Here’s a piece of information sent
to me by a friend of mine, Professor Dr Charles Andrew Gomez, a Senior
Consultant ENT Surgeon on:
Overcoming Post-COVID-19
Long-Lasting Olfactory Issues written by Dr Antonio Segovia
Exploring the Impact of COVID-19 on Smell and Taste, Its Repercussions on Daily
Life, and Advances in Innovative Treatments
The COVID-19 pandemic has messed up millions of lives in all sorts of ways.
Even my wife wasn’t spared and had to deal with weird stuff like losing her
sense of smell, everything smelling foul, and taste changes when she got
infected.
Fortunately, in her case, these symptoms were temporary, lasting about 15 days.
However, in my line of work as a medical doctor, I have seen many patients
still struggling with these changes that mess up their quality of life and
mood, particularly those who find joy and healing through cooking.
The Extent of Post-COVID-19 Anosmia in the US
Post-COVID-19 anosmia statistics in the United States reveal a worrying
picture.
According to the World Health Organization (WHO), as of November 2023,
103,436,829 cases of COVID-19 have been reported in the US, with 1,138,309
deaths.
World meter updated these figures to 109,378,312 cases with 1,182,614 deaths as
of November 2023.
Olfactory disorder is common among COVID-19 patients, with
approximately 70% experiencing loss of smell during the illness
and 65% having olfactory dysfunction 18 months later.
This 2022 paper on MDPI found that:
24.2% of mildly symptomatic patients still experienced chemosensory (responsive
to chemical stimuli) dysfunction one year after infection, with 45.1%
presenting with dysfunction after 12 months and 35.9% suffering from parosmia
(abnormality in the sense of smell.)
Recent studies suggest that up to 20% of all COVID-19 patients experience
long-term olfactory disorders.
Mechanism of Loss of Smell and Taste in COVID-19
Anosmia (temporary loss of smell) is one of the primary neurological symptoms
and one of the most common and earliest indicators of COVID-19.
Interestingly, the sensory neurons that detect and transmit smell to the brain
are not among the cell types most vulnerable to SARS-CoV-2 infection.
Studies led by neuroscientists at Harvard Medical School have identified that
the virus primarily affects cells that supply metabolic and structural
support to olfactory sensory neurons and specific populations of stem
cells and blood vessel cells.
Cells contain the receptor, which SARS-CoV-2 uses to enter human cells.
It implies that in most cases, SARS-CoV-2 infection is unlikely to damage
olfactory neural circuits permanently and lead to persistent anosmia.
Accompanying symptoms and causes
Patients with post-COVID-19 anosmia
not only lose their sense of smell, but may also suffer from parosmia and
other related symptoms.
Parosmia is a condition where our sense of smell is distorted, causing us to
perceive smells differently from how they are.
People with parosmia *may experience odours that are unpleasant or different
from their true nature. All these sequelae cause:
Mood disturbances,
Weight loss, and a
decreased quality of life caused by damage to sensory neurons or brain
areas responsible for the smell.
Work-Life and Mental Health After the Pandemic
The COVID-19 pandemic has destroyed part of the work and private lives of many
people, as well as employees' mental well-being and self-rated health.
About 30% of employees reported that their work and personal lives had
worsened, while about 10% reported improvements at work and 13% in private
life.
The negative perception of the impact of the crisis is enormously strengthened
by lower mental well-being and self-rated health.
Conventional Treatments and New Options
Although there are pharmacological and topical treatments for anosmia, their
effectiveness is limited, especially in cases of parosmia.
It is where hope arises with A CT-guided stellate ganglion block (SGB) to treat
post-COVID parosmia.
With this technique, an aesthetic and a depot steroid are injected into the
stellate ganglion under the guidance of computed tomography.
A recent study indicated that most patients treated with this technique
experienced a significant improvement in their symptoms.
This technique helped a bunch of patients who hadn’t gotten relief before. But
patients got even more relief when they had the treatment on both sides. The
good old CT-guided stellate ganglion block (SGB)is a promising new way to help
those dealing with long-term smell issues after COVID-19.
The advancements are exciting, as this technique offers hope to those facing
persistent smell disorders post-COVID. However, microsurgery is a minimally
invasive new option that gives hope to those with long-lasting loss of smell
after COVID.
Conclusions
From my own experience and medical practice, I’ve noticed that not only does
losing your sense of smell after COVID-19 mess with daily life and enjoyment,
but it can also really hit mental health and job performance hard.
The roll-out of treatments such as the CT-guided
stellate ganglion block is like a light at the end of the tunnel for
folks grappling with these lingering disorders.
As you can see, the news is excellent for the many people still facing
long-term COVID-19 symptoms.
Overcoming anosmia and parosmia after COVID-19 is not just about regaining
smell; it’s about reclaiming mental well-being in daily life.
To truly get into the weeds on this topic, there’s a detailed research piece
you should look at in the Radiological Society of North America (RSNA).
You might find the “Analysis of Prevalence and Predictive Factors of Long-Lasting
Olfactory and Gustatory Dysfunction in COVID-19 Patients” in PubMed.
Here is some additional information on “Impact of the COVID-19 crisis on work
and private life, mental well-being” on BMC Public Health
Here’s my reply to my friend,
Professor Charles Andrew Gomez, who sent me the above article someone else
wrote about anosmia (loss of smell) from post-Covid effect:
…………………………………………………..
Thank you, Professor Andrew, for
this post Covid olfactory dysfunction information.
I am not surprised because this virus affects the nose first as Covid is a
respiratory infection
I am unsure the mechanisms in which this virus paralyzes the olfactory
sensation to the brain, but my feeling is, the effect may be temporary even
without all those elaborate, expensive, harmful radiation CT guided stellate
ganglion block treatment, whatever it is
The virus is not going to stay unchallenged by the immune system forever
Once the virus is overwhelmed, I believe as in most cases of repair systems by
the body, the olfactory cells and nerves will automatically regenerate,
and the patient will and must recover from loss of smell.
One very cheap and natural way to deal with this anosmia is to stimulate the
olfactory cells by steam inhalation with antivirus eucalyptus oil alone
or in combination with tea tree oil. The strong stimulating smell from the hot
vapour of this anti-viral oil will excite the olfactory cells and nerves.
See details here:
https://taionn.blogspot.com/2021/05/recommendations-of-steam-inhalation.html
This is physiologically logical and is my take. There is no need for all those
high end, highly expensive and time-consuming CT guided therapy which would be
inaccessible to a large population of people with post-Covid symptoms. Imagine
if we have 5 billion people world-wide, especially in poor countries like
India, Indonesia, Yemen or in rural areas of African countries with Long Covid
symptoms. How are they going to get CT-guided stellate ganglion block therapy?
Doctors who devise and recommend such expensive out-of-reach methods of
treatment that benefit only a few elite and rich patients will not get a Nobel
Prize in medicine or in physiology. Clinicians and scientists need to find the
cheapest and highly effective method that would benefit tens of hundreds of
millions of people world-wide who shall be eligible for the prestigious Nobel
Prize in medicine or in physiology
In the practice of medicine do it the easiest, cheapest, most effective and
most convenient and natural way for the patient
That is good and ethical medicine
Thank you
Jb
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