Silent invasion of COVID

Sudden loss of smell or taste? Check if you are harboring COVID silently?

Anosmia, or a temporary lack of scent, is a widely recorded COVID-19 symptom. It can be jarring and emotional to lose your sense of smell and taste, and adapting to the seemingly muted world can be challenging at first. A sudden, severe loss of taste and smell in the absence of an allergy or other chronic nasal condition could be an early symptom of COVID-19.However, if anyone is having some kind of unexpected taste or smell dysfunction, even if it is mild, they should isolate themselves and get a COVID-19 test. This loss of taste and smell will happen even though you don’t have any other COVID-19 symptoms.

Changes that might occur in a COVID positive person are:

  • Reduced sensitivity to taste and smell
  • Loss of sense of taste or smell
  • Strange taste of familiar foods
  • Unusual odour

Up to 80% of people who test positive for COVID-19 report experiencing a loss of smell or taste. Patients with normal smell function in COVID-19 tended to have a worse disease course and were more likely to be hospitalized and put on a ventilator, according to a recent study based on retrospective results. This means that patients who have a problem with their sense of smell may have a milder infection or disease. According to the data we have so far, loss of smell may be one of the first — or only — symptoms of disease in a significant portion of the COVID-19-infected population. It has even been proposed that smell and taste loss could be a screening tool since these symptoms appear quite early.

Why do people with COVID infection lose their smell and taste?

ACE2 is a protein on the surface of many cell types. It is an enzyme that generates small proteins – by cutting up the larger protein angiotensinogen – that then go on to regulate functions in the cell. Using the spike-like protein on its surface, the SARS-CoV-2 virus binds to ACE2 – like a key being inserted into a lock – prior to entry and infection of cells. Hence, ACE2 acts as a cellular doorway – a receptor – for the virus that causes COVID-19.

The first proposed mechanism is that nasal epithelial cells have a higher expression of ACE-2 receptors. The virus binds to these receptors, causing degeneration of the epithelial cells of the nasal mucosa, as well as inflammation and damage to the olfactory receptors in the brain.

Another hypothesis, currently the most widely accepted, suggests the direct changes to the central nervous system by the virus. It was found that the virus entered the CNS structures; its first access was the nasal epithelium, and it ascended through the cribriform lamina and olfactory bulb and followed the olfactory nerve pathway, to cause anosmia or hyposmia.

COVID-19, on the other hand, may cause smell loss in other ways. For example, an Italian research team discovered that loss of smell and taste occurs at the same time as a rise in blood levels of interleukin-6, an inflammation-signaling molecule

When do COVID-19 patients get their sense of smell back?

According to a study published in the Journal of Internal Medicine, patients reported olfactory dysfunction for an average of 21.6 days.

What can a person do when they lose their smell and taste?

When a person can no longer taste or smell their food properly, they can take steps to make meals more exciting. These include:

 • preparing meals with a variety of colors and textures

• enhancing flavors with aromatic herbs and spices • avoiding meals that combine multiple ingredients that can make the recipe dull

Smell training can help some people regain their sense of smell more quickly. Every day, the patient needs to smells four different scents for around 20 seconds each. Concentrating on each scent can assist in recovery. This training may be applied to taste by experimenting with various food flavors. Studies suggest you choose scents to represent the four smell categories of Flowery, Fruity, Spicy, and Resinous. However, you can choose any smell you feel comfortable with, have available, and enjoy.

To conduct smell training, pick objects from your home that include a variety of smells – try to choose common items. You may use lemon and orange rind, nutmeg, clove, mint, eucalyptus, ground coffee, coconut, and vanilla.

Studies have demonstrated improved olfaction in patients with post-infectious olfactory dysfunction after olfactory training. Olfactory training can be considered for patients with persistent COVID-19–related olfactory dysfunction because this therapy has low cost and negligible adverse effects.

Oral and intranasal corticosteroids have been used to exclude an inflammatory component in patients with olfactory dysfunction, however, corticosteroids are not currently recommended for individuals with post-infectious olfactory dysfunction because evidence of benefit is lacking and there is a potential risk of harm.

Intranasal sodium citrate, which is thought to modulate olfactory receptor transduction cascades, intranasal vitamin A, which may stimulate olfactory neurogenesis, and systemic omega-3, which may function through neuro-regenerative or anti-inflammatory mechanisms, are other drugs that have shown few promising result however there is no evidence that these therapies are successful in COVID-19-related Olfactory dysfunction in patients. Always consult your treating physician before taking any medicines.

So now on if you lose your smell or taste suddenly don’t forget to check for COVID infection.

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Published by Dr.Pratim Sengupta

Dr. Pratim Sengupta thinks of himself as conscious, living, soulful being with an inner urge to break the inertia of life. He feels that life is nothing but a material expression of the Supreme Almighty Consciousness. His conscious existence empowered him to see, to hear, to talk, to interact, to feel, to dream, to ask questions, and to seek solutions to every problem. In the flow of life, as he grew up, he understood that knowledge of life is the only way to understand the scientific basis of conscious existence. Hence Dr. Sengupta felt the urge to study the science of life – i.e. Medicine. After he completed his higher secondary education from the Ramakrishna Mission Vidyamandira in Belurmath, he joined the MBBS (Bachelor of Medicine, Bachelor of Surgery) course at RG Kar Medical College, Kolkata. The professional packaging of knowledge in terms of a time-bound, goal-oriented syllabus frustrated him a bit, but nevertheless ignited the urge within him to study further. He thus went on to his post-graduation (MD) in Medicine from IPGMER and SSKM Hospital, Kolkata. During his MD training, he got a glimpse of the vastness of knowledge, and the quest to learn precisely the facts of life narrowed down his area of interest to the functioning of the kidneys and the specialisation of Nephrology – a discipline that is complex, yet relatively new and still evolving in terms of complete understanding of renal physiology and pathology. So, Dr. Sengupta decided to study and train for the DM (Doctorate of Medicine) degree in Nephrology. Right from the start of his career, Dr. Sengupta was passionate about Research. During the MD programme he worked on Cirrhotic Cardiomyopathy, Autonomic Neuropathy of Lupus, and Insulin resistance in Diabetics. All these research studies were published in national journals. During his postdoctoral study in Nephrology, he worked on Hemodialysis efficiency, and suggested an angular placement of the Dialyser in order to increase efficiency. This innovative concept was accepted for presentation at the World Congress of Nephrology, Milan, in 2009, and also published in Hemodialysis International. Dr. Sengupta also worked on Plasmapheresis – a blood filtering technique by which toxic and pathogenic immunoglobulins can be removed from the body. He studied the role of Prethymectomy Plasmapheresis in Myasthenia Gravis patients, and his findings were published in the journal Interactive Cardiovascular and Thoracic Surgery. The patient-empowered nutritional model for nutritional care of kidney patients is another interesting and innovative area in which Dr. Sengupta has worked for quite a long time. Dr.Pratim Sengupta won the Bharat Jyoti award for his excellency in the field of medicine. He is also the president of our non-governmental organization, The Kidney Care Society. His tireless contribution to provide quality living for his patients is worth mentioning. He introduced Mukti, blending ancient Indian yoga with modern medicine for well being of every patient. He has also introduced an unique online course "Art of Living with diabetes" which is a complete solution to diabetes management. He has authored many books, blogs, for the patients. Searching and researching for solutions to problems in the field of Nephrology remains the passion and dream of Dr. Pratim Sengupta, and he intends to persist on this journey as long as he is conscious. Meanwhile, even as he pursues his dreams, Dr. Sengupta diligently puts into practice all he has learned about Nephrology over the years, at the Belle Vue Clinic in Kolkata and ILS hospital,Dumdum where he is available for his patient

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