Your Good Health: Persistent Symptoms After COVID May Indicate a Bacterial Infection
COVID infections, like all viral infections, can increase the risk of developing bacterial sinus infections.
Dear Dr. Roach: I recently had COVID and experienced a loss of taste and smell. Even after recovering from COVID, I continued to 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, and I was experiencing a milky lime-green snot and a persistent foul odor. Is this a long-term side effect of COVID?
P.M.H.
I believe this is not solely due to COVID-19. The fact that antibiotics improved your symptoms suggests a bacterial sinus infection. Sinus infections can be challenging to treat and may require extended antibiotic courses. In some cases, a CT scan is necessary to confirm the diagnosis. The smell and discharge are indicative of a bacterial sinus infection. COVID infections can predispose individuals to such infections. It's advisable for your regular doctor to consult an ENT (Ear, Nose, and Throat) specialist for further evaluation.
Dear Dr. Roach: I have Type 2 diabetes and take metformin and insulin. My cardiologist and endocrinologist now suggest stopping insulin and switching to a weekly shot of Mounjaro or a daily pill of Rybelsus. They mention that these medications have been available for years, but why weren't they prescribed earlier? The price of insulin is now capped at $35, and doctors are recommending these new medications. What is your opinion on taking 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 individuals with Type 2 diabetes. These medications help with weight loss, which is often a goal for people with Type 2 diabetes. They also provide better heart protection compared to insulin and metformin. As a result, they are considered the first-line treatment for individuals with diabetes who are overweight or obese due to their positive impact on heart health.
While the cost of GLP-1 medications can be a concern, most patients receive coverage when prescribed for diabetes. It's important to note that these medications have side effects and 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, it's likely that the heart or weight benefits played a significant role in their recommendation. In general, doctors prefer prescribing cost-effective medications that offer similar benefits to more expensive alternatives. Physicians are prohibited from earning any financial incentives from pharmacies or manufacturers for prescribing medications.
