INTEGRATED AYURVEDA MANAGEMENT OF POST COVID OLFACTORY DYSFUNCTION (GHRANASHA): A SINGLE CASE REPORT

Abstract

Background: Olfactory dysfunction is one of the most consistent and often persistent sequelae of coronavirus disease 2019 (COVID-19), with sustentacular cell injury and secondary neuroinflammation of the olfactory epithelium as the principal biomedical mechanism.  A subset of patients remain anosmic beyond three to six months despite corticosteroids and olfactory training. In Ayurveda, such loss of smell is described as Ghranasha, a Kapha Vata Pradhana disorder of the Ghranavaha Srotas amenable to Nasya Karma and allied Panchakarma procedures. Case Presentation: A 34-year-old female schoolteacher presented with complete anosmia, hypogeusia, and intermittent parosmia persisting for five months after a mild, RT-PCR confirmed episode of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. Diagnostic nasal endoscopy and contrast magnetic resonance imaging (MRI) of the olfactory cleft were structurally unremarkable, and an eight-week course of oral corticosteroids with essential oil based olfactory training had produced no appreciable benefit. Diagnostic Assessment: Baseline evaluation using the Sniffin' Sticks threshold, discrimination, and identification (TDI) test battery revealed a score of 9 out of 48, consistent with functional anosmia. Visual analogue scores for smell and taste were low, and high sensitivity C-reactive protein (hs-CRP), ferritin, D-dimer, and MRI olfactory bulb volume indicated persistent low grade post-viral inflammation with bulb volume reduction. Therapeutic Intervention: The patient received Snehapana with Go Ghrita followed by Sarvanga Abhyanga and Swedana, Marsha Nasya with Shadbindu Taila followed by Pratimarsha Nasya with Anu Taila, Dhoomapana, and Shamana Chikitsa with Vyaghryadi Kashaya, Saindhavadi Churna, Chyawanprash, and Trikatu Talisadi Churna over ten weeks, supported by Pathya Apathya and Pranayama. Outcome: At the end of ten weeks, the TDI score improved to 33 out of 48, crossing the normosmia threshold, with parallel improvement in taste perception, a fall in hs-CRP, ferritin, and D-dimer toward reference limits, and an increase in olfactory bulb volume on MRI. No adverse events were recorded. Conclusion: This case suggests that a structured, Snehapana based Shodhana protocol combined with sustained Nasya Karma and Rasayana oriented Shamana Chikitsa was followed by clinically meaningful and objectively verifiable recovery in corticosteroid refractory post-COVID Ghranasha. Unlike previously published Ayurvedic case reports of post-COVID Ghranasha, which have relied on subjective smell identification scores, this case corroborates recovery using the validated Sniffin' Sticks test alongside inflammatory and radiological biomarkers, and supports the case for controlled clinical trials in this condition.