why it is not recommended to take corticosteroids in case of symptoms like loss of smell


Several medical experts warn against the use of corticosteroids in cases of anosmia (loss of smell) or ageusia (loss of taste), proven symptoms of Covid-19. However, they recommend that patients taking it to treat chronic illnesses especially not stop their treatment without medical advice.

“Pivalone: ​​one to two sprays, two to four times a day in each nostril.” This is what can be read on the prescription issued by a doctor who diagnosed a loss of smell – one of the symptoms of Covid-19 – in his patient. Problem: this nasal congestion medication is classified as a corticosteroid. Gold pseveral health experts warn that these anti-inflammatory treatments are clearly contraindicated in the face of the coronavirus.

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“You shouldn’t take it”, clearly decides Doctor Jerôme Marty, general practitioner and president of the French Union for Free Medicine (UFML), interviewed by Franceinfo. “No corticosteroids, no anti-inflammatory drugs, because we have had severe cases of people who had taken them. Whether by inhaled form, by spray, by patch, or by cream.”

Faced with the appearance of many cases of brutal anosmia (loss of smell), often associated with ageusia (loss of taste) but without nasal obstruction, the French ENT Society has published its recommendations (link in PDF), Friday March 20. “We advise doctors not to prescribe corticosteroids by general or local route in front of any clinical picture with acute anosmia or dysgeusia”, is it written.

Why such a decision ? “In the current state of knowledge, it is not known if the nose washes are at risk of viral dissemination along the airways. It is therefore recommended not to prescribe in this context, especially as these anosmias and dysgeusia are not usually accompanied by disabling nasal obstruction, write the specialists. According to the preliminary data we have, the natural course of acute anosmias linked to Covid-19 often seems favorable. In cases of persistent anosmia, we advise you to provide the patient with a list of rehabilitation exercises to practice daily. “

Contacted on this subject by Franceinfo, the High Authority for Health (HAS) interviewed two of its health professionals who came to the same conclusion: they “advise against” also the use of local corticosteroids like Pivalone in case of anosmia. An opinion which joins that of the High Council of Public Health (HCSP) on the therapeutic recommendations in the management of Covid-19 (link in PDF), published on March 23: “Nonsteroidal anti-inflammatory drugs and corticosteroids are contraindicated for the treatment of symptoms of Covid-19”, is it written.

The French body which advises the Ministry of Health nevertheless provides an important clarification on this subject: “Patients receiving these treatments for chronic pathologies should not stop them without the advice of their attending physician, she writes. In asthmatic patients, inhaled corticosteroids should not be stopped. In addition, corticosteroids by general route are not contraindicated in patients with an asthma attack. “

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