To offer you such a space to raise your queries and concerns, News18.com has developed the ‘Health Hacks’ column, your one-stop information board where all your health-related, specifically COVID queries, will be answered.
The column will be written by Dr. Chandrakant Lahariya (MBBS, MD), a Physician-Epidemiologist and a leading expert on COVID-19 disease and vaccines. In this fortnightly column, Dr. Lahariya will pick up one topic and give you tailored solutions, catering to the health needs of your entire family — kids, adolescents, adults, and senior citizens, and all the other members of your family.
In this week’s column, Dr. Lahariya discusses high fever and other symptoms of common viral infections, manifesting more strongly among people due to immunity debt, and explains how long COVID symptoms like anosmia and parosmia can linger for up to a year.
In the last month, many people consulted me with complaints of high fever, cough, and severe cold. A few of them also had either lost or had an altered sense of smell. Here, I am specifically talking about those who had either recovered from a confirmed COVID-19 infection or were fully vaccinated.
As the Pandemic rages on, it is not unnatural to worry about and get alerted by these symptoms, and that’s why there is a need to be aware about why such health issues are manifesting in several cases, even though, in many cases it has slim to no connection with COVID-19.
An ‘Immunity Debt’ to be paid
In the past one and a half years, people have stayed in their houses or worn masks when stepping out of their homes. This has not only successfully broken the chain of COVID-19 transmission, but also brought down viral illnesses drastically. Several studies suggest that the incidences of flu and other respiratory diseases such as
Respiratory Syncytial Virus (RSV) and tuberculosis have come down globally during this period. While this may seem like good news, there is a minor downside to these current circumstances.
Many of the pathogens (viruses and bacteria) are innocuous and keep challenging our immune system. Before COVID-19 Pandemic, our immune systems would habitually take on these viruses and develop antibodies against them. However, as our exposure to viruses and bacteria reduced during the Pandemic, so did our immune system’s ability to develop antibodies against them. Therefore, as the monsoon began, we found ourselves more susceptible to these viral diseases, and cases of fever, cold, and cough have been on the rise.
Our immune system’s inability to ward off these illnesses during the COVID-19 Pandemic can be called an immunity debt that can be tackled by several lifestyle changes.
In the pandemic period, we all must keep adhering to mask-wearing when going to a public place (I believe, this is worth repeating). Also, eat a healthy and nutritious diet. Vitamin supplementation is not needed. However, you can take your assessment. If your diet is rich in carbohydrates and less in fruits, please reduce carbohydrates and increase fruits and green leafy vegetables. That will essentially fulfill your vitamin and mineral needs; eating timely and light meals is an integral part of healthy living. Regular physical activity, in an incremental manner, should also be done. Most important is to maintain a routine.
As we return to normalcy, that will happen one day, we must remember that we will need our immunity far more than we ever did; therefore, it is important to start taking care of it from now on.
Oh, I can’t smell anything. The Anosmia
The loss of smell had been a major complaint in people getting COVID-19. Now, there are increasing cases of an altered sense of smell by many individuals, who in the past developed COVID-19. In fact, it is generally believed that loss of sense of smell (Anosmia) and sense of taste (ageusia) are very specific to COVID-19 infection. Therefore, if anyone experiences these two symptoms together, they should get themselves tested for COVID-19.
However, it must also be said that there is no need to panic. Till the test report becomes available, isolate yourself and keep wearing a mask and follow other pre-cautions, all the time.
But, it may give you some sense of relief to know that COVID-19 alone doesn’t cause these symptoms. Several respiratory viruses like rhinovirus, Parainfluenza virus, and a few others affect nasal epithelium cells and result in loss of smell.
Before the Pandemic, when any of us had an episode of common cold, we lost some of our sense of smell. Though, in COVID-19, it is more pronounced. Essentially, any infection/illness that causes swelling and inflammation of the nasal mucosa and increased mucus secretion, which manifests as nasal obstruction, and therefore, may result in the loss of smell, to an variable extent. In this epithelium are the receptors of the olfactory nerve, which send the signals of smell from nasal mucosa and epithelium to the brain.
When SARS CoV2 infection happens, that epithelium gets inflamed, and receptors and the nerve-ending in nasosinusal mucosa gets affected and even damaged. So they fail to transmit the signal, and people stop the sense of smell.
This is a temporary phenomenon. Most people start getting a recovery path, 2-3 weeks onwards and nearly all get full recovery to their sense of smell. A small proportion of COVID-19 patients may take a longer time to recover from Anosmia. This is because a larger area of the nasal epithelium is affected in those individuals, likely more deep damage of a significant number of olfactory receptor neurons. Yet, these nerve-ending have amazing capacity to recover, and nearly all would recover.
Ah, I get strange smells. The Parosmia
Many weeks and even months after COVID-19 infection and recovery, a proportion of people start complaining of an altered or distorted sense of smell. In this condition, the smell of certain things — or, in some cases, everything – can be distorted. This condition is called Parosmia. Some of the people with Parosmia may have developed Anosmia
earlier, but that is not necessary. Parosmia is now recognized amongst the common post or long COVID-19 symptoms.
Parosmia can develop after many weeks of recovery. It is distressing as a pleasant smell may appear very repugnant during this illness. For example, a perfume or deodorant one likes may smell awful. Even the smell of your favorite food could be sickening. For example, a nice soup may smell disgusting and repugnant. Parosmia may start around 4-8 weeks after recovery but can develop six months or even later.
Though Parosmia is very discomforting, there is a positive side to it. Parosmia in a person indicates that the sensory receptors and the ending of the olfactory nerve, which might have been damaged after infection, are regenerating. The new regenerated olfactory neurons sprout and attempt to make new connections and send signals to the brain. There are approximately 350 types of receptors, in our nasal mucosa, to detect the smell (our sense of smell is an outcome of a combination of different signals), which our brain finally interprets to recognize millions of smells around us. In this recovery process, the receptors and nerve endings re-learn and send signals by ‘hits and trials’.
Therefore, some of the signals are sent in the wrong combination and end up reaching different sub-sections of a person’s brain, and results in an altered sense of smell, the Parosmia.
There is no special test to detect and Parosmia is diagnosed based on clinical symptoms. Though a few other illnesses can also cause Parosmia, in the pandemic period, it is most likely a long or post COVID-19 symptom. There is no specific treatment for Parosmia; however, some experimental work on olfactory retraining therapy is in the research stage. Nearly all people with parosmia recover (You can be assured). All it needs is a bit of patience. If it is causing some distress, one can consult a doctor/physician.
Dr Lahariya can be reached at his email [email protected] or at Twitter Handle @DrLahariya
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