What Taste and Smell Tell Us During COVID-19 and Beyond

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      he first thing I would do is to send them to patient advocacy websites, such as http://www.abscent.org, www. fifthsense.org, and http://www.thestana.org, which is the Smell and Taste Association of North America, a new organization that I’m helping to get started. I would suggest that people go to these sites and look at their resources. They can talk to other people who are going through this, find suggestions for coping mechanisms and cooking ideas, and tap into information about prognosis and the potential for recovery.

      There’s also information about a therapy called smell training. We don’t have extensive data yet as to whether this therapy helps people who are recovering from COVID-19-induced smell loss—it’s too soon to say—but there are data for other types of smell loss indicating that smell training can help accelerate recovery, particularly for post-viral smell loss. This therapeutic process is similar to what you might think of doing if you were relearning how to play the piano and hadn’t played in a long time. What would you do? You would sit down and practice scales, retraining your brain to match each note with where it is produced on the piano. For smell training, you sit down with a set of odors each day, sniff them, and then think about what each one is. This kind of activity can help the brain to remember to reconnect those signals with that quality. We think that the therapy helps to reestablish neural connections and to promote regeneration of the olfactory cells.

      The other thing that we haven’t talked about yet often happens during the recovery process. People go through a stage called parosmia, when something doesn’t smell like it should—and usually it smells bad. Your coffee might smell like feces, or your beloved pet might smell like burning rubber. This is a very difficult condition for people to manage and cope with. It’s actually probably worse than a reduced sense of smell or having no sense of smell. People experiencing parosmia have trouble eating because food doesn’t taste like food and can smell extremely unpleasant. We suspect that as cells are regenerating, they may not be initially connecting to the right places in the olfactory bulbs, and it could take months for those connections to get refined and sorted properly.

      Parosmia is a condition that we hardly ever saw before the emergence of COVID-19. Monell had a clinic where we saw patients from all over for many years, and we rarely had patients come in with this condition. Now, with COVID-19, parosmia is becoming much more common, occurring at some point during the recovery process. For anyone experiencing parosmia, my advice would be, don’t give up: there is the potential for recovery even after many months.

      Jesus: Hey, Dad? God: Yes, Son? Jesus: Western civilization followed me home. Can I keep it? God: Certainly not! And put it down this minute--you don't know where it's been! Tom Robbins in Another Roadside Attraction

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