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Loss of Smell Lingers for Some COVID-19 Survivors

Study finds that older adults are likely to struggle longer

Sick woman trying to sense smell of fresh tangerine orange, has symptoms of Covid-19, corona virus infection - loss of smell and taste, standing at home. One of the main signs of the disease.

Dima Berlin / Getty Images

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​When it comes to recovering your sense of smell after COVID-19, it seems that age matters, according to researchers at Virginia Commonwealth University (VCU) studying the unusual symptom of the disease.​​

First, the good news: More than half of adults (52 percent) recover their sense of smell within 14 days, two-thirds (66 percent) get it back within a month, and three-quarters (74 percent) recover it after three months, according to the study.​​

But recovery rates aren’t as good for adults age 40 and older. Six months after reporting that their sense of smell was either “poor,” “very poor” or “absent,” 26 percent had yet to regain it. In comparison, only 17 percent of adults under 40 continued to experience olfactory dysfunction at the six-month mark.​​

The findings, reported in the American Journal of Otolaryngology — Head and Neck Medicine and Surgery, suggest that worldwide more than 20 million people could have lingering loss of smell more than six months after their COVID-19 diagnosis.​​

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“With our cohort, we did see about an 80 percent recovery rate in a six-month period or longer. However, 20 percent is still a lot of people, given the millions that have been afflicted with COVID-19,” study coauthor Evan Reiter, vice chairman of VCU School of Medicine’s Department of Otolaryngology — Head and Neck Surgery, said in a statement.

​​Study findings​​

The latest report was based on detailed questionnaires competed by 798 study participants through June 2021. The first survey was completed 14 days after diagnosis of COVID-19, with follow-ups completed one, three and six months after diagnosis.

​​Aside from age, the latest data suggests that COVID-19 survivors whose early symptoms included nasal congestion were more likely to see olfactory improvements. The researchers weren’t particularly surprised to find that younger adults are more likely to recover their sense of smell. They suggest it likely can be explained by “some sort of innate resiliency to injury” and note that similar results have turned up in other studies, though none followed COVID-19 survivors to the six-month mark.

​​As to nasal congestion, the researchers speculate that some individuals may have experienced a loss of smell because their nose was stuffy rather than as a direct result of COVID-19.

​​What you can do​​

Although the study does not address what COVID-19 survivors can do to regain their sense of smell, Reiter suggests “smell training” may help improve it perhaps by increasing the sensitivity of any olfactory sensors and neurons that remain functional.​​

“I continue to recommend that to my patients. It’s low cost and low risk,” Reiter said.​​

John Brooks, M.D., an epidemiologist at the Centers for Disease Control and Prevention and chief medical officer for the agency’s COVID-19 response, also recommended “smell training” — sniffing lemon, clove and other spices — as potential therapy during a congressional hearing in May.​​

Of course, Reiter suggests the best way to retain your sense of smell is to avoid getting COVID-19 in the first place.​​

“Get vaccinated, wear a mask, hand hygiene — all of the seemingly simple things that are readily available at least here in the United States, fortunately, are important,” Reiter said. “Prevention is worth a thousand pounds of cure, in this case, because the cure isn’t there.”​​

Research ongoing​​

Since April 2020, VCU researchers have been conducting a study of adults with COVID-19-associated smell and taste loss to determine how long the loss might last, what factors may influence recovery, and to help identify treatments.​​

“The more we learn from those who’ve been affected, the better we can advise their health care providers and even individuals themselves on how to manage those symptoms,” study lead author Daniel Coelho, M.D., a professor in the VCU Department of Otolaryngology — Head and Neck Surgery, said in a statement. ​​

In an earlier edition of the journal, VCU researchers reported that 56 percent of COVID-19 survivors weren’t generally enjoying life as much while experiencing a loss of smell or taste. More particularly, 87 percent indicated a reduced enjoyment of food, 55 percent a loss of appetite and 37 percent unintentional weight loss. Nearly half (45 percent) also were concerned that their inability to smell smoke posed a safety risk.​​

Going forward, the researchers plan to study how different variants of COVID-19, such as the delta variant, affect smell and taste loss and recovery.​​

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