Osteopathic Manipulative Therapy(OMT) Effects on Post-Acute Sequalae of COVID-19(PASC)

II. Description of the protocol and hypothesis with pilot data:

To date, individuals suffering from Long-COVID still do not have a specific proven treatment for this disease as a whole; however, an OMT sequence that was generated for prolonged post-COVID olfactory dysfunction was shown to generate significant increase in smell intensity after one treatment. Below is the abstract for a pilot trial:

Osteopathic Manipulative Therapy Effects on Prolonged Post-COVID Olfactory Dysfunction In 2019, the emergence of SARS-CoV2 created countless threats to public health that were unique to the pathogen. One of the first cardinal symptoms of infection is a sudden loss of smell and taste. Most people who survive their infection regain their sense of smell; however, a small amount of the population have prolonged decrease, complete absence, or abnormalities of smell long after the infection has resolved. This study represents a single-blinded pilot trial conducted during 2021 to examine the effects of a single treatment with OMT in individuals who have self-identified prolonged post-COVID anosmia, hyposmia or parosmia (n=20). This study was conducted at 2 locations within Ohio University.

Patients were randomly assigned to either the OMT group or a placebo/light touch/sham group by a flip of the coin and subsequently underwent pre-treatment smell testing of 4 items (Orange, Red Onion, Bourbon, and Perfume) they were then treated based on group selection, and subsequently underwent post-treatment smell testing to determine change in olfactory function. It was hypothesized that the OMT group would have a greater improvement in olfactory function when compared to the placebo group. A Mann-Whitney test indicated that the post and pre-treatment differences in the correct smell intensity scores of red onions were significantly higher for participants who received OMT treatment (Mdn = 2.00) compared to participants who received a non-osteopathic treatment (Mdn=1.00), U=20, p=0.019, r=5. There was a correlation of an increase in smell intensity in 2 out of the 3 remaining smell items, the mean difference between pre-smell treatment and post-smell treatment in the OMT group was higher than the placebo group. This therapy is a potential treatment for individuals suffering from this PASC related symptom and should be investigated further to determine the magnitude of OMT's effects on prolonged post-COVID olfactory dysfunction.

Side effects from the treatment group in the above study were minor but included light-headedness, drowsiness. After one treatment, there was significant improvement in olfactory dysfunction in participants in the treatment group as outlined by the study above. A poster presentation for the above study was accepted at 3 national conferences (American Academy of Osteopathy, American Academy of Physical Medicine and Rehabilitation, and American College of Physicians in San Diego) this past year.