The first sign of COVID-19 is often the loss of taste and smell, also known as anosmia, and even those without other symptoms have experienced this. Not being able to smell or taste your food can be an alarming realization, but this doesn’t typically last long, and you can help decrease these symptoms from home. Dr. David Rosen, an otolaryngologist at Jefferson Health, spoke with us on why this is happening and how to get your sense of smell and taste back after recovering from COVID-19.
Smell loss during and after a respiratory virus isn’t new. Typically, post-viral smell loss includes a runny nose or nasal symptoms. This is not the case with COVID, where the smell and taste loss arrive before any respiratory symptoms. COVID is a unique type of respiratory virus with quick access to the nervous system. Dr. Rosen says that this means that the virus easily travels up the nose and attaches itself to the olfactory nerve, which is at the top of the nose and responsible for conveying sensory information related to smell to your brain.
Dr. Rosen says the most common complaint of those recovering from COVID is that they can smell fine but have lost their sense of taste. After smell testing these patients, they’re only able to smell some of the scents, and they realize they, in fact, don’t have a good sense of smell.
“Generally, people can identify tastes, like sweet, sour, salty, bitter, and umami (savory), but if you can’t smell, you can’t tell the difference between something like cherry or grape. It just tastes sweet,” Dr. Rosen says. So, most people are having smell loss, which leads to their loss of the sense of taste. When you eat food, the aroma goes to the base of the tongue, and then it goes up into the nose for you to say, ‘Oh, this is cherry.’”
Many videos have surfaced online of people trying to trigger their sense of taste with aromatic foods like blackening oranges and eating them or biting into onions like they are apples. While some of these attempts may seem absurd, they may actually work. These unique exercises are similar to those of olfactory training. “Olfactory training actually utilizes the body’s neuroplasticity, which is the body’s ability to form new nerve pathways. These methods help the body create new neural pathways and help recover the sense of smell,” says Dr. Rosen.
There is no wrong time to start trying to trigger your sense of smell and taste to return. If you have COVID or have recently recovered but still have smell and taste loss, Dr. Rosen recommends starting early smell exercises. Alpha lipoic acid, vitamin A supplements, and over-the-counter steroid nasal sprays may be helpful. Olfactory training can easily be done at home and has been the most helpful in promoting smell fibers to start working again.
Dr. Rosen recommends smelling readily available items around the house and slowly mastering new smells. It’s good to begin smelling coffee, perfumes, citrus, or different types of essential oils—master identifying these and then move on to a new scent. There is no downside to doing these tests, and data has shown that it helps patients recover quickly.
Recovery time varies from patient to patient. While some recover within days, some may take months, and this is why treatment can be tricky. Patients who have lost their smell after COVID may have a side effect of parosmia so that when their sense of smell returns, things can smell very bad to them. Dr. Rosen says that any sign of smell is a good sign of recovery. This means that some neuro-regeneration is happening, and the smell fibers are just not fully back to normal.
This is when you would want to start doing more olfactory training to help stimulate the olfactory nerve.
The good news is, the majority of patients recover quickly, so this loss of taste and smell is temporary. If you are still suffering from these symptoms after recovering from other COVID symptoms, start doing more olfactory training and over-the-counter nasal steroid sprays.
The riskiest part of having no sense of taste and smell is not being able to smell gas. Other issues include it being difficult to cook and eat because the diet becomes more about texture instead of taste. “People become unable to have a normal diet due to everything tasting flat, which results in weight loss issues,” Dr. Rosen says. Socially, one of the things that connect people is food, which becomes a disconnect when you can’t share the same way with your friends and family.
The first thing Dr. Rosen does is perform nasal endoscopy in the office to make sure there isn’t another cause for smell loss. He may prescribe patients with a steroid rinse and possibly oral steroids. At this point, patients are instructed on how to perform smell training exercises. Many COVID patients have previously been prescribed oral steroids for the COVID infection. But additional oral steroids may be helpful. If patients still haven’t recovered after six months, they may be eligible for a platelet-rich plasma (PRP) study. This is where plasma is inserted into the nose through a needle or sponge at the olfactory cleft to trigger a regenerative cell growth process, just as doctors would do to heal scars or encourage hair growth.
If you’re concerned that you lost your sense of smell and were diagnosed with COVID, there is no underlying condition causing this, so you don’t need to worry too much. If it has been months and you are still unable to smell, contact a doctor. It is also important to make sure that there isn’t a more serious cause of the loss of taste and smell. The sooner you pursue treatment options, like a more aggressive medical treatment or olfactory training, the better.