DEAR DOCTOR, It’s been six weeks since my sister recovered from Covid-19, but she hasn’t gotten her sense of smell back. She is worried; does this get back to normal? Is there anything she can try at home to help? SIMON DEAR SIMON, It is good to know that your sister survived Covid-19 infection. Because in the second wave around early and mid-2021, hundreds of people worldwide lost one or more of their loved ones to Covid-19. The nose is the portal for entry of the Covid-19 virus, in majority of cases as the virus spreads through droplet infection. An affected person exhales the virus while coughing and or sneezing, in air borne droplets, and these can be inhaled by a person sitting or standing opposite to him. The nose is also the beginning of the respiratory system. From there, it can travel to the throat and then to lungs if unchecked or load of infecting virus is high. Affection of lungs results in viral pneumonia, which if severe, can lead to sudden death. Thus, respiratory failure is one of the causes for death in Covid affected patients. Severity of disease and survival depends on many factors. Older people, those with reduced immunity as patients with diabetes or HIV infection or on long term steroid therapy are more vulnerable to develop severe infection with complications or die. As inner lining of the nose gets inflamed after entry of the virus, sense of smell is reduced or lost, as an early sign of Covid infection. In majority of cases, it is the first or only symptom suggestive of infection by Covid-19. In most of these cases, affected people have recovered their sense of smell by four to six weeks after initial infection. Because that is the usual time of healing of nasal mucosa (inner lining of nose). In some cases it may take longer, but it is sure to return if a person has survived the infection. In the initial stages, steam inhalation two to three times daily, helps to destroy the virus lodged in the nasal passage and prevents its further progress. There are some home remedies as well, which people claim are very effective. However, since Covid-19 infection itself has been a very new disease of which people were unaware and unprepared, similarly, its treatment, both pharmaceutical and non-pharmaceutical is very new. Different remedies have been suggested at different times, but when scientific studies are done overtime, efficacy of different treatments will be established. One such remedy is putting one drop of warm castor oil drop in each nostril. Chewing a piece of ginger slowly or drinking ginger in decoction or tea is also effective. Peel and put three to four garlic pods in a cup of water, boil it, drain it and then drink that water. As such, simple steam inhalation, done two to three times every day is also useful. Drinking warm water frequently keeps the throat warm and moist and also helps to destroy the virus lodged in extension of inner lining from nose to throat. Whatever remedy one finds easy and feasible can be followed. Only thing needed is regularity and patience. After adopting any one or more of home remedies, one will not get immediate results after just one or two times. Preventive measures against being infected or spreading infection to others around are still very relevant, more than two years since the spread of this pandemic. Regular handwashing, keeping social distance, covering the nose and mouth by face mask, is still useful. Anybody having cold or cough should use a tissue to clean secretions from nose and or mouth and that tissue should be disposed after putting a drop of disinfectant or burnt. Dr. Rachna Pande, Specialist internal medicine rachna212002@yahoo.co.uk
