Smell Still Gone—Distorted After COVID-19 Infection? You’re Not Alone

Hundreds of millions of Americans have contracted COVID-19, and many have not yet fully recovered weeks or even months after first experiencing symptoms.

One such lingering symptom, smell loss, or anosmia, continues to affect people's lives, like that of 47-year-old Miladis Mazariegos, who hasn’t been able to smell correctly since contracting COVID-19 one year ago.

Changes in taste and smell fundamentally changed her lifestyle, says Mazariegos, who was once accustomed to treating her family of five to home-cooked meals and sharing lunches with coworkers. Now, she says she has lost the ability to bond with loved ones over Salvadoran-inspired and other dishes she used to cook.

Mazariegos initially lost her sense of smell entirely during infection when all she could taste of her breakfast was sweetness.

"Suddenly, sweet stuff tasted great, and I usually hate sweet stuff," she says. Other than that, "everything else tasted bland, like I was eating a piece of paper."

Her experience is consistent with what Kristin Seiberling, MD, an otolaryngologist at Loma Linda University Health, has previously discussed about post-viral anosmia: without smell, the only “tastes” left are basic ones that our tongue delivers directly to our brain: sweet, salty, sour, and bitter.

Six months later, Mazariegos’s smell returned, but in a distorted way. Most foods smelled metallic, like iron, she says, with onions and garlic smelling the worst. The unpleasant odors prevented Mazariegos from enjoying meals in restaurants or spending extended time in her home kitchen.

“I can’t add my touch to my dishes anymore,” she says. “I want to get some sense of my life back.”

Mazariegos was relieved to hear of specialists at Loma Linda University Health who are able to help patients with her condition. She connected with Seiberling for treatment aimed at helping her regain a proper sense of smell. Since then, she says her sense of taste has nearly recovered and her sense of smell has slightly improved.

Instead of food bearing a metallic scent for 35-year-old Ruby Valentine from Moreno Valley, it smelled like burnt candles or crayons. Valentine experienced total smell loss, followed by a distorted sense of smell for a total of ten months after her COVID-19 infection in January 2021. The unpleasant odors of certain foods forced Valentine to base her diet on what smelled bearable, she said.

After consulting with Seiberling, Valentine began olfactory sensory retraining to help stimulate her olfactory nerves and reteach them to sense odorants again.

"These nerves have not been removed or cut. They are just not working post-viral infection,” says Seiberling.

First, Valentine says she tackled sniffing essential oils, catching hopeful whiffs of eucalyptus and lavender. Then, during the fall of last year, Valentine detected the smell of a pumpkin, motivating her to continue her smell training with known household scents like lotions, soap, and shampoo. Little by little, Valentine’s proper sense of smell returned.

“You never realize how important your smell is until you don’t have it,” Valentine said. During that time, she had to take extra precautions with personal hygiene and ensure smoke detectors were always working in her home. “I’m thankful even for the real bad smells now.”

Christopher Church, MD, an otolaryngologist at Loma Linda University Health, also noted additional health dangers of lacking a sense of smell: accidentally eating spoiled food, developing or worsening depression from lack of enjoyment of eating and drinking, decrease in socialization, and health concerns from adding more salt in the diet to try to add flavor.

“Losing one’s sense of smell can be devastating to some patients, particularly if the loss is complete,” says Church, but in some cases like Valentine's, olfactory sensory retraining can work.

“Olfactory nerves are unique amongst the nerves in our body in that they can regenerate,” he says. "When they're injured, and the nerves do grow back, the connections aren't right, and odors don't smell right. That's where the olfactory training exercises may help by helping the brain make sense of the new inputs.”

Moreover, Church says the medical community no longer contends that the recovery of taste and smell occurs only within the first year after a viral infection. He says there is hope that further research on post-viral anosmia and smell recovery may yield more options for patients facing such life-changing symptoms.

“While there are not yet any medical treatments that have been shown to reverse smell loss, brilliant scientists are researching how the olfactory system works and how we might help it recover, so effective medications and treatments may be available someday.”

This article was originally published on the Loma Linda University Health news site