In this episode of BackTable, Dr. Puya Dehgani-Mobaraki, president of Associazione Naso Sano, discusses his research and his experience as a rhinologist with SARS-CoV-2 and its effect on the olfactory system.

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SHOW NOTES

First, Dr. Dehgani-Mobaraki explains the goals of the Associazione Naso Sano, which is to provide community education about rhinologic conditions, distribute research grants to young researchers, and host international grand rounds. Then, he discusses his own experience with SARS-CoV-2. He was infected with the virus in early 2020 and could not be tested because he had no upper respiratory symptoms, only anosmia. He also reflects on the research he did in 2020, which focused on immune adaptation after infection. His research group discovered that there was a strong relationship between antibody production and smell loss. He notes that later variants of the virus became more infectious, but not more lethal. After December 2021, he noticed that the virus mutations led to a different pathway of generating symptoms, resulting in more upper respiratory symptoms and less anosmia. Furthermore, he reminds listeners that smell and taste disorders are not unique to SARS-CoV-2 and can be triggered by Parkinson disease, Alzhiemer disease, brain trauma, and nasal polyposis.

Next, he speaks about his personal experience with treating patients with anosmia. Usually, COVID patients will regain their sense of smell any time from 20 days to 6 months after infection. However, some patients experience longer lasting parosmia, an altered quality of smell, and phantosmia, the perception of smell without stimulus. He notes that these symptoms can be difficult and distressing to patients. Smell and taste disorders can lead to weight loss and psychological disturbances, as these two senses are integral to community formation and pleasure. Although some patients can self-train to live with altered smell and taste, some may require medical consultation for a structured smell re-training plan or medications, such as oral steroids, PRP injections, zinc, or alpha-lipoic acid. Finally, Dr. Dehgani-Mobaraki speaks about his most recent research project, which may suggest that SARS-CoV-2 can reactivate Epstein Barr virus through autoimmune pathways.