Please select the eligibility criteria that correspond to the clinical trial below.
Title: Determinants of Olfactory Dysfunction in Chronic Rhinosinusitis
Brief Summary: Olfactory dysfunction is a cardinal symptom of chronic rhinosinusitis, a disease which affects 12.5% of the adult population across all racial and ethnic groups. Previous research has documented olfactory deficit in 68% of patients with chronic rhinosinusitis and 20% with complete anosmia, suggesting that olfactory dysfunction affects over 25 million individuals in the United States with chronic rhinosinusitis. This proposed investigation will be used to predict olfactory outcomes following treatments for chronic rhinosinusitis and gain insights into mechanisms of olfactory dysfunction in this population.


Options:
A: Inclusion Criteria:

* anosmia post covid-19 infection

Exclusion Criteria:

* nasal polyps or fractions or syrgery in nose from 6 months or less
B: Inclusion Criteria:

* Outpatients ≥ 18 years presenting to Cleveland Clinic Health System in Ohio and Florida who test positive for COVID-19 having any of the following symptoms

  1. Fever or chills
  2. Shortness of breath or difficulty breathing
  3. Cough
  4. Fatigue
  5. Muscle or body Aches
  6. Headache
  7. New loss of taste
  8. New loss of smell
  9. Congestion or runny nose
  10. Nausea
  11. Vomiting
  12. Diarrhea

Women of child bearing potential:

1. have had a menstrual period within the past 30 days, or
2. have had previous sterilization, or
3. are perimenopausal (less than 1 year) who have a negative pregnancy test, or
4. women of childbearing potential who do not meet the above and have a negative pregnancy test.

Exclusion Criteria:

* Patients who are found to be positive during hospitalization
* Patients who reside outside Ohio or Florida.
* Pregnant women:

  1. Current known pregnancy
  2. Positive pregnancy test (women of child bearing potential who have not had previous sterilization as defined as hysterectomy or tubal ligation)
* Women of childbearing potential who do not meet the above criteria, last menstrual period greater than 30 days and have a positive pregnancy test.
* Lactating Women
* End stage kidney disease
* Advanced liver disease awaiting transplant
* History of Calcium Oxalate kidney stones.
C: Inclusion Criteria:

* adults 18 yrs or older patients
* confirmed case (+ve PCR),
* recovered/discharged (2 -ve PCR),
* suffered from sudden recent anosmia or hyposmia

Exclusion Criteria:

* patients already on nasal steroid
* with previous chronic rhinological pathologies,
* patients on systemic steroid for previous systemic disease,
* anosmia improved before COVID19 recovery,
* pregnancy
* patients who will not complete the follow up period.
D: Inclusion Criteria:

* Adult ( \> 18 years of age)
* A diagnosis of medical recalcitrant CRS as defined by 2015 Adult Sinusitis Guidelines outlined by the American Academy of Otolaryngology
* Provide written informed consent and authorization.
* Study participants must be able to complete consent, all study evaluations, olfactory testing, and study-related health questionnaires written in the English language.
* Patients must self-select subsequent treatment option (endoscopic sinus surgery or continued medical therapy) to be dictated by the disease process and judgment and preferences of each individual, following counseling for each treatment option.
* Present to the enrolling site with indication for a CT scan or a CT scan completed, off-site, from another provider
* Complete appropriate standardized medical treatment by the Interim Assessment, 6-week follow-up period including, but not limited to, at least one course of either topical corticosteroids (\>21-days) or a 5-day course of oral corticosteroid therapy, and at least one course (\>14-days) of culture-directed or broad spectrum antibiotic therapy.

Exclusion Criteria:

* Children (\< 18 years of age)
* Any patient unable and/or unwilling to complete questionnaires or clinical testing or cooperate with all study protocols.
* Non-English speaking / English translation services required
* Unwilling or unable to provide informed, written consent.
* Contra-indications for any type of continued medical therapy required for treatment of symptoms related to CRS
* Patients who have not undergone previous prescribed medical therapy as described in Inclusion Criteria.
* Individuals of any vulnerable population including: children, pregnant women, neonates, decisionally impaired adults, or prisoners.

Answer: D