Dr. Jeanette Brown, assistant professor of medicine and medical director of the comprehensive long-hauler COVID-19 clinic, shares the longterm effects COVID-19 can have on patients during a virtual conference Thursday. (Screenshot)
SALT LAKE CITY — Even if COVID-19 patients avoid severe illness, about 30% will still have symptoms including fatigue, heart conditions and an abnormal sense of taste and smell that may affect them for a long period of time — perhaps even for life in some cases, University of Utah Health specialists said in a virtual conference Thursday.
University of Utah Health opened a comprehensive long-hauler COVID-19 clinic in mid-July. They have seen about 100 patients so far, with 300 working to get scheduled. They receive around 10 referrals a day, both within the state and in neighboring states, said Dr. Jeanette Brown, assistant professor of medicine and medical director of the clinic.
A recent study was released that shows promising data that vaccination can potentially reduce the risk of getting “long COVID,” though Brown noted that the app used to collect that data is “a little cumbersome, so it might not be completely inclusive.” That being said, “protection from severe disease and becoming long-haulers is an important reason to get vaccinated,” she concluded.
A loss of smell, and thus taste because the two senses are so interconnected, is a well-known early sign of COVID-19 that often precedes many other symptoms. While the majority of people recover their sense of smell within six months, it is common for it to be altered, resulting in a condition called parosmia, where smells are distorted and normal smells can become terrible.
Dr. Richard Orlandi, a professor of otolaryngology at University of Utah Health, explained that this loss experienced by 80% of COVID-19 patients, is a result of the virus directly attacking the nerves that conduct the sense of smell in the nose, causing them to die out and then regrow.
“(Parosmia) is a little bit like pulling all of the wires out of a switchboard and putting them all back in. Sometimes those connections don’t end up where they were originally. Roses can smell like rotting food or gasoline can smell like lavender,” he said.
Around 5-10% of patients seem to have a permanent loss of their sense of smell, which impacts taste. But Orlandi concedes the data in this case only goes back as far as the cases go back — just over a year.
This loss of smell can lead to a lower quality of life and even depression, he said. But it can also be immediately dangerous in some circumstances, like if people can’t smell a fire or natural gas and are unable to react in time to be safe.
It is possible to improve the condition through smell-retraining therapy, initially developed to help people who had lost their sense of smell through head trauma or other viral illnesses. Patients smell a few different smells a day, like coffee, peanut butter, essential oils, lavender, etc., and do this once or twice a day every day.
Dr. Kevin Shah, an assistant professor of cardiovascular medicine at University of Utah Health, has seen many patients who have no known pre-existing heart conditions develop long-term chest pain, shortness of breath, palpitations and lightheadedness in long-haul COVID-19 patients.
In more severe “long COVID” cases, patients can develop pericarditis, inflammation of the heart sac; myocarditis, inflammation of the heart muscle; dysautonomia, a dysfunction of the nerves that regulate involuntary body functions; and postural orthostatic tachycardia syndrome, a hyper-exaggerated response to changes in position.
He has seen children and young people develop myocarditis or myopericarditis, and atrial fibrillation — an irregular, fast heartbeat — has been a side effect in some cases. Cardiologists are starting to recommend heart monitors for young people in these cases, he said.
Orlandi stated that, although in very rare circumstances the vaccine can cause myocarditis, it is far more likely that COVID-19 will cause myocarditis, and the effects of the vaccine so far outweigh the risks.
The doctors recommend that everyone be vaccinated, even people who have already had COVID-19. Brown explained that just because you have recovered from COVID-19 once does not mean that you won’t get it again or will easily recover a second time. Some of her patients who have gotten COVID-19 for a second time have ended up with even more severe cases.
“Natural immunity seems to fade and getting a vaccine after a COVID experience does really boost the immune system so that you’re not getting it again in the future,” Orlandi said.
Brown also noted that doctors at the clinic take extremely thorough histories and try to “keep an open mind” that the long-hauler symptoms could be something else. She noted that a colleague of hers caught an instance in which a patient who was experiencing fatigue had a gastrointestinal bleed, not “long COVID.”
“It’s key for us as medical providers to make sure that we’re not forgetting about other conditions it possible could be manifesting,” she said.
Information regarding how patients experiencing “long COVID” symptoms to apply to be seen in the clinic can be found on their website.