeSH
- celosvětové zdraví MeSH
- čichová sliznice účinky léků virologie MeSH
- COVID-19 * komplikace patofyziologie MeSH
- hormony kůry nadledvin farmakologie MeSH
- lidé MeSH
- management farmakoterapie normy statistika a číselné údaje MeSH
- nežádoucí účinky léčiv diagnóza etiologie prevence a kontrola MeSH
- odhad potřeb MeSH
- poruchy čichu * farmakoterapie epidemiologie etiologie MeSH
- SARS-CoV-2 patogenita MeSH
- spontánní remise MeSH
- výzkumný projekt MeSH
- Check Tag
- lidé MeSH
- Publikační typ
- časopisecké články MeSH
- Názvy látek
- hormony kůry nadledvin MeSH
We hypothesized that screening for nonadherence to antihypertensive treatment using liquid chromatography-tandem mass spectrometry-based biochemical analysis of urine/serum has therapeutic applications in nonadherent hypertensive patients. A retrospective analysis of hypertensive patients attending specialist tertiary care centers was conducted in 2 European countries (United Kingdom and Czech Republic). Nonadherence to antihypertensive treatment was diagnosed using biochemical analysis of urine (United Kingdom) or serum (Czech Republic). These results were subsequently discussed with each patient, and data on follow-up clinic blood pressure (BP) measurements were collected from clinical files. Of 238 UK patients who underwent biochemical urine analysis, 73 were nonadherent to antihypertensive treatment. Their initial urinary adherence ratio (the ratio of detected to prescribed antihypertensive medications) increased from 0.33 (0-0.67) to 1 (0.67-1) between the first and the last clinic appointments. The observed increase in the urinary adherence ratio in initially nonadherent UK patients was associated with the improved BP control; by the last clinic appointment, systolic and diastolic BPs were ≈19.5 and 7.5 mm Hg lower than at baseline (P=0.001 and 0.009, respectively). These findings were further corroborated in 93 nonadherent hypertensive patients from Czech Republic-their average systolic and diastolic BPs dropped by ≈32.6 and 17.4 mm Hg, respectively (P<0.001), on appointments after the biochemical analysis. Our data show that nonadherent hypertensive patients respond to liquid chromatography-tandem mass spectrometry-based biochemical analysis with improved adherence and significant BP drop. Such repeated biochemical analyses should be considered as a therapeutic approach in nonadherent hypertensive patients.
- Klíčová slova
- adherence, antihypertensive agents, blood pressure, chromatography, liquid, hypertension,
- MeSH
- adherence k farmakoterapii psychologie MeSH
- antihypertenziva * analýza terapeutické užití MeSH
- biologické markery * krev moč MeSH
- chromatografie kapalinová metody MeSH
- dospělí MeSH
- hypertenze * diagnóza farmakoterapie epidemiologie psychologie MeSH
- krevní tlak účinky léků MeSH
- lidé středního věku MeSH
- lidé MeSH
- management farmakoterapie normy MeSH
- měření krevního tlaku metody psychologie MeSH
- senioři MeSH
- výsledky a postupy - zhodnocení (zdravotní péče) MeSH
- zlepšení kvality MeSH
- Check Tag
- dospělí MeSH
- lidé středního věku MeSH
- lidé MeSH
- mužské pohlaví MeSH
- senioři MeSH
- ženské pohlaví MeSH
- Publikační typ
- časopisecké články MeSH
- Geografické názvy
- Česká republika epidemiologie MeSH
- Spojené království epidemiologie MeSH
- Názvy látek
- antihypertenziva * MeSH
- biologické markery * MeSH
