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A Closer Look at COVID’s “Loss of Taste and Smell” Symptom

Friday, December 11, 2020 2:30 PM

COVID-19, the respiratory disease caused by the new coronavirus, can have a variety of symptoms, ranging from headaches to sore throat to fever and chills to respiratory symptoms like a cough or shortness of breath. Everyone experiences the virus a little differently.

However, what makes COVID-19 different from the flu or a regular cold is one of its cardinal symptoms, the complete loss of taste and/or smell. Many of us take these two senses for granted. Now, what if they were suddenly gone? What if unexpectedly, you can’t smell coffee brewing in the morning, your favorite perfume or your daily shampoo?

For 80 percent of people who contract COVID-19, they report this specific symptom, also called anosmia and dysgeusia. In some people, anosmia and dysgeusia are the first or an early symptom, and for some the only symptom of COVID-19.

Loss of Smell

It’s commonly reported that sense of smell most often diminishes by the third day of infection and many patients also lose their sense of taste at the same time. This can happen suddenly and is often is without signs of nasal congestion or discharge. When you lose your sense of smell, you may find that food tastes bland and it’s hard to tell different foods apart.

We asked Susan Rubin, MD, Neurology to provide us some insight into this particular symptom:

Why do people lose their sense of taste and smell with COVID-19?

“We don’t definitively know why people lose their taste and smell but it is hypothesized that the virus enters often through the nose and can cause direct viral damage or inflammation to the olfactory bulb which controls our sense of smell. Since taste is impacted by the smell of foods both often end up being lost together although the virus also enters through our mouth so direct damage to the taste buds is also a consideration but not proven. It may also cause damage to the blood vessels that supply the olfactory bulb causing ministrokes in the bulb (or loss of blood flow to that structure).”

When can you expect your sense of taste and smell to come back?  

“About a third of people do get their smell and taste back in about 8 days and most within a month. However, some people never get it back or only get a partial return. Since there are other causes of a loss of taste and smell you need to rule those out if it doesn’t start to come back as your other COVID symptoms improve. Older adults, smokers and those with sinus infections and allergies often have had some impact already on their taste and smell so they will often have less recovery due to the pre-existing damage.”

How do you know when you’re getting better? 

“When things start to taste or smell more normal. Obviously, if you also have other symptoms of COVID you want to see those improving as well and the respiratory symptoms often improve before the taste and smell.”

Can this symptom be permanent? “Yes.”

For someone who has lost their sense of taste and smell for more than a couple months, what can they do to regain their senses?

“There is smell therapy which focuses on exposing you to different odors to help “awaken” the olfactory bulb but this is not a proven therapy. If you are a smoker stop smoking and it might help to see an ENT to rule out other causes. Try using spicier flavors to stimulate your recognition of tastes and use mindfulness to try to engage your memory of these scents and tastes.”

Does the severity of the loss of smell correlated with how bad your other COVID-19 symptoms will be?

“There is no direct relationship between the severity of the loss and the severity of other symptoms or the disease and this can be the only symptom patients experience although that is rare. The bigger concern is the relationship between the severity of the loss of taste and smell and the development of depression. Not being able to smell familiar scents can impact mood. It also can impact our overall health due to poor appetite (when you can’t smell or taste food, we lose our desire to eat) resulting in undesired weight loss.  It also can lead to external threats like not being able to detect fires, gas leaks or spoiled food. Our sense of smell and taste is important in our everyday lives.”