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Covid-19: Study shows why loss of smell continues even after recovery

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Covid-19 has hit the headlines once again. As cases continue to grow in China, multiple researchers are trying to find out more about the symptoms. They are trying to figure out how Covid-19 affects people in the long run. Loss of smell has been one of the most common symptoms that people who tested positive for Covid-19 faced. Now, a new study has provided an insight into why some people don’t fully regain their sense of smell even months after recovering from Covid-19. The researchers found that it is connected to an ongoing immune assault on olfactory nerve cells and an associated reduction in the number of those cells.

A team of researchers from Harvard, Duke and the University of California-San Diego looked at the olfactory epithelial samples that were collected from 24 biopsies. They included nine patients who suffered from long-term smell loss, also called anosmia, after Covid-19 infection.

Loss of smell is a common symptom of Covid-19. Image courtesy: Shutterstock

Loss of smell continues in some people even after recovering from Covid-19

Senior author Bradley Goldstein, associate professor in Duke’s Department of Head and Neck Surgery and Communication Sciences, says that one of the first symptoms that have usually been linked with Covid-19 infection is “loss of smell“. He notes that many people whose sense of smell is affected during the infection, will recover within the next one to two weeks. But there are some people who do not fully regain their sense of smell.

In the study, published in Science Translational Medicine, the researchers wanted to investigate the olfactory epithelium, which is the tissue in the nose where olfactory nerve cells are located, in people with smell loss for a long term.

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The researchers found infiltration of T cells that were involved in an inflammatory response in the olfactory epithelium. And this inflammatory process continued despite the absence of SARS-CoV-2, which causes Covid-19.

It was also found that the number of olfactory sensory neurons went down. It was possibly due to damage of the delicate tissue from the ongoing inflammation.

People with Covid-19 may be more likely to develop new health conditions

After recovering from Covid-19, life doesn’t always go back to normal. At least not for everyone. According to Centers for Disease Control and Prevention, some people, especially those who had severe Covid-19, face multi-organ effects or autoimmune conditions with symptoms that last for weeks, months, or even years after getting infected by Covid-19.

Covid-19 end
People who had Covid-19 may end up with new health conditions. Image courtesy: Shutterstock

Multi-organ effects can involve lungs, heart, kidney, brain and even skin. As a result of these effects, people who have had Covid-19 may be more likely to develop the following health conditions –

• Diabetes
• Heart conditions
• Blood clots
• Neurological conditions

Symptoms you can have after Covid-19 infection

Most people with coronavirus make a full recovery within 12 weeks, but for some, symptoms can last longer, as per the UK National Health Service.

Some post Covid-19 symptoms may include

•  Memory and concentration issue.
•  Chest pain or tightness.
•  Difficulty in sleeping.
•  Depression and anxiety
• Cough, headaches, sore throat, and changes to sense of smell or taste.

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Deadly fungal infections a concern in patients post-COVID-19, flu | CTV News – CTV News Calgary

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While fungi are not about to start turning the human race into zombies, like in the HBO blockbuster series The Last of Us, the World Health Organization (WHO) says invasive fungal infections are an increasing threat to human health.

Aspergillosis is one fungal infection common in our environment but, in some circumstances, it can turn deadly. In an average day, most of us will inhale hundreds to thousands of Aspergillus spores with no adverse effects, but for people with weakened immune systems it can cause deadly infections. That includes people undergoing cancer treatments, or bone marrow transplants, but it is now recognized that some viral infections, like influenza (flu) and SARS-CoV-2 (COVID-19) increase the risk of deadly fungal infection even in otherwise healthy people.

“When these kinds of things happen in the ICU, it can be devastating because even advanced medicines still can’t treat these infections,” said Dr. Bryan Yipp, an intensive care physician and researcher at the University of Calgary.

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“Once many of these infections really get ingrained and take over, clearing them with medications alone, antifungal or anti microbials, can be very difficult.”

Dr.Yipp began studying Aspergillus — a type of fungus that is a common mould — and its connection to viral infections in 2019, following three deaths in intensive care units of patients initially admitted for influenza, but who subsequently died of the fungal infection.

“It was very much a surprise when people first started identifying the fungus in the lung.  There was a lot of discussion around the table of ICU doctors, infectious disease doctors, asking ‘Was Aspergillosis really the cause of death, or was this just a secondary finding?'” said Yipp. “The pathologists who looked at the samples and the autopsies, were convinced that it was Aspergillosis that was the main problem.”

UCalgary researchers have determined exposure to Aspergillus, a common fungal mould, can lead to a potentially dangerous Aspergillosis infection in people with weakened immune systems.

Working in Yipp’s lab, lead researcher Nicole Sarden, a PhD candidate, isolated the mechanism by which the immune system starts failing to prevent fungal infections.

“In healthy humans. specific immune cells, called B cells, produce molecules (antibodies) that basically tag invaders so that other cells in the immune system, called neutrophils, can recognize them, eat them, and clear the infection,” said Sarden

“But when you have infections with viruses, such as influenza, or if you get COVID, these molecules are no longer present, which means that the immune systems that are trying to eat, and clear the fungi cannot do it because they cannot see it.”

Working with both mice and human blood and tissue samples, the researchers discovered that following a viral infection, neutrophils could identify a fungal infection and surround it but did nothing to destroy it.  

“The virus kills the B cells, no messenger molecules exist, so the neutrophils that would normally attack, the fungus, are blinded. They sit there and don’t know what to do,” said Sarden.

The research team also discovered that reintroducing Aspergillosis reactive antibodies can protect infected mice, leading to hopes a similar treatment will be available in the near future for humans with Aspergillosis infections.

While Yipp and Sarden focused on Aspergillus, it is not the only fungus that can cause serious, or fatal infections. It is estimated fungal infections kill an estimated 1.5 million people worldwide every year. Most of those are due to four different fungi; Cryptococcus, Candida, Aspergillus, and Pneumocystis.  Since the advent of COVID, a previously rare infection of the fungus Mucormycosis has been increasing rapidly in India. It affects the sinuses, brains and lungs of its victims. The rise in Mucormycosis has also been seen in patients who are recovering or have recently recovered from COVID.

Yipp is hopeful the research being conducted at Calgary’s Cumming School of Medicine could lead to treatments for these infections as well.

“We have some hunches that that could be a similar mechanism to what we see here with what we have found.” said Yipp. “So we think that this could be applied to multiple different types of fungi around the world.”

The research team, led by Sarden, published their findings in the journal Science Translational Medicine.

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Barrie hospital declares COVID outbreak in transitional care unit – BarrieToday

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Royal Victoria Regional Health Centre (RVH), in collaboration with the Simcoe Muskoka District Health Unit, declared a COVID-19 outbreak in the Barrie hospital’s transitional care unit on Friday, Jan. 27.

According to RVH, eight patients have tested positive for COVID-19 and have been isolated.

“Enhanced cleaning measures are underway, as well as swabbing of patients and staff,” RVH said in a news release Monday afternoon. 

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Admissions to the unit are on hold at this time, and visitors are not permitted. However, RVH says some exceptions may apply.

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Guidance for diagnosing and managing migraine – News-Medical.Net

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Migraine is a major cause of disability, affecting about 12% of people. A 2-part series published in CMAJ (Canadian Medical Association Journal) on diagnosing and managing the condition with both acute and preventive therapy provides guidance for clinicians. https://www.cmaj.ca/lookup/doi/10.1503/cmaj.211969.

“The goal of treatment of migraine attacks is to provide rapid relief from pain and other migraine-related symptoms, to restore patient function and to prevent recurrence,” writes Dr. Tommy Chan, Department of Clinical Neurological Sciences, Western University, London, Ontario, with coauthors.

“A stratified approach to treatment that empowers patients to choose from different options, depending on attack symptoms and severity, and encourages them to combine medications from different classes (e.g., nonsteroidal anti-inflammatory drugs and triptans) for severe or prolonged attacks, is preferred.”

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Part 2 of the review, which will be published February 6, focuses on preventive treatment to reduce the frequency and severity of migraine attacks.

Journal reference:

Tzankova, V., et al. (2023) Diagnosis and acute management of migraine. Canadian Medical Association Journal. doi.org/10.1503/cmaj.211969.

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