- Some people who’ve recovered from COVID-19 say they’ve lost their sense of smell or experienced distorted scents, especially with food.
- Experts say this ailment can affect people’s ability to taste food and do daily tasks. It can even affect people’s moods.
- There are few treatments for the disorder, although some aroma therapies may help.
Sometimes in the middle of the night, Caroline Bauerle smells cigarette smoke in her smoke-free home.
“Is it a ghost?” she wonders.
It’s not. The scent comes to her as a lingering side effect of COVID-19 called phantosmia, or olfactory hallucinations.
Along with anosmia, which is the loss of the ability to smell, phantosmia is popping up as a lingering symptom for people with long-haul COVID-19.
“I really hope it resolves,” said Bauerle, who lives in Maryland and is experiencing both of those conditions.
“Physically, I’m OK, but it’s been 9 months, and this is the weirdest thing I have ever experienced,” she told Healthline.
At first, medical experts treating people with COVID-19 weren’t surprised to see symptoms associated with smell.
After all, says Dr. Hira Shaheen, who treated COVID-19 on the front line in Pakistan and also serves as a medical consultant for Volant Aroma, loss of smell is a common symptom for many lesser but similar viral infections.
“The respiratory tract gets swollen or inflamed, and that temporarily impacts olfactory cells in the nose,” Shaheen told Healthline.
But long-term loss of smell and scent confusion may be due to permanent or severe damage to olfactory cells, she said.
Why and how? That’s still being
“We assumed that the virus directly attacked the olfactory tissue that sensed smell and passed information to the brain. But then multiple studies revealed that it actually impacted sustentacular cells, which are supporting cells present around the sensory tissue patch,” Shaheen explained.
“So, the jury is still out on it, and we need more research before identifying the exact mechanism.”
For those still struggling with a lasting lack of smell, distorted smells, or both, the impact is about more than wanting to savor the scent of, say, bacon.
Loss or confusion of smell can impact everything from the ability to eat, do basic tasks, and even how your emotional well-being fares.
“It’s a terrible thing,” said Bauerle. “You don’t realize how much you rely on it for life.”
Emma Alda has been running a Florida-based fish and aquarium business with her brother for 20 years.
When they were both diagnosed with COVID-19, she said, loss and confusion of smell was one of their first symptoms.
“It’s embarrassing to say, but we were both unable to smell bowel movements when going to the bathroom,” she told Healthline. “Things like flowers and nature didn’t have the ‘sweetness’ we were used to, either.”
But for Alda, that wasn’t the worst part.
“We both have been keeping aquariums for nearly 20 years, and when you are keeping fish, you just get used to that scent of the water, of the tanks, of everything,” she explained.
When they got back to work, she realized something was off.
“All of this began to smell like copper to us, maybe other metals,” Alda said. “You know what a quarter smells like? Yeah, that’s what we were getting from what should have been fish-inhabited water. As you can expect, this affected our ability to do our jobs and filled us both with concern.”
They had to bring in someone with full smell ability to assist them.
The situation can impact one’s ability to eat as well, since eating is closely tied to smelling what you choose to savor.
All that can also impact a person emotionally, Shaheen said — even pushing a person toward depression.
“There is a healthy chance that loss of smell induces or at least aggravates anxiety and mood disorders,” she said. “In the long term, it can lead to depression.”
For one thing, scents stimulate emotional memory and impact mood because they release neurochemicals (dopamine, serotonin) in the brain, she explained.
Also, she said, “the olfactory system is present quite close to the brain circuits that process emotions and memory. So, there is an anatomical link also that interlinks depression with scents.”
Alda’s doctor told her that — at least for now — there’s no treatment.
Shaheen said that she’s seen success in a treatment called “smell training,” which has long been used for those who suffer from anosmia after brain injury.
In it, a person exposes themselves to robust scents a few times a day over an extended period of time, waking up the olfactory sense.
A good ear, nose, and throat doctor can help guide a person through that, Shaheen said, adding that she’s steered quite a few people who’ve recovered from COVID-19 toward that treatment.
It may also take patience.
Bauerle has other family members who developed COVID-19 and smell loss as well. But each of them has recovered their ability to smell.
She realizes she may have to wait.
“I really do hope it resolves,” she said. “I cannot cook the way I used to. And not smelling much at all? It’s a very alien feeling. I’m ready for it to resolve.”