I know there's no such thing as a normal case of Covid but I've had an odd (but minor) case so far.

Day 1 I actually thought I had food poisoning. Diarrhea so bad I swore it was the oysters I had the day before. But the diarrhea continued for another 5 days. On day 6 I started feeling aches and on day 7 I knew I had it. Tested positive on day 8 and by the end of the day I was already starting to feel better. Woke up this morning (day 10) and I'm more or less back to normal. However I just lost my sense of smell this morning.

I know this is a common symptom but I thought the loss of smell generally happens at the beginning? And I still have my sense of taste?

My uncle was feeling under the weather for about a week before losing his sense of smell. Was tested the following day and tested positive. Unsure the under the weather was the beginning of the infection or not, but he started to regain his sense of smell about 7-8 days after losing it. So that would lead me to believe he likely lost it closer to the end than the beginning.

Same here, lost smell when I had COVID. It has been 3 weeks and still not completely returned.

My cousin who tested positive said his taste/smell was the last symptom to present. Had chills & fever come and go randomly, body aches, but only lost taste for 2 days then slowly came back over the following week.

He's 22, though, so not sure how meaningful that is.

any way to get your heart checked for damage from the mild infection?

cone said:

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any way to get your heart checked for damage from the mild infection?

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I think I've about hit my deductible for the year so I could go get an MRI. Would it be better to wait a month to see if there's long lasting impact?

I never had a fever or coughing, primarily just diarrhea, body ache, headache with a little congestion. I'm also 31 if that matters. I did see the report about the Red Sox's pitcher having heart issues from his Covid bout.

My wife lost her senses of smell and of taste right at the end, after her fever broke.

It took about a month for things to get back to normal.

Good friend's wife lost her sense of smell toward the end. It sounds like that might not be unusual.

Went on a 7.5 mile run last night
Didn't finish my dinner which is very strange for me.
Rumbling stomach all morning
Diarrhea

Getting kind of nervous.

What does the run have to do with it? Is that normal run for you?

Not sure if I had any illness, but a few weeks ago I couldn't complete my normal exercises; had to quit about 2/3 through - inexplicably.

Yes. Normal Sunday evening run. It is very unusual to not finish my dinner after burning 1,000 calories running. Hopefully just a weird stomach bug.

Olfactory nerve inflammation. I've seen medrol dose pak speed recovery in a couple patients.

Is elevated heart rate a symptom? Just rode my bike and my heart rate seemed to be 5-10% higher than normal at the same power output. Was on vacation last week so havent ridden in 10 days or so but I doubt I would have lost aerobic fitness that fast.

Note: I don't think I have covid just another thing that has me a bit on edge.

One thing I'm curious about is the link between the cytokines storm we hear about and the loss of smell.

I have been thinking about the loss of smell a lot when it comes to coronavirus. It just seems such a weird symptom to have and also weird that it comes late in the process.

I personally deal with Type 2 diabetes so I know that it is one of the primary comorbidities for COVID.

I also know that one of the early signs of Type 2 is the loss of smell. I notice it as my blood sugars get out of control and it comes back when I have them back in line. Also, my uncle went years undiagnosed as a diabetic and he always said he had no sense of smell then.

So, I looked up cytokines and found this on cytokine diabetes:

https://www.webmd.com/diabetes/inflammation-and-diabetes#:~:text=Researchers%20discovered%20that%20in%20people%20with%20type%202,alters%20insulin%27s%20action%20and%20contributes%20to%20the%20disease.

Quote:

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Researchers discovered that in people with type 2 diabetes, cytokine levels are elevated inside fat tissue. Their conclusion: Excess body fat, especially in the abdomen, causes continuous (chronic), low levels of abnormal inflammation that alters insulin's action and contributes to the disease.

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Is it possible that the effects of the virus generate a diabetes type reaction in the body releasing the cytokines? Almost a form of diabetic coma?

For any of the doctors reading - for your sicker patients, what does their blood sugar levels and insulin response look like? To me, it would explain the weird loss of smell effect and also why some people get sicker than others if they can handle the sugar swing it causes.

Interesting question, and I wonder if you are possibly referencing some of the work citing a potential pathophysiology for the anosmia so often seen in COVID-19 patients, as seen below:

Proinflammatory Cytokines in the Olfactory Mucosa result in COVID-19 Induced Anosmia

More recently, however, it has come to light that the pathophysiology that we see in viral neuropathy resulting in anosmia seen with most rhinoviruses, adenoviruses, and even coronaviruses differs in a significant way from SARS CoV-2. See below:

How COVID-19 causes smell loss

Cliff notes: most viruses directly attack the smell sensory neurons, but SARS CoV-2, instead, attacks the support cells for the neurons because of the receptors on these cells (ACE-2, etc.). The article makes the assumption that this will mean that COVID-19 patients will recover their sense of smell in greater frequencies. At this point, the jury is still out, in my humble opinion, but hopefully that will be the case.

Here is a TL;DR summary related to diabetic neuropathy in general:

Mechanism of diabetic neuropathy blah blah blah so many words

Microangiopathy seems to be more important in diabetes, if not the key, with regards to diabetic neuropathy, but the mechanism is obviously different between the two conditions. Where this relates clinically is the role of steroids in preventing long-term recovery in patients suffering anosmia related to COVID-19. While there is not a direct recommendation for steroids in this case, we as ENT doctors do, in general, like to give fairly high dose steroids early when we are seeing patients with a sudden onset of a loss of sense of smell. The indications are very clear when we see patients with sudden sensorineural hearing loss, which is typically related to a viral condition or a microangiopathy. MOST ENT physicians, in my opinion, would probably therefore recommend steroids to someone with new onset anosmia (as I did just yesterday for a 22-year-old undiagnosed patient who refused COVID testing because her Mom with whom she lives did not want her to be tested?????), but would defer to their PCP or whoever is treating their COVID-19. And, clearly, high dose steroids would be at least partially contraindicated in diabetics, especially brittle diabetics, because they increase blood sugar levels.

This stupid virus just sucks, why can't it just act normal like all the others?

I'll share something interesting that I noticed yesterday. My sense of smell came back, whats weird is I never really knew it was gone, it was just really dull.

But starting yesterday I really started noticing things that my nose must have been blind to. Just makes me wonder if i cleared it and never knew. Looking back now most of July my smell was off, but yesterday It was great.

Example: morning coffee was really good, I could smell the loaf of bread when I opened it, I could smell myself.

I think I wasn't smelling that for about 4 weeks now.

When I think back on the month I also had some mild symptoms, but they were so mild I didn't really pay attention to them.

Kool said:

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Interesting question, and I wonder if you are possibly referencing some of the work citing a potential pathophysiology for the anosmia so often seen in COVID-19 patients, as seen below:

Proinflammatory Cytokines in the Olfactory Mucosa result in COVID-19 Induced Anosmia

More recently, however, it has come to light that the pathophysiology that we see in viral neuropathy resulting in anosmia seen with most rhinoviruses, adenoviruses, and even coronaviruses differs in a significant way from SARS CoV-2. See below:

How COVID-19 causes smell loss

Cliff notes: most viruses directly attack the smell sensory neurons, but SARS CoV-2, instead, attacks the support cells for the neurons because of the receptors on these cells (ACE-2, etc.). The article makes the assumption that this will mean that COVID-19 patients will recover their sense of smell in greater frequencies. At this point, the jury is still out, in my humble opinion, but hopefully that will be the case.

Here is a TL;DR summary related to diabetic neuropathy in general:

Mechanism of diabetic neuropathy blah blah blah so many words

Microangiopathy seems to be more important in diabetes, if not the key, with regards to diabetic neuropathy, but the mechanism is obviously different between the two conditions. Where this relates clinically is the role of steroids in preventing long-term recovery in patients suffering anosmia related to COVID-19. While there is not a direct recommendation for steroids in this case, we as ENT doctors do, in general, like to give fairly high dose steroids early when we are seeing patients with a sudden onset of a loss of sense of smell. The indications are very clear when we see patients with sudden sensorineural hearing loss, which is typically related to a viral condition or a microangiopathy. MOST ENT physicians, in my opinion, would probably therefore recommend steroids to someone with new onset anosmia (as I did just yesterday for a 22-year-old undiagnosed patient who refused COVID testing because her Mom with whom she lives did not want her to be tested?????), but would defer to their PCP or whoever is treating their COVID-19. And, clearly, high dose steroids would be at least partially contraindicated in diabetics, especially brittle diabetics, because they increase blood sugar levels.

This stupid virus just sucks, why can't it just act normal like all the others?

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Very interesting and thanks for the response! Pretty clear I need to try not to over-think this because a lot smarter people than me are looking at this. . . .

Nothing wrong with thinking, that's for sure. I am not too proud to say that I learned a thing or two, if not three, in searching for the "answer" to your question as well.

I read an article a while back that seemed to link loss of smell (and other brain symptoms) to micro clots. In other words small blood clots might be causing small strokes in the brain.

I will see if I can find the article.

Maybe I'm dreaming things but it feels like inflammation near the bridge of my nose. I can feel it get a little better each day. Makes sense why an anti inflammatory drug would help bring smell back.