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TO YOUR GOOD HEALTH: COVID can lead to sinus infection

DEAR DR. ROACH: I am a 49-year-old woman who recently had COVID. When I was sick with it, I lost my sense of taste and smell. I no longer have COVID, but I still have a stuffy nose with no sense of taste or smell. Then one day, out of nowhere, I smell this horrible smell, like an infection. I went to the doctor and was told that it was a sinus infection. I was given 14 days of antibiotics.

I took my meds, and then when I thought all was better, nope! I was smelling this horrible smell again, only to be accompanied with some awful drainage. Is this just a long-term side effect of COVID?

• P.M.H.

ANSWER: I do not think that this is just COVID-19. The fact that the symptoms got better with antibiotics makes a bacterial sinus infection seem very likely.

It sounds as though your infection was incompletely treated. Sinus infections can sometimes be difficult to treat and require longer courses of antibiotics. I’ve even had a rare patient who required a sinus sampling by their ENT physician to determine the right antibiotic, while many of my patients have required a CT scan to confirm the diagnosis.

The odor and discharge are strongly suggestive of a bacterial sinus infection. COVID infections, like all viral infections, can predispose a person to bacterial sinus infections.

DEAR DR. ROACH: I have Type 2 diabetes. I take metformin and a shot with 8 units of insulin. My cardiologist and endocrinologist now say that I can stop taking insulin and switch to a weekly shot of Mounjaro, or I can take a daily pill of Rybelsus.

They say that both medications have been around for years, but if so, why weren’t they prescribed before? Now that the price of insulin is capped at $35, doctors are recommending these new medications. What is your opinion on taking these new GLP meds instead of insulin?

• S.B.

ANSWER: Tirzepatide (Mounjaro when prescribed for diabetes, approved in 2022) and semaglutide (Rybelsus orally and Ozempic when used as an injection for diabetes, approved in 2017) are called GLP-1 agonists and have several advantages over insulin for many people.

They help many people lose weight, which is often but not always a goal in people with Type 2 diabetes. They also help protect the heart compared to insulin and metformin. They should be considered the first-line treatment for people with diabetes who are overweight.

The price of GLP-1 meds can be a problem, although many get coverage when it is prescribed for diabetes. There are side effects, and these medicines are not for everybody. If you were doing well on insulin and metformin, there may not have been a compelling reason for a switch.

Starting at $3.23/week.

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