The loss of smell has become a hallmark symptom of COVID-19. Studies have suggested that as many as 80 percent of COVID-19 patients experience a loss of smell and taste. Most regain them within a few weeks.
But for an estimated 15 percent to 30 percent of COVID survivors, the struggle to smell and taste can linger for many months.
We asked Dr. Philip Chen, an otolaryngologist at UT Health San Antonio and the only fellowship civilian trained rhinologist in San Antonio, about the loss of smell and how to reverse the damage.
What is life like without a sense of smell?
It’s really challenging and difficult. As someone who treats sinusitis for a career, I’ve met some who have not had a sense of smell for many years. It affects their ability to enjoy food. It can feel alienating and be hard for people to adjust. It can also be potentially dangerous if you can’t smell food that has gone bad or smell smoke to detect a fire.
What enables us to detect smells?
Michele Crippa, a celebrated epicure who lost his sense of smell after contracting COVID-19, helps Martina Madaschi recognize smells at a therapeutic workshop in Piacenza, Italy.
FABIO BUCCIARELLI/NYTWhen you breathe in there are particulates in the air that are aromatic. Those small particulates travel up the top of the nose where specific nerves detect specific kinds of smells.
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We have thousands of these different configurations that allow us to smell different things. For example, cinnamon is a conglomeration of different types of smells that your brain puts together to recognize as cinnamon. Each smell fiber can detect one type of scent.
After smell particulates are picked up by smell nerves, they travel to the olfactory bulb and the brain processes it.
Why does COVID get rid of your ability to smell?
Nobody knows how or why smell detection goes away. They think it could be that the virus damages the nerve itself. Maybe it damages the olfactory bulb and the brain processes. Some have even suggested that the virus induces local inflammation.
Some people report a loss of taste, too. What’s the connection between smell and taste?
So you have your five basic tastes that are perceived by your tastebuds. You have your sweet, salty, sour, bitter and unami. But when you swallow the food that you’re eating or drinking goes into your stomach, those smell particles go up into your nose through the back of your pallet. It’s how you can tell you’re eating a lemon, or lime or an orange. We usually don’t lose our taste but our ability for flavor detection.
Will you immediately notice a loss of smell?
People don’t always realize when their sense of smell has gone. Let’s say you’re super sick with COVID and you’ve felt awful with muscle aches and a fever. You’re not thinking that your smell has diminished. But when you finally realize it, it’s a month down the road.
This isn’t specific to COVID, but we find the sooner we learn about your loss of smell, the more effective your treatments will be. As soon as you notice your loss of smell is off, you should talk to your doctor or find an ear, nose and throat doctor who does loss of smell.
As annoying as this COVID thing has been for the last 18 months, we still have a long time to go. Eighteen months is a short amount of time when it comes to health and science. If you notice something, tell your doctor. The more you share with your doctor, the more opportunities we might have to spark another study or move treatments forward.
How can you reverse the damage of your loss of smell?
There’s no real silver bullet. Age is one major factor in restoring your sense of smell. Being younger helps, as does being patient and knowing that it may take some time.
Olfactory training has gained a lot of popularity recently. It’s kind of like physical therapy training for your nose. The idea is that you just inhale essential oils gently. Usually you do four of them. Something floral; like a rose; something that has resin, like eucalyptus; then citrus, like a lemon; then spicy, like a clove.
Martina Madaschi works to recover her sense of smell during a therapeutic workshop in Piacenza, Italy.
FABIO BUCCIARELLI/NYTYou put a little bit of oils in a jar or a piece of cotton or fabric and inhale one at a time and then do the next bottle. You’re trying to train your mind on what these things smell like. This takes time but seems to work for a lot of people.
A study out of Germany a few years ago found that 50 percent of patients who tried it regained their sense of smell. It’s safe and is essentially just smelling things and suggestions in the literature shows that it works.
This is the least invasive and the least medical of all of the things you can do. Your doctor might try topical steroids to decrease inflammation around the nerves.
What should you not do to restore your sense of smell?
There was an online video that went viral recently. It suggested that if people hit the back of their heads, they would get their sense of smell back. That is an awful piece of advice. First of all, you can hurt yourself. There’s no evidence at all that hitting yourself will return your sense of smell. It’s just the opposite because trauma can actually lead to the loss of smell and taste.
A lot of patients like to go to health food stores to look for different types of drops or things they can inhale or vitamins. Some of those may work, but the truth is we don’t know. There isn’t a lot of literature that shows whether they work or not.
Timothy.Fanning@express-news.net
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