Did Montelukast save my life?

Back in March I had the virus (COVID-19) but not in the same way as other people. I spent a scary night aching all over like the flu. My partner and I both had dry coughs and what is left of my sense of smell was eliminated. Later as I recovered I notice that much of my food tasted strange and sweet things were obnoxious. There was no fever.

There was rudimentary diagnosis from the NHS 111 service - and so we self-isolated - but this was never recorded anywhere. We think we got it from someone on the London Underground.

At the time loss of smell and taste was not recognised as a symptom and it was thought the disease behaved much like flu. Now doctors and scientists think differently.

When it happened I had taken Montelukast several times in the previous days as I had been to a number of functions and meals. And spring was starting up.

Could Montelukast have saved my life? It is now known that one of the ways the disease causes its damage is through an over-reaction of the immune system, of the white blood cells. Montelukast suppresses part of the immune system, the leukotrienes, a kind of white blood cells.

This study, http://www.englemed.co.uk/20/20aug101_covid19_eosinophils_link.php, found that eosinophils, the precursor of leukotrienes, are the main source of immune system over-reaction in COVID-19 infection.

So did Montelukast save my life? That night I went to bed wondering whether I would wake up in intensive care. As I say the symptoms were unusual - no fever and the aching all over - but they were unpleasant and frightening.

I have also read that people with asthma have proved surprisingly resilient against the virus - they have not faced the high death rate experienced by others who were believed to be at risk. Steroids, which also form the basis of asthma treatment, have now been proven to be an effective treatment against the virus. Could Montelukast be a useful preventative treatment for some of us?

Six months later I count myself as among those who have not fully recovered from infection. I have experienced a strange congested feeling ever since. In the spring and summer I put it down to hay fever and took more Montelukast. However I don't like taking it in the winter as since it is an immune suppressant and I get concerned it could make me vulnerable to flu. I have just had a screening blood test ordered by the GP and the one measure that is out of sorts is my white blood cell level - it is low. I might have taken Montelukast a few days beforehand. I cannot remember as it never occurred to me it might be a problem. It could be a legacy of COVID-19 infection. I wonder if the GP will know?

Indeed earlier this year I went down with flu in spite of having the flu vaccine (so it is very unlikely that my episode in March was another bout of flu). I was let down, I think, by my unstable immune system. The choice of whether to take Montelukast during the winter is now even harder.

RAS