Loss of smell is a common symptom of an active COVID-19 infection.
This may sound like a minor and temporary inconvenience, but the condition can last for months after recovery from the virus. The experience of living without a normal sense of smell is often more troubling than imagined and can affect the ability to taste, too.
“Loss of smell can be one of the first symptoms of COVID,” says Jose W. Ruiz III, M.D., an otolaryngologist (ear, nose, and throat specialist) with the University of Miami Health System. It typically happens about 4.4 days after infection onset and is sometimes the only symptom of this viral infection.
“When researchers survey COVID-19 patients, about half of them report having loss of smell,” Dr. Ruiz says. “However, one study shows that when smell is tested, 98% of post-COVID patients have loss of smell (even though only 35% think they do).” Other viral infections can also trigger this symptom.
“Before 2020, I used to see about three to five patients per year with viral-induced loss of smell. But last December, I routinely saw five new patients with loss of smell every clinic day,” Dr. Ruiz says. “I’m seeing this more often in younger and healthier adults who contracted COVID and had very mild or no other symptoms.”
What’s it like to lose the ability to smell?
Patients with COVID-19-induced olfactory dysfunction can experience a complete loss of smell (anosmia), a reduced ability to smell (hyposmia), or an altered response to all scents (parosmia). Parosmia ranges from mild to severe.
“Many patients with parosmia say everything takes on the smell of something in particular—like smoke, trash, chemicals, or feces. These patients are often more distraught than the ones with only loss of smell,” Dr. Ruiz says.
Much of your ability to taste is attributed to your olfactory sense. Patients with a complete loss of smell may report that everything tastes bland or like cardboard (a condition called dysgeusia), which is troubling. But some parosmia patients say everything tastes far worse—like garbage or feces—which dramatically affects their lives and can lead to unwanted weight loss.
“For example, I recently saw a 20-year-old patient who contracted COVID-19 a year ago in March 2020,” Dr. Ruiz says. “They had no other related symptoms like fever, headaches, or shortness of breath. However, they had been suffering from loss of smell and taste for about four months. When they finally began to smell and taste some things, everything smelled ‘bad’ and tasted ‘bad.’ This young patient continues to experience this bad taste and says things smell like garbage, burnt rubber, metal, and even smelly armpit, or a combination of those unappealing scents.”
This is one of the many reasons that young and healthy people should not hesitate to get vaccinated against COVID-19, he says. Healthy adolescents and young adults may assume that the coronavirus can’t dramatically affect them, even if they get infected. But, the loss of smell and taste can be life-altering. If you’re protected from catching this virus, you will also be protected from its symptoms.
Can loss of smell be fixed?
Dr. Ruiz says, “I’m seeing patients seeking treatment weeks and months after they first lose their sense of smell.”
Smell therapy (olfactory retraining) can help revive a viral-induced loss of smell. “Patients with COVID-induced loss of smell should try this one therapy we know can improve their smell,” he says. This technique can help speed the recovery of olfactory sensitivity and discrimination. It should be performed twice a day for several months (ideally more than five months).
“I tell patients to buy a set of various essential oils (or other odorants) that cost about $15 to $20,” Dr. Ruiz says. “I recommend putting the set next to your toothbrush, so you remember to do the following smell therapy twice each day. Open one bottle and concentrate on the smell, either by testing yourself or focusing on what the smell should be. Each time, this should be done with a few different scents. It may take several months, but this will improve your recovery.”
Dana Kantrowitz is a contributing writer for UMiami Health News.
While COVID-19 is the primary reason that anosmia has been in the news, the symptom is also linked to many other medical conditions. According to the National Institutes of Health, anosmia can occur due to allergies, infections, structural blockages of the nose such as polyps or tumors, some medications, and head trauma to name a few. Read more.