COVID-19 and your sense of smell: What you need to know
Is COVID-19 keeping you from smelling the roses? If so, you are not alone. Loss of sense of smell, called anosmia, is one of the most common symptoms of acute COVID-19 infection. Up to 73% of patients with COVID-19 report experiencing a loss of smell prior to confirmation of their diagnosis. In more than a quarter of patients, it was the first presenting symptom of infection, and evidence exists that the loss of sense of smell is often the only presenting symptom.
So, what exactly causes this loss of smell? Is it permanent? Should I get tested for COVID-19? MultiCare Ear, Nose and Throat doctor Sepehr Oliaei, MD, answers these questions and more.
Q: How does COVID19 cause loss of smell in the nose? How about loss of taste?
A: Emerging data shows that the nose appears to be the primary gateway for the initial COVID-19 infection. Damage to the lining of the roof of the nasal cavity where the sense of smell is conveyed, as well as damage within the central nervous system (brain) have been described as possible methods by which COVID-19 infection leads to a sensory loss of smell. Change in the sense of taste is usually a secondary symptom. Many of the flavor profiles in food are derived from the sense of smell rather than direct taste of the foods, which is the likely correlation between these two symptoms.
Q: I can’t smell or taste anything, should I be tested for COVID-19?
A: If the symptoms come on suddenly and you have never experienced them before, it may be reasonable to self-isolate and get tested. However, it is important to recognize that other conditions, such as allergies, sinus infections, other viruses and neurologic conditions may cause loss of smell and taste as well.
Q: I have been diagnosed with COVID19 and am experiencing a loss of smell. How long will it take to get better?
A: In the vast majority of patients (up to 90%), symptoms resolve within four weeks of onset.
Q: Is there anything I can do to speed up the recovery?
A: Clinical trials are ongoing to determine the effectiveness of steroidal nasal sprays in improving sense of smell after recovery from COVID-19. However, the safety of this treatment, as well as oral steroids, during the acute phase of COVID-19 infection has not yet been determined.
Q: What if my sense of smell never returns?
A: While there are rare cases of delayed recovery or permanent loss of smell due to COVID-19, long-term outcomes are still to be determined. If you have not had recovery of sense of smell or taste within one year of the infection, chances are the loss could permanent.
If you are experiencing a loss of smell and/or taste and think you may have COVID-19, or you have been diagnosed with COVID-19 and your symptoms have not yet resolved, contact your primary care physician or an ear, nose and throat specialist.
Sources
- COVID-19 Anosmia Reporting Tool: Initial Findings Otolaryngol Head Neck Surg. 2020 Jul;163(1):132-134.
- COVID-19 and anosmia: A review based on up-to-date knowledge. Am J Otolaryngol Sep-Oct 2020;41(5)
- Olfactory and gustatory dysfunctions as a clinical presentation of mild-to-moderate forms of the coronavirus disease (COVID-19): a multicenter European study. Eur Arch Otorhinolaryngol. 2020 Aug;277(8):2251-2261.
