CharmCityMD

I'm only a medical student, so Dr. Unsal could give a better answer than me. However, I've written two papers on the neurocognitive effects of COVID-19. While I don't think the exact mechanism is known yet, it is not due to intracranial hypertension. You'd see global cognitive dysfunction with intracranial hypertension, rather than anosmia.

It's more likely that the symptom is peripherally driven, such that the smell "signal" never reaches the brain. This could be caused by inflammation of sensory epithelium restricting airflow to the olfactory cleft. Or, if the smell does reach the sensory neurons, it's possible that damage to the supporting cells (which express ACE2 and TMRSS2, a receptor and enzyme that allow SARS-CoV-2 entry into a cell) can reduce signal transmission to the brain. I'd be happy if Dr. Unsal expanded on this and/or corrected anything I have gotten wrong.

Hi Dr. Galea, thank you for taking the time to answer questions.

The United States has a significant shortage of physicians, particularly primary care in rural areas. As such, one major barrier to health care access is distance. Do you think telemedicine will play an increasing role in healthcare? Additionally, what do you think would be the benefits and consequences if so?