The reasons why COVID-19 alters children’s diet

What many parents perceive as capricious behavior when their child refuses to eat may actually be evidence of the coronavirus-associated olfactory distortion known as parosmia (Getty Images)

Does your child eat worse after getting COVID-19? It could be parosmia, an alteration of smell by which the patient perceives a normal smell as unpleasant or repugnant. In this way, the smell of a lemon can be perceived as that of rotten cabbage or even chocolate can smell like gasoline. And children, in particular, can find it difficult to eat foods they once loved, warn smell experts from the University of East Anglia (UEA) and Fifth Sense, the charity for people affected by smell and taste disorders. taste.

Parosmia is known to affect some adults after passing COVID-19, but now that the incidence of infection is higher in minors, more cases of this alteration of smell are also being seen in children. The pandemic has brought this smell disorder into the spotlight, spurring research and a large number of publications in medical journals.

“Parosmy is thought to be a consequence of having fewer functioning odor receptors, which means that only some of the components of a mixture of odors can be captured. It’s a bit like Eric Morecambe told Andre Previn: ‘It’s all the right notes but not necessarily in the right order,'” explained Professor Carl Philpott, a leading odor expert from UEA’s Norwich Medical School, who together with Fifth Sense published a guide to help parents and health professionals better recognize the disorder.

For the specialist, in many cases, the condition “causes children to stop eating and many may find it difficult to eat. This is something that until now has not really been recognized by medical professionals, who simply think that children have difficulty eating without realizing the underlying problem.

It is known that parosmia affects some adults after passing COVID-19, but now that the incidence of infections is higher in minors, more cases of this alteration of smell are also being seen in children (REUTERS)

“If children have distortions of smell, and food smells and tastes disgusting, it will be very difficult for them to eat the foods they once loved. We are very interested in sharing more information on this topic with the medical profession so that they are aware that there is a larger problem here,” said Fifth Sense President and Founder Duncan Boak.

To regain their sense of smell, the researchers recommend that both children and adults consider “smell training.” “It involves smelling at least four different scents, for example eucalyptus, lemon, rose, cinnamon, chocolate, coffee or lavender, twice a day every day for several months. Children should use scents that are familiar to them and that are not triggers for parosmia. In younger children this might not be helpful, but in adolescents it might be something they can tolerate,” said Philpott, who is seeing adolescent patients with parosmia for the first time in his career.

But one key question remains unanswered: How long does COVID-19-linked parosmia last? Scientists do not have defined deadlines. “Before COVID-19, parosmia received relatively little attention,” Nancy Rawson, vice president and associate director of the Monell Chemical Senses Center in Philadelphia, a internationally known nonprofit research group, told The New York Times. international.

In a french studio As of early 2005, most of the 56 cases examined were attributed to upper respiratory tract infections. Today, scientists can pinpoint more than 100 possible reasons for smell loss and distortion, including viruses, sinusitis, head trauma, chemotherapy, Parkinson’s disease and Alzheimer’s disease, according to Zara Patel, associate professor of otolaryngology at the University at Stanford and director of endoscopic skull base surgery.

In 2020, parosmia became remarkably widespread, frequently affecting patients with the new coronavirus who lost their sense of smell and then largely regained it before they began to experience distortions in their sense of taste and smell (REUTERS )

In 2020, parosmia became remarkably widespread, frequently affecting patients with the novel coronavirus who lost their sense of smell and then largely regained it before they began to experience distortions in their sense of taste and smell. An article in June last year in the magazine Chemical Senses, based on questionnaires, revealed that 7% of post-coronavirus patients experienced distortion of smell.

A subsequent study based on an online survey in the UK revealed that 6 months after the onset of COVID-19, 43% of patients who had initially reported losing their sense of smell reported experiencing parosmia, according to an article of the publication Rhinology. That emergence occurred an average of 2.5 months after the patients’ loss of smell, the article reported.

Mystified by the onslaught of taste and smell problems, scientists around the world are paying unusual attention to the human olfactory system, the areas of the nose and brain where odors are processed. They have focused on the olfactory epithelium, a postage stamp-sized piece of tissue behind the bridge of the nose. It is literally the nerve center for smell detection and sends messages to the brain.

When people suffer from the common cold, mucus and other fluids can block the nose, preventing odors from reaching the nerve center. But that kind of blockage doesn’t normally occur in patients with anosmia and parosmia caused by COVID-19. Some researchers initially speculated that the virus was shutting down odors by attacking the thousands of olfactory neurons within that nerve center. But then they discovered that the process was more insidious.

When people suffer from the common cold, mucus and other fluids can block the nose, preventing odors from reaching the nerve center. But that type of blockage does not normally occur in patients with anosmia and parosmia caused by COVID-19 (Getty Images)

Those neurons are held together by a scaffolding of supporting cells called sustainacular cells, which contain a protein called ANG2. A study published in July led by Harvard researchers found that the protein acts as a code for the virus to enter and destroy supporting cells.

In short, parosmia appears to be caused by damage to these cells, which distorts and prevents key messages from reaching the brain, according to a leading theory among some scientists. As those cells repair themselves, they could make misconnections and send signals to the wrong relay station in the brain. That, in turn, could lead to parosmia and phantosmia.

The National Institutes of Health issued a call in February 2021 for proposals to study the long-term side effects of COVID-19. Stanford’s Patel is currently enrolling people in a parosmia trial, preferably those who have had the disorder for 6 months or more, but not as long as a year. Meanwhile, many patients are turning to support groups for guidance. These types of organizations existed in Europe before COVID-19, but none operated in the United States.

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