Carrying children who had Covid and lost their sense of smell

Orange. Eucalyptus. Lavender. Peppermint.

Doctors at Colorado Children’s Hospital and Seattle Children’s Hospital will use scents like these to treat children who have sensed the sense of smell of Covid-19. Parents will attend clinics and return home with a set of essential oils for their child to sniff twice a day for three months. Clinicians will check their progress monthly.

The Clinic for Odor Disorders at the Children’s Hospital in Colorado was approved to open on March 10. So far, five children have been examined and one has been enrolled. Seattle Children’s expects to open its program this spring.

It has been clinically proven that the treatment is known as “odor training” in adults. However, clinicians said, there is virtually no data on whether the method will work in children.

Although children are much less likely to develop Covid or suffer its consequences from adults, the number of pediatric patients is constantly growing. More cases means that more children show long-lasting symptoms known as “long covid”. Among these complaints is loss of odor.

The link between coronavirus infections and odor disorders in adults has been well documented in both patients with short-term illness and so-called long-term carriers. However, scientists are still not sure how many people develop this complication or how the virus triggers it. Various research teams have found clues that could explain the phenomenon, including inflammation and disorders in the structures that support the cells responsible for olfactory function.

But scarce research has focused on odor disorders in children, said Dr. John McClay, a pediatric ear, nose and throat surgeon in Frisco, Texas – let alone those induced by Covid. That’s because children rarely develop these issues, he said, and the new coronavirus is just that – a novel.

“Everything is so new,” said McClay, who is also chairman of the American Academy of Pediatrics ’otolaryngology education committee. “You can’t actually hang your hat on anything.”

Works for adults. Will it work for kids?

One intervention for adults who lost their sense of smell – whether as a result of a neurological disorder such as Alzheimer’s disease, a tumor that blocks nasal airflow, or any number of viruses, including Covid – was olfactory training.

It generally works like this: Doctors test a patient’s sense of smell to determine a baseline. Adults are then given a set of essential oils with specific scents and instructions on how to train the nose at home. Patients usually sniff each oil twice a day for weeks or months. At the end of the training, doctors re-test them to assess whether they have improved.

Dr. Yolanda Holler-Managan, a pediatric neurologist and assistant professor of pediatrics at Northwestern Feinberg University School of Medicine, said she did not see why this method would not work on children as well. In both age groups, the olfactory nerve can regenerate every six to eight weeks. As the nerve heals, training can help strengthen your sense of smell.

“It’s like helping a muscle get stronger again,” she said.

Late last spring, when doctors began to detect odor and taste problems in adults with Covid, dr. Kenny Chan, a pediatrician for ears, nose and throat who oversaw the new clinic in Colorado, realized that this could be a problem with children as well.

Dr. Kathleen Sie, head of Otolaryngological Head and Neck Surgery at Seattle Children’s Hospital, became aware of the problem when she received an email from someone at a local emergency center. After reading the message, Sie called Chan to talk about it. The conversation turned to her in order to lead the fragrance training clinic in her institution.

Both clinicians have to deal with the challenges that “scent training” can pose to children. For starters, some young patients may not know how to recognize certain scents used in tests for adults – spices like cloves, for example – because they are too young to have a frame of reference, McClay said.

As a workaround, Chan replaced some scents with scents that could be more recognizable.

Finding children who have odor disorders is also inconvenient. Many with Covid are asymptomatic, and others may be too young to verbalize what they are experiencing or recognize what they are missing.

Nonetheless, McClay said, the potential benefits of a simple treatment outweigh the cost and challenges of setting up a drug for children. Adult fragrance training kits sell for less than $ 50.

“There’s no zero data to say that this does anything,” Chan said. “But if no one cares to look at this issue, that issue will not be resolved.”

This article was reprinted from with the permission of the Henry J. Kaiser Family Foundation. Kaiser Health News, editorially independent news, is a program of the Kaiser Family Foundation, a non-partisan health policy research organization not affiliated with Kaiser Permanente.