Mach 2022 COVID Column

A-   Recent researches have shown that several Long COVID symptoms appear to be linked to the direct effect of the coronavirus on a vital central nerve. The “Vagus” nerve by example on it long trajectory from the brain to the organs like lungs, heart, intestine and diaphragm, play also a vital role in controlling the heart rate and blood pressure, the motility of the digestive system, the gag reflex etc. Subjects present with valgus nerve poor functioning due to anatomical thickening, trouble with swallowing and impaired breathing. Signs like diarrhea, tachycardia, dizziness, problems with swallowing and hypotension were common in the 22 patients studied. (20 women- vs 2 men). It looks like the nerve was found inflamed diffusely when checked by ultrasound study. The diaphragm does not move as well jeopardizing breathing. Eating and Digestion was impaired as well as swallowing in 13 patients. This study seems to corroborate that some of the symptoms of Long COVID is mediated through a direct impact on the nervous system.

B-    Women on Estrogen replacement therapy are less likely to die from COVID. A recent study publishes in Sweden (BMJ Open) this year seems to associate Menopausal hormone replacement therapy (HRT) to a reduced risk of death in the disease. This is an observational study suggesting that women may be more protected from a poor outcome during a SARS-CoV-2 infection when compared to men.

C-    The options to treat COVID-19 rest on the monoclonal antibody drugs to help the immune system to fight the virus. The Antiviral drugs which stop the virus from replicating. The Corticosteroids which serve as anti-inflammatory medication. Remdesivir (Veklury) that block the reproduction of the virus. Guidelines are often updated by the CDC. It is certainly recommended to take the vaccine and it booster especially in the case of immunosuppressed individuals. Motrin, Antihistaminic, convalescent plasma are used less now.

D-   Phantosmia is that sensation of smelling something that nobody else around seems to smell. It is termed to describe olfactory hallucinations that your sense of smell are sensing that aren’t really there. Most people tend to detect bad smells like sewage, chemical burned smells. You may smell it in one nostril or both. The smell is non-constant. This sign can be seen with head injury or with respiratory infections or in Seizures involving the temporal lobe or Parkinson’s disease as well as COVID-19. Finally, it can be seen with brain tumor. Another smell disorder is Parosmia when you present some damaged tissues following an upper respiratory infection. Many people infected with SARS-CoV-2 infections lose their smell and sense of taste or they develop a phantom smell like a sense of burned. Most people recover from Parosmia/Phantosmia but occasionally, this can last longer. It is not well proven why individuals will develop such symptoms. Phantosmia can reduced the quality of life and be associated to Depression, loss of appetite and weight loss. A consultation with an otolaryngologist or a neurologist or an allergy specialist can help find a cause. Most of the time after a COVID-19 infection or a head injury, there is no treatment. If you have a damaged nerve, healing will restore the sense of smell.

E-    A patient who was hospitalized for 550 days in a hospital for COVID-10 is finally discharged home in New Mexico. He was greeted with fanfare. Diagnosed with COVID-19 in September 2020, he was placed on a respirator and remained heavily sedated.

F-    COVID-19 death toll is now more than 6 million in the third year of the pandemic. The USA has reported 857,999 total Deaths while Brazil recorded 650,000, India 515,000 and Russia 350,000. Deaths are increasing in remote island which remained protected for the last 2 years like Tonga and Solomon Islands. The Omicron strain is preforming these ravages. Hon Kong is also reporting a surge in cases. This is still a disease of the unvaccinated where the majority of death is seen on this segment of the population.

G-   A new COVID-19 variant is discovered and we will hear more soon about it. This is the “Delcatron” being a combination of the Delta and the Omicron strains, and it was detected in France, Denmark and the Netherlands. No changes in the severity or the epidemiology was seen either but it is expected to see the spreading of this strain. The mask mandate may have been removed but the pandemic is far from being over. The USA today has reported that 2 case with the Delcatron virus have already been reported in the United States. The name Delcatron is not being used fully yet.

Maxime J-M Coles MD
Boca Raton FL


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