• Why does COVID-19 cause you to lose your sense of smell?
• What’s it like to lose your sense of smell during COVID?
• What can a COVID-19 patient do to get their sense of smell back?

By now you’ve probably heard that one of the lingering symptoms of COVID-19 is the debilitating loss of smell and taste that so many people experience. It turns out, this defining symptom can hang on long after the patient has recovered. Interestingly, the symptom is more prevalent in mild COVID cases. One recent study showed 86% of patients with mild symptoms of COVID-19 experienced olfactory disruption, while only four to seven percent of patients with more severe coronavirus symptoms also lost their sense of smell.

Eyewitness News Channel 9, WFTV, recently interviewed Dr. Hao “Mimi” Tran, M.D., F.A.C.S., a board-certified otolaryngologist at The Ear, Nose, Throat and Plastic Surgery Associates. Her practice is seeing a rise in the number of patients troubled by a lack of smell after a bout with COVID-19. She stated, “Smell is one of those senses that we take for granted until we lose it.”

Why Does COVID-19 Cause You to Lose Your Sense of Smell?

It appears that COVID-19 disrupts the olfactory cells in the upper nasal cavity. While we don’t yet completely understand the relationship between the coronavirus and a loss of smell, more research is coming in and we’re beginning to understand the answer.

Harvard Medical School worked with an international team of researchers to study the effects of COVID-19 on our sense of smell. They determined that the delicate support cells that carry a scent to the brain are a primary target of COVID-19. Researchers said there is more to study, but, a “SARS-CoV-2 infection is unlikely to permanently damage olfactory neural circuits.” That is good news for COVID patients, who, Dr. Tran says, “are very alarmed by their loss of smell.”

At this point, we know that hyposmia, which is a decreased sense of smell, or anosmia, the complete loss of smell, is an early indicator that you have the COVID-19 virus. But there are all kinds of conditions that can cause the temporary or even permanent loss of smell, such as a sinus infection, a cold, or even Parkinson’s or Alzheimer’s. We know that respiratory viruses can cause a temporary or permanent loss of smell and dysgeusia, or distortions in how things taste. Early studies show COVID-19 affects up to 98% of afflicted patients in this way, whether it is just some loss of sensation or full anosmia.

The data tells us one in five people over the age of 40 have at least some loss of smell. That means if you’re experiencing hyposmia or anosmia it doesn’t automatically mean you have COVID-19.

What’s It Like to Lose Your Sense of Smell During COVID?

A cough, shortness of breath, headaches, and fever, are all signs of COVID-19. WFTV interviewed Michael Imbt, a COVID-19 patient in the Orlando area.

He had a milder case of the illness during the summer of 2020, with severe body aches and headaches, coughing, and sneezing. However, it was the loss of smell and taste that lingered for two months long after the other symptoms were over.

Michael’s experience was typical. Many COVID-19 patients say they cannot get their sense of smell and taste to return, sometimes for months after they test negative for the coronavirus. Dr. Tran says “We are seeing a lot more patients with this complaint.”

It’s not just the loss of smell that lingers after COVID, either; some patients report that things that normally smelled good to them now smell “off.” One post-COVID patient reported that food smells like “burnt tires.” This smell recurs throughout the day during normal activities.

This loss of smell is a critical marker for patients who are otherwise asymptomatic or have very mild COVID symptoms. The onset can happen suddenly and it can be very disconcerting, especially if you don’t feel really sick. Many times, people don’t recognize they’ve lost their sense of smell at first, instead recognizing a loss of taste. What they don’t realize is that much of what you think of as a sense of taste actually comes from your ability to smell. Chewing food releases aromatic molecules that travel up to your nose via the opening at the back of your throat (the pharynx) that connects to the nasal cavity. It’s a kind of “mouth smelling” that is completely or partially disrupted by COVID-19, along with the traditional sense of smell. This is why foods taste bland when you have a cold.

What Can a COVID-19 Patient Do to Get Their Sense of Smell Back?

Dr. Tran and the team at The Ear, Nose, Throat and Plastic Surgery Associates have treatment protocols to help patients experiencing olfactory dysfunction. An initial evaluation usually consists of a thorough exam of the nasal cavity as well as obtaining a smell score through a validated smell identification test, by scratching and sniffing 40 different scents. Medications like Prednisone and nasal steroid sprays (i.e. Flonase, Nasacort, Rhinocort, Nasonex) are usually initiated. Dr. Tran also recommends a series of smell exercises to stimulate the sense of smell. She suggests “essential oils like lavender, lemon, eucalyptus—we have patients do smell exercises twice a day for up to three months.” Patients simply open the bottle of essential oils and waft the smell back and forth under their nose for about 30 seconds. Over time, this stimulation may jump start the ability to smell normally.

Losing your sense of smell can be annoying, but it can also be dangerous. You would lose the ability to smell signs of danger, such as smoke or a gas leak in the home. Losing your smell could affect your taste buds and your appetite. One recent study suggests that a loss of smell can even lead to depression and anxiety in COVID-19 patients. Even before COVID-19, there was a body of evidence that correlated a loss of smell with an onset of clinical depression.

More research needs to occur, but currently it appears most COVID-19 patients regain their sense of smell within two to three weeks. Dr. Tran suggests that if you’ve hit the one month mark after your bout with COVID and you still can’t smell, it’s time to call the offices of The Ear, Nose, Throat and Plastic Surgery Associates. We can help.