How COVID-19 can damage the five senses


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Considering how sick he was, Michael Goldsmith seemed like one of the lucky ones because he survived. After falling seriously ill with COVID-19 in March 2020, he spent 22 days on a ventilator in intensive care. Fortunately, Goldsmith’s condition improved and he was transferred to an intermediate level of care in the hospital as he recovered. It was then that he began to realize that he had lost most of his hearing in his left ear.

“Everything I heard had to be loud, and then it sounded like Charlie Brown’s teacher,” said Goldsmith, now 35, referring to the absurd noises the professor made in the famous cartoon.

He also had a static noise in that ear which turned out to be tinnitus. After fully recovering from the infection and returning home to Bergenfield, New Jersey, the computer security analyst and father-of-two saw doctor after doctor, seeking relief for his problems. ‘hearing. He tried several different prescription drugs, and he still wasn’t better off.

It’s easy to take our senses for granted, until there’s a problem with one of them. This is something that many people who have suffered from COVID-19 have discovered when they unexpectedly lost their sense of smell and taste. More recently, however, it has become evident that a COVID-19 infection can also affect sight, hearing, and touch.

In the short and long term, this virus can affect all the ways we perceive and interact with the world.

While it is not life threatening, “it is disarming to lose any of these senses, especially so suddenly as it occurs against the background of this infection,” says Jennifer Frontera, professor of neurology at NYU Grossman. School of Medicine.

Hearing impaired

Like Goldsmith, many people who have recovered from COVID-19 have gone on to experience hearing loss. In March question of International Journal of Audiology, researchers looked at published case studies and other reports on symptoms of COVID-19, and they estimate that hearing loss has occurred in about 8% of patients with COVID, while about 15% have developed tinnitus.

The mechanisms are not fully understood, but experts suspect the disease may affect the Eustachian tube, which connects the middle ear to the throat. “With any viral infection, you can have eustachian tube dysfunction, which can lead to fluid buildup in the middle ear – this acts as a mechanical shock absorber on the eardrum,” says Elias Michaelides, associate professor at otolaryngology at Rush University. Chicago Medical Center.

Once someone recovers from the disease, the eustachian tube empties and hearing returns to normal in most cases, although it may take a few weeks, he says. In the meantime, taking an oral decongestant and using a steroid nasal spray can help speed up drainage, says Michaelides.

But if the virus damages sensory neurons in the inner ear or cochlea, sudden hearing loss can occur and it can be permanent. It is not clear exactly how this nerve damage occurs, although it may have to do with COVID-19’s ability to trigger a cascade of inflammatory effects and damage to small blood vessels.

Because Goldsmith’s hearing did not improve in his left ear after fully recovering and trying various prescription drugs, he went to see J. Thomas Roland, Jr., chair of the Department of Otolaryngology. -head and neck surgery at NYU Langone Health. Roland told him he was a good candidate for a cochlear implant, a small electronic device that can directly stimulate the auditory nerve and generate signals that the brain registers as sounds.

“The inner ear is a very delicate organ and very sensitive to microvascular issues and inflammation, so I’m not surprised that people have experienced hearing loss or tinnitus related to COVID,” says Roland.

In September 2020, Goldsmith had a cochlear implant surgically placed in her left ear. It made all the difference, he says. “I now have 80% recognition of single words, and it’s even higher with full sentences in my left ear. And when the device is turned on, her tinnitus goes away completely. “I wish I didn’t need it,” Goldsmith says, “but I’m glad I got it. “

Blurred vision

Other people who have had COVID-19 have reported vision problems. A study published last year in BMJ open ophthalmology have found that sensitivity to light, sore eyes and blurred vision are some of the most common eye disorders in patients. And in a to study involving 400 hospitalized COVID-19 patients, the researchers found that 10% had eye problems, including conjunctivitis, vision changes and eye irritation.

“There is definitely a viral load in the eye that causes symptoms, but that doesn’t mean it necessarily causes long-term eye disease,” says study co-author Shahzad I. Mian, professor. of Ophthalmology and Visual Sciences at the University of Michigan School of Medicine.

Still, some doctors find that the SARS-CoV-2 virus can increase the risk of blood clots throughout the body, including the blood vessels in the retina, which can cause blurred vision or some degree of loss of blood. vision, says Julia A. Haller, chief ophthalmologist at Wills Eye Hospital in Philadelphia.

If a person experiences vision changes possibly related to COVID-19, it is important for them to see an eye doctor as soon as possible, experts say. “Some forms of vision loss can be treated with medication, depending on the extent of the damage suffered,” says Haller.

Tingling and numbness

A person’s sense of touch can also be affected by COVID-19 infection, as the disease has been shown to cause persistent neurological symptoms.

In a study published in May 2021, the researchers evaluated 100 people who had not been hospitalized for COVID-19 but had persistent symptoms. They found that 60 percent had numbness and tingling six to nine months after the onset of their illness. Sometimes these symptoms were widespread throughout the body; in other cases, they were located on the hands and feet.

The exact mechanisms behind these stubborn symptoms are not well understood, but they are most likely linked to local inflammation and local infection with the COVID-19 virus in the nerves, says Igor Koralnik, professor of neurology at Northwestern Feinberg School. of Medicine and Head of the Division of Neuro-infectious Diseases and Global Neurology at Northwestern Memorial Hospital in Chicago.

“In most of the cases, [the numbness and tingling] gets better over time, ”he says. “Everyone goes at their own pace. And in some cases, tingling and other symptoms of neuropathy can be treated with drugs like gabapentin, a drug used to prevent seizures and relieve nerve pain.

Loss of smell and taste

Perhaps the most recognizable effect of COVID-19 on the senses is the double blow of loss of smell and taste. Elizabeth DeFranco, a medical representative in Cleveland, Ohio, experienced both sensory changes shortly after developing a mild COVID-19 infection in June 2020.

“I was eating salt and vinegar chips, and I couldn’t taste anything,” recalls DeFranco, 58. Then she realized that she couldn’t smell anything either. These losses remain with her to this day, although from time to time she will smell a brief scent of freshly cut grass.

Virus-induced odor loss existed before anyone had ever heard of COVID-19, but the percentage of people who experience dysfunction or loss of smell is much higher with this virus than with other types of infections, according to experts. A review of studies published in 2020 found that of 8,000 subjects with confirmed COVID-19, 41 percent had problems with smell and 38 percent reported problems with taste. When people who contract COVID-19 lose their sense of smell, a condition called anosmia, they lose it in all areas, not just with one type of smell.

Generally speaking, there are two main types of odor loss. Conductive odor loss can occur when nasal congestion or obstruction prevents odor molecules from passing into the nasal cavity. Sensorineural odor loss involves damage or dysfunction of olfactory neurons, which appears to be what is happening with COVID-19.

“With COVID-19, most people don’t have a lot of nasal symptoms, and yet the loss of smell can be quite severe,” says Justin Turner, associate professor of otolaryngology-head surgery and neck at Vanderbilt University Medical Center and director of the Vanderbilt Smell and Taste Center. “We believe this is due to damage to the sustentacular cells that live in the nose and are particularly susceptible to infection with the virus.”

As people recover from COVID-19, regenerating cells can kick in and make new, functioning neurons, Turner explains. This allows most people to regain their sense of smell six to eight weeks after infection, but not everyone. At this point, doctors may prescribe systemic or topical steroids and sometimes odor conditioning, which involves repeated exposure to essential oils with different scents. It’s like the olfactory equivalent of physiotherapy.

“What you’re doing is exposing the olfactory system to these scents and helping the brain form new connections,” says Turner. “Once the damage [to neurons] has been done, we rely on the regenerative capacity of the olfactory system to help people regain their sense of smell.

Loss of the sense of taste usually goes hand in hand with loss of smell, says Michael Benninger, professor and chair of the department of otolaryngology-head and neck surgery at the Cleveland Clinic Lerner College of Medicine.

“We are not see people who have really lost their sense of taste [with COVID-19 infection]. When people lose their sense of smell, their taste is diminished, ”which means that their ability to distinguish between different flavors is lost. “If the smell comes back, the taste comes back too,” says Benninger.

Since recovering from COVID-19, DeFranco has tried many interventions, including steroid medications, antibiotics, cryotherapy, craniosacral therapy, supplements, homeopathic remedies, and smell retraining. Nothing helped. So she found ways to work around these limitations to protect her security. She installed additional smoke detectors in her house because she could not smell the smoke. She throws away all of her food before the expiration date and often has a neighbor smell food from her refrigerator to make sure it hasn’t spoiled.

The worst: “It’s very depressing to think that this anosmia could last forever. I don’t like to eat, ”she says. “I may never be able to appreciate the taste of wine or chocolate or the smell of barbecue or baked cookies or the salt in the air when I go to the ocean. No one can really sympathize unless it happens to them.

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