Four years after its appearance Corona virus Its effects persist in many others, for example, in those who have not yet recovered sense of taste and smell After contracting the disease COVID-19 Caused by SARS-CoV-2.
According to World Health Organization (WHO)The ageusia And AnosmiaNames for loss of those senses, respectively, were given to 4 in 10 patients, and 20% of those who experienced distortions in smell, according to data from Oregon Health and Science University. No They recovered it in the next three months COVID-19.
This significant percentage of people who did not recover the ability to perceive perfumes and tastes was a motivation. Hokkaido University And Japanese pharmaceutical company Shionogi has developed a pill that has proven to be effective in combating these symptoms of the coronavirus. Thus was born Encitrelvir is an antiviral pill -known as Xocova- works as an inhibitor of 3CL protease, an enzyme essential for the replication of SARS-CoV-2.
Doctor Stella Maris Cuevas, Otorhinolaryngologist, smell and allergy specialist, explained in conversation with Infobay: “So far there is only training, which is rehabilitation and it is for anosmic patients who have lost their sense of smell, or for patients suffering from changes like hyposmia, loss of sense of smell. That’s what it is so far, it’s known since 2009, who introduced this exercise or rehabilitation, which is exercises to be done one at a time and the patient doesn’t have to stop that exercise with smell. Brings up memories of places, situations or people until you recognize them. Once you know that scent, you move on to another second scent.
The tablet was tested during the predominance of Ómicron variation, And its initial purpose was not precisely to alleviate the patients’ anosmia and viodosia, but to attack the virus in general.
In Japan, the drug is available for people with mild to moderate symptoms. Regardless of your risk factors. “Emergency regulatory approval received of Ministry of Health, Labor and Welfare (MHLW) of Japan. for the treatment of SARS-CoV-2 infection in November 2022. It remains an investigational drug outside of Japan. Provided by the US Food and Drug Administration (FDA). Encitrelvir “Fast Track designation is designed to expedite the review of potential new treatments for serious conditions that do not require medical attention,” they note. Shionogi.
“This medicine gives good results in terms of smell. Need to do more research to know a little better. But in principle, if you compare the placebo to the treatment group, that’s what they have The latter has better results in restoring smell and taste.“, the doctor explained to Infobae Patricia Portillo Masal (MN: 117.216), otorhinolaryngologist and smell and taste specialist at an Italian hospital in Buenos Aires.
“This antiviral drug is given in the acute phase of the disease, through Slightly reduces the attack or impact of the virus. The loss of smell in COVID occurs precisely in part because of the damage the virus does to the olfactory mucosa (or olfactory epithelium) and the same protective inflammatory response. The sense of smell we perceive is in the nostrils, where the olfactory receptor neuron and an accompanying supporting cell are located in the olfactory mucosa. Also, we sense sweet, salty, bitter and acidic tastes in the mouth through the taste buds, and the combination of taste and smell gives taste,” concluded the expert.
And he added: “With this medicine, we can reduce the number of people who lose their sense of smell or increase the number of people. “They improved their sense of smell after losing it in the treatment group compared to the placebo.”
Dr. Cuevas cautioned that this is a study under investigation: “It’s an Asian creation, and the idea ageusia And Anosmia They usually resolve naturally, but in other cases rehabilitation, training, etc. can work.
“Sudden loss of smell, along with taste (Smell accounts for 80% of taste) SARS-CoV-2 enters through the nasal passages and emerges as a result of contact with the olfactory epithelium,” explains the National Institute of Medical Sciences and Nutrition “Salvador”. Zubirán” from Mexico. And they added: “It It is a layer made up of three types of cells: Supplementary cells, basal cells and olfactory cells. The latter are called “first neurons” and are the only neurons found outside the brain. The first neurons, at the level of the cilia of their dendrites, have a receptor, a structure that is damaged by the coronavirus.
They pointed out that this is a phenomenon previously observed in other infections such as viruses and bacteria that attack and damage neurons, including the flu. The difference is that the incidence of anosmia and parosmia in Covid-19 is comparatively higher.
“Losing your sense of smell is dangerous,” said the doctor Adiel Ash Rabinovich, Otorhinolaryngologist at ABC Medical Center because it does not allow detection of smoke, gas leaks or spoiled food. The SARS-CoV-2 virus causes an inflammatory state in the body, especially lung tissue, kidneys and even the brain; The result is a loss of smell.
“Anosmia is caused by a specific blockage inside the nose and damage to the central nervous pathways that include the olfactory epithelium, whose mucus acts as a cellular receptor for SARS-CoV-2,” he said. Smell gradually, but there are cases in which help must be provided to restore this sensation.
The study was published in the journal Science Nature. In one trial, people with mild or moderate coronavirus symptoms received 125 or 250 mg of encytrelvir or placebo. At the start of the study, 20% of participants reported some degree of loss of smell or taste.
After the third day of treatment, the proportion of participants reporting such symptoms in the encytrelvir groups began to decrease more dramatically than the proportion in the placebo group. On day seven, the percentage of participants with loss of smell or taste was a 39% decrease in the group that took the 250 mg tablets than the placebo group. Three weeks after starting treatment, All groups reported similar symptoms.
Although scientists know that many patients recover these feelings naturally, the drug gives very good results. however, There are no plans to launch it in Europe or other continents yet.
“The drug seems to be working well, but there are currently no plans to introduce it in Europe, where the smell is most known. The cradle of the smell is in Europe, particularly Germany and Spain. It is a Japanese creation from Asia, and is said to be well tolerated by Covid patients. Mild to moderate. Until, that is, I understand that this is a drug that is given to patients with Covid, not to those with effects,” Cuevas added.
“Most people recover on their own, but we know that some people have had long-term problems with smell and taste,” he published in Nature. Yohei Doiis an infectious diseases researcher at Fujita Health University in Toyoke, Japan, and one of the study’s researchers.
Additionally, smell and taste problems are less common now than in the early stages of the epidemic. Omicron Dominated, “the loss of taste and smell started to be less and less,” he said Amesh Adalja, an infectious disease specialist at the Johns Hopkins Health Care Center in Baltimore, Maryland. “But it’s still happening and it’s a distressing sign,” the expert said.
Over time, Dr. Cuevas said, the sense of smell returns on its own. “You have to give it time and ask the patient to remove all odors, because just as the sense of smell gives taste, they also have to be careful because without smell or taste, they can ingest it. In the worst case, they can burn the food, that is, the sense of smell. Nonexistent or little patient quality of life is altered.”
And he added: “You have to take some time to teach the patient these guidelines and do the training with the help of antioxidants recommended as a vitamin complex, which are B1, B6, B12, zinc, vitamin C and D. We use some solution hypertonic salt. For example, any other type of pathology, such as chronic rhinosinusitis or allergic rhinitis, should also be ruled out, where there is already an inflammatory process.”
Cuevas concluded: “This is a work that raises many expectations, but we must think that it applies to mild and moderate cases, which will heal on their own.”
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