November 10, 2020

Wine 'tasted like gasoline': How Covid-19 is changing some people's sense of smell

Daily Briefing

    While many Covid-19 patients have reported losing their senses of smell and taste, some patients are experiencing something a little different: The disease has changed—rather than eliminated—their senses of smell and taste, with at least one patient reporting that it's made wine taste like gasoline, the Washington Post's Allyson Chiu reports.

    'It tasted like gasoline'

    Jennifer Spicer, a 35-year-old infectious disease physician at Emory University School of Medicine who had Covid-19, lost her senses of smell and taste during her bout with the illness. However, after some time, her Covid-19 symptoms dissipated, and her senses of smell and taste began returning.

    "I thought I had recovered," Spicer told Chiu. And while her senses of taste and smell hadn't yet fully recovered, Spicer said she was again drinking and eating "completely normally" for a time. "I felt a lot of relief," Spicer said.

    But one day, Spicer took a sip from a glass of wine and noticed it tasted different. "It tasted like gasoline," Spicer told Chiu.

    Spicer checked and found nothing wrong with the wine, so she tasted it again. "I was like, 'Oh, this is not tolerable. This is not pleasurable at all,'" Spicer said. "So I ended up dumping the entire glass of wine down the sink. It was that bad."

    Spicer also noticed that a number of scents had changed for her. For example, the scent of cooked garlic and onions is no longer tolerable for her. Meat now smells rotten to Spicer, and mint-flavored toothpaste became so intolerable that she had to switch to a bubblegum-flavored toothpaste, Chiu reports.

    And like wine, coffee now smells like gasoline, Spicer said. "Coffee is really the saddest thing for me because I really just enjoy having a cup of coffee in the morning."

    Why your sense of smell—and, therefore, taste—can change with Covid-19

    The condition in which a person's sense of smell is altered, known as parosmia, is typically unpleasant, Richard Doty, director of the University of Pennsylvania's Smell and Taste Center, said.

    "It's more debilitating in some ways than loss of smell," he said, adding that some distortions can make everyday food and drinks taste awful, since taste is tied to smell. "Even water can become unpleasant."

    According to Chiu, social media among Covid-19 patients is being inundated with reports of parosmia and phantosmia, a related odor-distortion condition that causes people to smell things that aren't there. And data published in Chemical Senses in June showed that around 7% of about 4,000 Covid-19 patients who responded to a questionnaire said they experienced smell distortion of some kind.

    Experts aren't sure exactly what percentage of Covid-19 patients experience parosmia, but according to Justin Turner, medical director of Vanderbilt University Medical Center's Smell and Taste Center, it's "probably a significant number." Typically, these distortions happen in recovering Covid-19 patients who are starting to regain their sense of smell, Turner said.

    "In many ways, having a parosmia in the setting of Covid-19, or any other viral upper-respiratory infection that causes smell loss, is actually kind of a good thing because it suggests that you're making new connections and that you're getting a regeneration of that olfactory tissue and returning to normal," he said.

    Experts also aren't entirely certain why parosmia occurs in Covid-19 patients, but some experts have a theory on why some viruses, including the novel coronavirus, can cause the condition, Danielle Reed, associate director of the Monell Chemical Senses Center, said.

    "One speculation would be that as the olfactory receptor neurons recover, regrow, and rewire into the brain that they don't do it perfectly," she said. So instead of the brain being wired to make "a lemon smel[l] like a lemon … the neurons wander a bit and don't connect properly. And so the brain is confused about how to interpret that information," Reed explained.

    Donald Leopold, a professor of otorhinolaryngology at the University of Vermont Larner College of Medicine, said parosmia is sort of like playing a piano with some keys missing.

    "Normally, you have a smell, let's say a rose, and a rose hits six keys," Leopold said. "If you have a cold caused by a virus or if you catch the coronavirus and it kills some of those neurons, let's say you've only got three of those neurons left, that no longer allows you to smell a rose correctly. Just like if you hit those three keys, it wouldn't sound like the same beautiful chord you played on the piano."

    How Covid-19 patients can live with parosmia

    According to Turner, parosmia typically goes away as a patient regains their smell function. Until then, Turner said some experts have recommended "smell training," in which a person smells different items like essential oils, lemon, or eucalyptus at least twice a day for 10 to 15 seconds at a time over the course of weeks. In theory, that training could help a person's brain make the correct sense connections again, Turner said.

    "It's very easy to do, and there's not really a whole lot of downside to it," Turner said, "other than we know that it doesn't work for everybody."

    If scent training doesn't work and eating and drinking some things is still nauseating, Whitney Linsenmeyer, a spokesperson for the Academy of Nutrition and Dietetics, said people still should focus on eating a healthy diet. She recommended drinking smoothies, as they "can be a good way to still get a lot of nutrition packed in, but to make it a little bit more tolerable for people that are really not enjoying eating like they usually would."

    Linsenmeyer also said people can research alternative, and potentially more palatable, foods.

    Spicer said she recommends people with parosmia seek out others having similar experiences, potentially through online support groups.

    "Some people, I think, benefit enormously from just being able to talk to somebody else who's going through what they're going through," she said. "That's not the same as a medical treatment, but I think some people get enormous peace of mind to just be able to unburden themselves with another person who can understand" (Chiu, "Wellness," Washington Post, 11/5).

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