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Green-headed sunbirds

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Data that COVID-19 causes a temporary loss of smell in some of the patients appeared several months ago. Initial research and survey of complaints helped to identify this common symptom - in some patients, it even turned out to be the only manifestation of the new coronavirus. But in the past few months, an unusual symptom has become increasingly mentioned in communities, chat rooms and forums - a strong distortion of odors a few months after recovery.

Many people note that it is very difficult to characterize new smells: they are not at all similar to the usual, familiar ones. But in one thing, all those suffering from an incomprehensible symptom are in solidarity: these smells are definitely not pleasant. The intensity of discomfort is different: someone just had to give up coffee drinks and change their toothpaste, and someone has practically not been able to eat for a month.

Due to the lack of published scientific data, doctors only shrug their hands at such complaints. Therefore, people with a newly acquired olfactory distortion gather in groups and communities, where they try to share their own observations, support each other and give advice. In the English-speaking environment, these people are supported by the non-profit organization AbScent. Her team consists of otorhinolaryngologists, researchers, patients and activists. AbScent has been around for years, researching olfactory issues and keeping the public informed. But with the advent of COVID-19, their audience has grown dramatically, and a separate section has appeared on the site for people suffering from loss or distortion of their sense of smell in connection with the coronavirus. A lot of useful information can be found on their website, from a regularly updated list of scientific publications to a detailed guide for patients.

In the Russian-speaking space, people with post-coronavirus distortions of smells and tastes gather in the Smells / Tastes after COVID-19 chat - at the time of publication, it consists of three and a half thousand people. In their first chat messages, most of the participants talk about how they first found themselves in an environment where they are not considered crazy - relatives, friends and doctors often simply do not believe in the reality of their problem.

Luda's story

“My parents got sick with coronavirus in May. Mom's CT scan showed right-sided pneumonia, although the first test for COVID-19 came back negative. But in July, she passed an antibody test - and she had them. I fell ill in June, and my illness was practically asymptomatic: literally one day of a runny nose and a temperature of 37. And after a while I lost my sense of smell for a whole month: just like that, for no reason. It returned gradually, and at some point I noticed a change in the previously familiar smells. My brother's girlfriend has the exact same story. And she and I are the only ones for whom the smells have changed - my mother, for example, doesn't have that.

In mid-July, I began to feel strange odors in the subway and did not understand what was happening until, by chance, a friend waved her hand in front of my face, having previously used an antiseptic. All these antiseptics in the subway stink terribly, this is what I noticed in the first place. After that, I somehow went to visit my grandmother and I started to feel sick from the smell of food being prepared. It was so unbearable that I held my breath and ran away: I seriously thought that she was frying human flesh with onions (the heroine calls the smell of “human flesh” the smell that she remembered during laser vision correction. Approx. ed.).

No one in the family understood why I was reacting this way. One day I vomited when I made lasagna.Gradually, so many shampoos, perfume, boiled and fried eggs, raw onions, meat began to smell like that, and this is terribly disgusting - a mixture of something nauseatingly sweet and overcooked. Now it smells like that in shawarma stalls and canteens, it's hard for me to pass by these places. It is even more difficult to be at home in the kitchen or to wash in the shower, you have to constantly hold your breath. "

Alexander Melnikov

General Practitioner, Head of the Department of Somnology, National Medical Research Center of Otorhinolaryngology

“What is the reason for the violation of the sense of smell in the new coronavirus is not yet known exactly. But there are certain distinctive features of such violations in COVID-19. First of all, loss of smell (anosmia) is usually a fairly early symptom. In this case, a person may not have a runny nose or nasal discharge, but he loses his sense of smell. There is a fairly well-founded theory that olfactory disorders in COVID-19 in some cases are manifestations of lesions in the central nervous system. In the central nervous system there are olfactory bulbs - nerve structures, part of the brain. They receive and process signals from the olfactory receptors. Brain MRI of people with loss of smell due to coronavirus infection reveals changes in these structures. "

The SARS-CoV-2 virus is known to infect the body by attaching to ACE2 receptors on the surface of cells in the upper respiratory tract. A protein called TMPRSS2 helps the virus enter cells. Once the virus has entered the cell, it can begin to copy itself (replicate), triggering an inflammatory response from the immune system.
When the impairment of smell associated with the new coronavirus was just beginning to be studied, it was believed that this is how the virus penetrates and destroys olfactory neurons (cells responsible for transmitting a signal from an aromatic component that has entered the nose to the brain, where this signal will be processed). But recent research indicates that olfactory neurons lack the very ACE2 receptors needed for the virus to successfully attach. But they are on the stentacular cells - the cells that support the olfactory neurons. Some scientists now agree that it is the damage to these "supporting" cells, combined with the inflammatory edema of the nasal cavity, that causes the loss of smell - but the neurons themselves remain unharmed.

True, in the case of a particularly acute inflammation, the damage can "reach" to them: then we are talking about the next stage of impairment of smell. When neurons are affected, recovery can take much longer. Their regeneration takes place with the help of stem cells present in the nasal mucosa. It is in such cases that the first step towards recovery can be accompanied by the distortion of odors - parosmia.

Tatiana's story

“My daughter is sick, she is 20 years old. She works in a hospital, in the department of radiology - there, in the "red zone", and got sick. She suffered a mild illness. For four days, the temperature remained in the region of 37.5–37.8, CT scan - without signs of pneumonia. The coronavirus test is positive. At the end of the second week of illness, she developed a dry cough and aggravated asthma. The sick leave lasted 26 days.

Smells and taste disappeared from the second day of illness, and returned only a week after discharge. That is, there was no smell and taste for more than a month. A month and a half later, at the end of July, these [unusual] smells appeared. The daughter first felt this smell from her body and from the meat. I even threw out the chicken - I thought I was spoiled. Urine and feces also have a strong odor, which she describes as "sweet-putrid." In the early days, we realized that eggs, meat, onions, and carrots have the same unpleasant smell and taste. Then buckwheat, bread, cottage cheese and tomatoes were added.

The MRI examination showed the vertebrobasilar arterial system syndrome, the endoscopy of the nasal sinuses - mucosal edema. Lore said that these are the consequences of the virus: other viruses can also cause this symptom. For example, acute herpes and cytomegalovirus. He prescribed vitamin B and hypoxene to nourish the vessels of the brain. In general, the doctors we visited say that we are the first with such a problem. Today we even visited a psychiatrist. They did not hear about such a "miracle" either - but they willingly recognized us as their patients and prescribed a strong antipsychotic. In general, we understood one thing: the problem is unknown and, the worst thing, no one wants to study and explain it. "

Should anosmia or parosmia be treated?

Alexander Melnikov: “At the moment, there is no scientific evidence on the effectiveness of the treatment of olfactory disorders associated with damage to the central nervous system and viral infections. But the topic of what is generally prescribed for COVID-19 for "treatment" is very broad. Unfortunately, they prescribe whatever they want - especially this applies to all kinds of vitamins and dietary supplements. This is a separate issue. What has occurred to someone - especially if a person with a degree and has a certain position - then he begins to promote as know-how in treatment. When assessing the effectiveness of various methods, it is necessary to take into account the spontaneous course of the process - olfactory disorders often go away on their own, and it is rather difficult to predict here.

It is also important to understand that the overall experience with COVID-19 loss of smell is small, only a few months. But there is data about other viral infections, about the loss of smell with damage to the central nervous system, including after brain injuries or due to demyelinating diseases. And this data suggests that there is no cure for anosmia. Another thing is if the violation of the sense of smell is associated with the nasal cavity - when a person is worried about rhinitis, sinusitis, polyposis. In such cases, it is necessary to treat the process in the nose and, with successful treatment, the sense of smell is restored. "

The creator of the chat "Smells / tastes after COVID-19" Yulia points out in the rules that it is forbidden to give any advice on treating a symptom with drugs: "Their uncontrolled intake can cause serious harm to health, especially since the effectiveness of any drug in our case has not yet been proven." The goal of the group is mutual support and collection of scientific information about parosmia and taste changes after coronavirus. In addition, the chat publishes links to questionnaires and studies that can help doctors and researchers study the symptom, because the main problem at the moment is the lack of information. Such uncertainty becomes a source of anxiety for many who find themselves face to face with an undescribed syndrome.

Julia's story

“I recently visited a neurologist at a state clinic. The doctor finds no indications for an MRI examination - I barely begged for a CT scan of the brain.

The therapist honestly said yesterday: "We just don't know anything yet, observations are just being made."

A man once wrote to me, assuring him that he has connections in the medical community and they want to take control of us and conduct research. But he never came to me again. There is another doctor who "in secret, only to me" claims that research has been carried out, that everything is very bad and dangerous, and only her clinic treats it (and the whole world does not know). But I don't even tell anyone about this - you never know who writes what on the Internet. I was not provided with any confirmation of their "research".

The distortion of odors after the coronavirus affected me. What can I do?

At the AbScent webinar, specialists and patients talk about parosmia as a step towards full recovery of the sense of smell. And even though some aromas after recovery may not remain exactly as you remember them, the acute phase with unbearable odors will end sooner or later.

If you speak English, you can participate in one of the organization's Zoom conferences: the next one will be held on September 15 and will focus on changes in the field of nutrition and intimate life caused by impairments of smell.

You can also help research by completing the Parosmia Questionnaire or the COVID-19 Impact Survey Questionnaire. The latter is being conducted by the Global Consortium for Chemical Sensor Research. On the main page of the questionnaire, you select the item that suits you, and you are sent to the appropriate questionnaire or offered instructions for self-examination.

What can help to transfer the acute phase of parosmia more easily?

- If food smells so disgusting to you that you cannot eat anything, try bland food: rice, boiled potatoes. If you can't even eat these foods, stock up on protein shakes without flavors or flavors.

- Avoid known triggers: coffee, fried or baked meats, any fried food, eggs, garlic, onions, mint toothpaste, chocolate, and some artificially flavored foods.

- If your sense of smell is dulled rather than altered, try the so-called smell training method: prepare for yourself several bubbles, each of which will be filled with different essential oils. Sign the bubbles and do small "workout" sessions several times a day, inhaling the scent from each bubble and noting how you feel.

- Take care of your mental health: try different meditation or relaxation practices, consult a psychologist. Severe impairments to the sense of smell can cause severe stress, and stress, in turn, can worsen symptoms.

Ⓘ Green-headed sunbirds

  • Olive sunbird Cyanomitra olivacea A. Smith, 1840
  • Cyanomitra veroxii A. Smith, 1831
  • Azure-headed sunbird Cyanomitra oritis Reichenow, 1892
  • Bannerman's nectar Cyanomitra bannermani Grant et Mackworth-Praed, 1943
  • Cobalt-headed sunbird Cyanomitra cyanolaema Jardine et Fraser, 1851
  • Malachite-headed sunbird Cyanomitra verticalis Latham, 1790
  • Blue-headed sunbird Cyanomitra alinae Jackson, 1904
  • 1851 - Ruby-faced Sunbirds Cinnyris Cuvier, 1817 - Olive-bellied Sunbirds Cyanomitra Reichenbach, 1854 - Green-headed Sunbirds Deleornis Wolters
  • Harpactes kasumba - red-headed Asian trogon Harpactes oreskios - green-headed Asian trogon Harpactes orrhophaeus - brown-bellied Asian trogon
  • Carmine-cheeked Sunbird Chalcoparia singalensis Asian Sunbird or Purple Sunbird Cinnyris asiaticus Yellow-bellied Sharp-tailed Sunbird Aethopyga

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