{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,4]],"date-time":"2026-10-04T16:53:16Z","timestamp":1791132796191,"version":"4.1.0"},"reference-count":37,"publisher":"Wiley","issue":"10","license":[{"start":{"date-parts":[[2026,5,11]],"date-time":"2026-05-11T00:00:00Z","timestamp":1778457600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc-nd\/4.0\/"},{"start":{"date-parts":[[2026,5,11]],"date-time":"2026-05-11T00:00:00Z","timestamp":1778457600000},"content-version":"tdm","delay-in-days":0,"URL":"http:\/\/doi.wiley.com\/10.1002\/tdm_license_1.1"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Int Forum Allergy Rhinol"],"published-print":{"date-parts":[[2026,10]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Olfactory dysfunction is a hallmark feature of COVID\u201019, yet the potential for recovery with long\u2010standing COVID\u201019\u2010related smell loss (CRSL) remains uncertain, particularly when treatment is initiated years later. This study evaluated olfactory outcomes in patients with CRSL compared with non\u2010COVID\u201019\u2010related smell loss (non\u2010CRSL), with emphasis on delayed treatment initiation.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>This retrospective cohort study included 104 patients evaluated at a tertiary clinic between January 2023 and February 2025, comprising 47 patients with CRSL and 57 with non\u2010CRSL. All patients completed serial Sniffin\u2019 Sticks testing (threshold, discrimination, and identification [TDI]) at \u22652 visits. Minimal clinically important difference (MCID) was defined as a \u22655.5\u2010point increase in TDI score. All patients received olfactory training combined with twice\u2010daily steroid nasal irrigation. Subgroup analyses examined delayed treatment initiation (&gt;2 years), treatment adherence, and COVID\u201019 vaccination status.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      Baseline TDI scores were higher in the CRSL group than in the non\u2010CRSL group (19.6\u00a0\u00b1\u00a06.3 vs. 16.8\u00a0\u00b1\u00a06.8;\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0&lt;\u00a00.05). The CRSL group demonstrated significant improvement in TDI scores at follow\u2010up (19.6\u00a0\u00b1\u00a06.3 to 23.9\u00a0\u00b1\u00a06.5;\n                      <jats:italic>p<\/jats:italic>\n                      \u00a0&lt;\u00a00.001), with 46% achieving MCID, whereas the non\u2010CRSL group showed no significant change. Among CRSL patients initiating therapy &gt;2 years after onset (\n                      <jats:italic>n<\/jats:italic>\n                      \u00a0=\u00a036; mean 30.8\u00a0\u00b1\u00a05.5 months), 50% achieved MCID. Treatment adherence was strongly associated with improvement, whereas COVID\u201019 vaccination showed a favorable but attenuated association after adjustment.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p>Clinically meaningful olfactory recovery remains achievable with long\u2010standing CRSL, even when treatment is initiated &gt;2 years after onset. Prospective studies are needed to clarify causal relationships given known spontaneous recovery in post\u2010viral olfactory dysfunction.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1002\/alr.70182","type":"journal-article","created":{"date-parts":[[2026,5,11]],"date-time":"2026-05-11T15:20:32Z","timestamp":1778512832000},"page":"1125-1132","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Lost and Found: Is Olfactory Recovery More Promising After COVID\u201019 Than Other Causes, Even 2 Years Later?"],"prefix":"10.1002","volume":"16","author":[{"given":"John W.","family":"Hunsicker","sequence":"first","affiliation":[{"name":"Department of Otolaryngology Head and Neck Surgery University of Alabama at Birmingham  Birmingham Alabama USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Mabel","family":"Berg","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology Head and Neck Surgery University of Alabama at Birmingham  Birmingham Alabama USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nicolaus","family":"Knight","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology Head and Neck Surgery University of Alabama at Birmingham  Birmingham Alabama USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-2131-8005","authenticated-orcid":false,"given":"Jessica W.","family":"Grayson","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology Head and Neck Surgery University of Alabama at Birmingham  Birmingham Alabama USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3292-9167","authenticated-orcid":false,"given":"Bradford A.","family":"Woodworth","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology Head and Neck Surgery University of Alabama at Birmingham  Birmingham Alabama USA"},{"name":"Gregory Fleming James Cystic Fibrosis Research Center University of Alabama at Birmingham  Birmingham Alabama USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Justin H.","family":"Turner","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology Head and Neck Surgery University of Alabama at Birmingham  Birmingham Alabama USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5173-8959","authenticated-orcid":false,"given":"Do\u2010Yeon","family":"Cho","sequence":"additional","affiliation":[{"name":"Department of Otolaryngology Head and Neck Surgery University of Alabama at Birmingham  Birmingham Alabama USA"},{"name":"Gregory Fleming James Cystic Fibrosis Research Center University of Alabama at Birmingham  Birmingham Alabama USA"},{"name":"Division of Otolaryngology, Department of Surgery Veterans Affairs  Birmingham Alabama 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