Post-COVID Syndrome: Lost your sense of smell?

Woman smelling lemon

Along with enduring cough, fatigue and other symptoms, post-COVID syndrome can continue for weeks after the original infection. One alarming symptom of post-COVID syndrome is the loss of taste and smell. Eating loses a lot of its pleasure, and it can be strangely disorienting to miss the normal scent of your own home. You can't even stop and smell the flowers.

Ear, nose and throat (ENT) doctor Christie Barnes, MD, cares for people who have lost their sense of smell. Here she explains how long it can take to recover, treatments and more. 

How long it takes to smell again

Early data shows that 95% or more of people fully recover their sense of smell after COVID-19. "Luckily for humans, our sense of smell is highly regenerative. Olfactory nerves come back much easier than other types of nerves in the body, like spinal cord nerves or touch sensation nerves," says Dr. Barnes.

What's more variable is how long it takes. 

The vast majority of people recover their sense of smell in two or three weeks. For a smaller percentage of patients, it may take months.

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Why your nose matters

Taste and smell are closely linked. There are only five types of taste buds or "flavors" on your tongue: sweet, sour, bitter, umami (also called savory) and salty. The rest of what we taste is a combined signal from our tongues and noses.

"Smell does the heavy lifting for taste," says Dr. Barnes. All the nuances of flavors – from your favorite dish to rich chocolate to smooth wine – are really coming from delicious smells. "Most people's taste isn't technically damaged," says Dr. Barnes. "Their taste is significantly decreased because of their loss of smell."

How well can you smell? Take the test

"One of the benefits of coming to our clinic is to understand how significant the loss is," says Dr. Barnes. To start, you take a 40-question test and get a score based on your ability to identify smells correctly. With this standardized test, we can track your recovery over time. You'll also get to talk about other quality-of-life issues that come with losing your smell. 

An ENT doctor can also give you tips to make food start to come to life again. "With certain textures and spices, you can activate certain nerves to add some interest in the food you're eating," says Dr. Barnes. You'll also discuss safety issues that a working nose has no problem detecting – like spoiled or rancid food.

Treatments for getting your smell (and taste) back include olfactory training and topical nasal steroids.

Smell training

Some data supports smell (or olfactory) training, which is basically like strength training for your sense of smell. You might use essential oils or even spices from your kitchen cabinet. Here's how smell training works:

  1. Present your nose with a specific smell for 20 seconds. Lemon is a great scent since it's so memorable.
  2. Tell yourself that you're smelling lemon. Recall and intensely think about exactly how lemon smells.
  3. Repeat with another scent. Common ones are rose, eucalyptus and clove.

The goal is to rebuild the connections between your brain and your nose. Repetition is key. "You should spend time on olfactory training every day, just like you would exercise," says Dr. Barnes. Anywhere from 30% to 50% of patients who do olfactory training see an improvement in their sense of smell after 12 weeks.

Topical nasal steroids

If an ENT doctor determines that your loss of smell is related to swelling in your nose, they might prescribe a topical nasal steroid. This reduces inflammation in the nose.

"If you can recover even a little bit of your sense of smell, it makes a big difference. Losing your sense of smell really does negatively affect your quality of life," says Dr. Barnes.