An image of Professor Nirmal Kumar
Professor Nirmal Kumar. Photo: ENT UK

A Professor at Edge Hill University’s Medical School was among the first clinicians in the world to identify a “very strange” new symptom found in people suffering from long Covid. 

Nirmal Kumar, an Honorary Professor at Edge Hill and an Ear, Nose and Throat (ENT) Clinical and Consultant Surgeon at Wrightington, Wigan & Leigh Teaching NHS Foundation Trust, was one of the first to report patients suffering from parosmia, which distorts people’s sense of smell. 

Patients suffering from parosmia have reported “unbearable” odours such as fish and burning in place of normal smells. According to Prof Kumar, this new symptom seems to be mostly affecting young people and healthcare workers who have been exposed to the virus. 

He said: “We have started seeing an increasing number of patients presenting with an altered smell. In long Covid cases, we are seeing patients, many of them healthcare workers who are young and have recovered from normal Covid, who are then developing parosmia.” 

The surgeon, who is also the President of ENT UK, was among the first medics (along with Professor Claire Hopkins, President British Rhinological Society) to identify anosmia, loss of smell, as a coronavirus indicator in March 2020, and urged Public Health England to add it to the symptom list months before it became official guidance. 

After treating patients with long-term anosmia, Prof Kumar noticed that some patients were recovering only to experience parosmia.

He added: “We are finding a degree of symptoms that are very unpleasant, because as you can imagine, if you develop a distorted fishy smell or a smell of burning when there is none around, it is very unpleasant”. 

“We are calling this a neurotropic virus. We believe the virus is causing a distortion in the transmission of impulses to the brain and the nerves are not functioning as they should be. 

“The good news is that we have some fantastic training opportunities for the patients. We are essentially re-training the brain to help them recover their sense of smell.” 

Prof Kumar has been working on the NHS frontline throughout the pandemic and was one of the leading healthcare figures who successfully campaigned for enhanced personal protective equipment (PPE) for workers at the beginning of the outbreak especially when working in the proximity of the upper airway. This was readily agreed by Public Health England and has led to safer working conditions for clinicians and trainees on the front-line. 

Despite the challenges that Covid-19 had presented to medical education, Prof Kumar believes that technology is ensuring students are better prepared than ever before. 

He said: “Medical education is my passion and even though doctors are busy, we are fully aware that teaching and training the next generation is important”. 

“There are many things we can do and repeatedly practice without actually seeing patients, through technology-enhanced learning. Edge Hill has recently invested in a fantastic Clinical Skills and Simulation Centre (CSSC), which uses simulation training and augmented reality to enhance the practice of clinical skills. The advantage of this is that our students can continually practice and improve their skills under our supervision, without physically seeing the patient. Then when they get to see a patient or perform a procedure, they are better able to perform this safely – this is similar to how airlines use simulators to improve pilot training”.

Edge Hill’s Medical School is one of only three new freestanding medicine schools in the country and the only one in the North West of England. The school aims to develop a new generation of doctors who understand the needs of local communities and can respond to, and drive forward, new models of care.