OH, NOSE – Aurora Children’s Clinic trains children’s sense of smell that has been lost due to COVID-19

Evan Cesa, a patient, smells a small pot of fragrance on Monday, February 8, 2021, during tests at a clinic in Nice, France, to see how his sense of smell and taste has deteriorated since contracting COVID-19 A year into the coronavirus pandemic, doctors are making efforts to better understand and treat patients who are losing their sense of smell. A specialty clinic opened at Aurora Children’s Hospital Colorado to help COVID-19 patients retrain their sense of smell. (AP Photo / John Leicester)

Orange. Eucalyptus. Lavender. Peppermint.

Doctors at Colorado Children’s Hospital in Aurora and Seattle Children’s Hospital will use such fragrances to treat children who have lost their sense of smell from COVID-19. Parents visit the clinics and go home with a set of essential oils for their child to sniff twice a day for three months. Doctors will review their progress monthly.

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

The treatment known as “smell training” has been shown to be clinically effective in adults. However, clinicians said there is virtually no data on whether the method works in children.

Although children are much less likely to develop COVID or suffer from its consequences than adults, the number of pediatric patients has steadily increased. More cases mean more children have persistent symptoms known as “long COVID”. Loss of smell is one of these complaints.

The connection between coronavirus infections and odor disorders in adults is well documented in both patients with short-term illnesses and so-called long-distance drivers. However, scientists still aren’t sure how many people develop this complication or how the virus causes 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.

However, the sparse 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 caused by COVID. That’s because kids rarely develop these problems, he said, and the novel coronavirus was just that – novel.

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

It works for adults. Will it work for kids?

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

In general, this works like this: Doctors test a patient’s sense of smell to find a baseline. Adults are then given a range of essential oils with specific scents and instructions on how to train their noses at home. Patients typically sniff each oil twice a day for several weeks to months. At the end of the workout, the doctors test them again to see if they have improved.

Dr. Yolanda Holler-Managan, a pediatric neurologist and assistant professor of pediatrics at Northwestern University’s Feinberg School of Medicine, said she doesn’t understand why this method wouldn’t work for children either. In both age groups, the olfactory nerve can regenerate every six to eight weeks. While the nerve is healing, exercise can help strengthen your sense of smell.

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

When doctors began discovering smell and taste problems in adults with Covid late last spring, Dr. Kenny Chan, the pediatric ear, nose and throat specialist who oversaw the new Colorado clinic, said this could be a problem in children as well.

Dr. Kathleen Sie, head of ear, nose and throat 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, Chan called you to discuss it. The conversation shot to the spearhead of an odor training clinic in her facility.

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

To work around this problem, Chan replaced odors that might be more recognizable with some fragrances.

It is also difficult to find children with odor disorders. Many with Covid are asymptomatic and others may be too young to verbalize what they are experiencing or realize what they are missing.

Still, McClay said, the potential benefits of ease of treatment outweigh the costs and challenges of setting it up for children. Adult scent training kits cost less than $ 50.

“There is no data to suggest that this will do anything,” Chan said. “But if no one deals with this question, this question will not be resolved.”

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