Your Good Health: Persistent Symptoms After COVID Suggest a Bacterial Infection
COVID infections, like all viral infections, can make a person more susceptible to bacterial sinus infections.
Dear Dr. Roach: I'm a 49-year-old woman who recently recovered from COVID. During my illness, I lost my sense of taste and smell. Now, months later, I still have a stuffy nose and no sense of taste or smell. Then, one day, I noticed a horrible smell, like an infection. I visited my doctor, who diagnosed me with a sinus infection and prescribed 14 days of antibiotics.
However, the symptoms returned. I was experiencing a horrible smell and some awful drainage, with milky lime-green snot. I blew my nose repeatedly, but the symptoms persisted. Is this a long-term side effect of COVID?
P.M.H.
I don't believe this is solely due to COVID-19. The fact that antibiotics improved your symptoms strongly suggests a bacterial sinus infection. Sinus infections can be challenging to treat and may require extended antibiotic courses. In some rare cases, an ENT physician may need to perform a sinus sampling to determine the appropriate antibiotic, while others may require a CT scan for diagnosis confirmation.
The odour and discharge are clear indicators of a bacterial sinus infection. COVID infections, like other viral infections, can increase the risk of bacterial sinus infections. Your doctor might consider consulting an ENT physician for a more comprehensive evaluation.
Dear Dr. Roach: I have Type 2 diabetes and manage it with metformin and insulin injections (8 units). My cardiologist and endocrinologist now suggest I can stop insulin and switch to a weekly shot of Mounjaro or take a daily pill of Rybelsus. They mention that these medications have been available for years, but why weren't they prescribed before? Now, with the price of insulin capped at $35, doctors are recommending these new medications. What's your take on switching to these new GLP-1 medications instead of insulin?
S.B.
Tirzepatide (Mounjaro, approved for diabetes in 2022) and semaglutide (Rybelsus orally and Ozempic as an injection, approved in 2017) are known as GLP-1 agonists. They offer several advantages over insulin for many people with Type 2 diabetes. These medications help with weight loss, which is often a goal for those with Type 2 diabetes, and they also protect the heart better than insulin and metformin. As a result, they are considered the first-line treatment for people with diabetes who are overweight or obese due to their heart health benefits.
While the price of GLP-1 medications can be a concern, most patients receive coverage when prescribed for diabetes. These medications do have side effects, and they may not be suitable for everyone. If you were managing well with insulin and metformin, there might not have been a compelling reason for your doctor to switch. However, I assume your doctors were convinced by the potential heart or weight benefits.
In general, physicians prefer to prescribe cost-effective medications that offer similar benefits to more expensive alternatives. By law, doctors cannot profit from pharmacies or manufacturers for prescribing medications.
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