Your Good Health: Persistent Symptoms After COVID May Indicate a Bacterial Infection
COVID infections, like all viral infections, can make a person more susceptible to bacterial sinus infections.
Dear Dr. Roach: I recently had COVID and lost my sense of taste and smell. Even after recovering from COVID, 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, and I was experiencing a milky lime-green snot. Is this a long-term side effect of COVID?
P.M.H.
I believe this is not just 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 rare cases, an ENT physician might need to perform a sinus sampling to determine the appropriate antibiotic, while others may require a CT scan for diagnosis confirmation.
The smell and discharge are indicative 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 take metformin and insulin. 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 say these medications have been around for years, but why weren't they prescribed before? With the insulin price cap at $35, doctors are now 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, and they also protect the heart better than 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 heart health benefits.
The cost of GLP-1 medications can be a concern, but most patients receive coverage when prescribed for diabetes. While these medications have side effects and are not suitable for everyone, if you were managing well on insulin and metformin, there might not have been a compelling reason for your doctor to switch. However, the potential heart or weight benefits likely influenced their recommendation.
In general, doctors prefer to prescribe cost-effective medications if they offer similar benefits to more expensive alternatives. By law, physicians cannot profit from pharmacies or manufacturers for prescribing medications.
