Last February, it became clear to Atlantan Mark Byrd that he, his wife, and their little daughter had contracted COVID-19. All three of them fell ill and lost their sense of smell, which is one of the coronavirus's defining symptoms. Byrd experienced a brutal case of the virus, but it wasn't severe enough to require hospitalization. Due to his wife's immunodeficiency, a monoclonal antibody infusion was necessary, but finally all three of them recovered. The sense of smell returned to his wife and daughter, but not to him. He explains, "At the moment, I just didn't think too much about it," figuring he would eventually. Then, after four drawn-out months, Byrd started to detect the slightest smells. However, as another month passed, he started to have a persistent metallic taste in his mouth. Things started to go wrong at that point.
Byrd's ability to smell entirely recovered, although it was altered. According to him, hand soap smelled like decaying corpses. Roses smell like poop. He gagged after taking a beer in the afternoon. Nobody else in his immediate vicinity seemed to notice these repulsive tastes and scents. Byrd got on the internet in search of answers because he was desperate and had a suspicion that COVID-19 was to blame. He soon found out he was not alone or crazy. There were few news reports, but thousands of people in Facebook groups had recovered from COVID-19 but had been left with a disconcerting distortion of scent. He later discovered that this illness is known as parosmia.
How Does Parosmia Relate to COVID-19?
A change in how scents are perceived is one of the symptoms of the condition parosmia. Most frequently, like in Byrd's case, the scents are disagreeable, such as the smell of sewage outdoors and the stench of dead people in hand soap. In contrast, Byrd was unable to smell offensive odors that others could. According to Dr. Jennifer Grayson, director of otolaryngology research at the University of Alabama at Birmingham, an increasing number of people who contracted COVID-19, lost their sense of smell a condition known as anosmia and taste, recovered from the virus, but never fully regained their sense of smell again. According to her, "Parosmia is more of a complicating and potentially permanent aspect of COVID and is not regarded as a long-haul symptom of COVID."
According to Grayson, phantosmia, an olfactory hallucination defined by smelling something that isn't there, such as smoke while nothing is burning, is closely related to parosmia. It may also be linked to dysgeusia, a disordered perception of taste. These strange tastes and odors are described by other members of the Parosmia/Post-COVID Facebook group as dumpster juice, hot garbage, potting soil, rotting flesh and dog and they can significantly reduce the quality of life. For instance, one member of the group said that toothpaste tasted like "how a landfill smells."
The majority of foods that tasted good before developing parosmia suddenly cause sufferers to gag or vomit, making eating agonizingly difficult. Think about attempting to consume a dish that tastes like rotting flesh. Since parosmia can last for months, a lot of these people start to lose weight, and some of them start to feel despondent and unhappy because they think they will never be able to smell or taste again.
The frequency of parosmia
There are literally hundreds of viruses that can induce parosmia, including the common cold. Other factors that can contribute to it include head injury, brain tumors, neurological disorders, drugs, chemical exposure, and smoking. However, a disproportionate number of cases linked to COVID-19 have raised awareness of the condition, according to Grayson. 56 percent of COVID-19 patients who had lost their sense of smell reported doing so 2.5 months after their first scent loss, according to a study that appeared in the February 2021 issue of the magazine Nature. In the majority of individuals, symptoms persisted six months later.
So what brings on parosmia in COVID patients? According to Grayson, there are three ways a virus might produce parosmia. One of them is caused by nasal congestion, which can expand and stop odorant particles from reaching the olfactory neurons. The sense of smell returns after the swelling goes down. The virus may also harm the cells that surround or sustain fila, which are tiny tentacles of smell nerves. The third is the idea that COVID-19 virus particles can damage the olfactory cortex, the area of the brain responsible for scent perception, by inducing inflammation and cell death all the way up the nerve to the brain. And for scent to return, those cells will need to renew, according to Grayson.
Can parosmia caused by COVID be treated?
According to Grayson, much of the research on the recovery of smell loss includes therapies like steroid nasal rinses and omega-3 supplementation, both of which are relatively safe treatments. But smell training is the most promising. In response to the rise in post-infection olfactory dysfunction linked to COVID-19, an international panel of experts examined the available research and produced a consensus statement published in the Rhinitis, Sinusitis and Ocular Allergy journal for treating the condition that supports smell training for COVID-19-related smell disorders.
According to Grayson, four fragrances—floral, fruity, spicy, and resinous—are the main emphasis of smell training. These four scents are frequently tested using the aromas of rose, lemon, clove, and eucalyptus. The actual training entails applying a few drops of essential oils that correspond to each of those fragrances on a cotton pad, then inhaling deeply for 10 to 20 seconds, concentrating as much as possible on the scent's memory, according to Grayson. Before moving on to the next perfume, people should practice sniffing each scent multiple times and give their nose some time to relax in between each aroma.
As Grayson advises, "it's crucial to do it every single day and to realize that it's not a terrible sign if you can't smell it at the beginning. After following this practice for six months, the training improves most people's sense of smell, according to researchers in a study published in the journal The Laryngoscope in November 2020. "It can take some time before people can start smelling something," the researchers wrote. The exercise, according to the researchers, may have aided in the regeneration and recovery of smell pathways.
Is COVID-19 Parosmia permanent?
According to Grayson, it's too soon to say whether parosmia caused by COVID-19 will last forever. What that looks like in COVID-19 is a much bigger question mark. We don't really know yet. The good news is that the return of some sense of smell — albeit unpleasant like in Byrd's case — is likely a sign of scent recovery, she says. Historically, pre-COVID, 85 to 90 percent of people would regain smell into a normal range within the first year of loss. We are more concerned about those who have lost their sense of smell and have no parosmias since they might never regain it.
Another promising development is that several members of the Parosmia/Post COVID Facebook group have commented on how their sense of smell has improved, while others have mentioned how their smell distortions have completely disappeared. "I would advise folks not to give up," adds Grayson. Instead, she advises individuals like Byrd to begin and maintain odor training. Additionally, they ought to stay current with scientific research and maintain contact with a nearby academic hospital. Because more interventions will be made available when information is revealed in the literature, the author explains.