Thread by @jschoggins

Here' my "n=1 / anecdote / was clearly bored" symptom diary of my #breakthrough #COVID19 case. And a short thread on things I found interesting about the disease process. (1/n)

https://twitter.com/jschoggins/status/1435231333006053377

My symptoms were not unique or special. They generally tracked with other reports on breakthrough delta infection in Isreal, Singapore, and US. Link to CDC report on Provincetown outbreak below as an example. (2/n)

cdc.gov/mmwr/volumes/7…

Let's talk about rhinorrhea, or runny nose - worst I've ever had. Was almost comical how many paper tissues I burned through. Makes sense, as nasal epithelial cells and are prime targets of SARS-CoV-2--> damage+inflammation. (3/n)

jci.org/articles/view/…

About headache. Was less "head" and more "face pain". Centralized, behind nasal bridge and intense. Consistent with nasal epithelial injury. I like the title of this SARS-CoV-2 hamster study : "massive transient damage of olfactory epithelium"...yep! (4/n)
ncbi.nlm.nih.gov/pmc/articles/P…

I'm most fascinated by loss of smell/taste. Some terms before expanding further:

anosmia: complete loss of smell

hyposmia: partial loss of smell

ageusia: loss of taste

A brief summary here: (5/n)

onlinelibrary.wiley.com/doi/10.1002/al…

Loss of smell (anosmia/hyposmia) is not that surprising and seen in other respiratory infections. Olfactory epithlial cells provide supportive functions to olfactory neurons. If epithelia is damaged, neurons don't get signals...smell gone. (6/n)

sciencedirect.com/science/articl…

Loss of taste (ageusia) is more enigmatic. Taste independent of smell is sensing stimuli on tongue taste buds: salty/sour (via ion channels), bitter/sweet/umami (via G protein coupled receptors). Interesting to speculate how infection affects this.(7/n)

link.springer.com/article/10.100…

I initially lost smell but retained basic taste. Thankful for salt & vinegar! But then I lost those. For 36h, no taste of any kind whatsoever. It returned quickly, but loss of smell still precluded "flavor-based" taste. I'm at ~50% loss in that regard, gratefully improving.(8/n)

Loss of smell/taste is also a problem in #longCOVID. While other COVID symptoms are more debilitating, the emotional toll of lost taste/smell should not be minimized. Looking forward to new research in this area. (9/n)
thelancet.com/journals/eclin…