As a former Daily Briefing editor who spent much of 2020 reading and writing about Covid-19, I felt as prepared as I could be when I contracted the virus myself in December of last year. I knew, for instance, how lucky I was to have a relatively mild case of Covid-19—but I was unprepared for one symptom I've been dealing with ever since: the long-term loss of smell and taste.
Becoming a Covid-19 'long-hauler'
Around 8:00 p.m. on a Sunday in late December, I decided to settle down for the evening. I'd been tired for the past few days, but I figured that wasn't unusual for a new mom who'd recently gone back to work full-time. I sat down with a book and warm cup of my favorite Youthberry tea. This is a particularly fragrant tea—and the berry scent is one of the reasons I enjoy it. But when I took a sip, I noticed that I didn't smell anything.
I put the tea down, grabbed the scented candle on my nightstand, and took a whiff. Nothing. I then proceeded to run around the house smelling things: shampoo, perfume, toothpaste—I couldn't pick up a scent. Then I turned to food—peanut butter, lemons, dried cranberries—and discovered that while I could detect the sourness of the lemons and the tartness of the cranberries, the actual flavors did not come through.
The next morning, I called my primary care doctor and scheduled an appointment for a Covid-19 test. Thankfully, I was able to get tested that morning and had my results by the evening: I was positive. I reported my close contacts to the contact tracer who called with my results, called my daughter's pediatrician, and began my 14 days of quarantine.
Having spent the past year reading and writing about Covid-19, I knew—despite my diagnosis—that I was fortunate in several ways. For one, I was able to get tested and get my results quickly and efficiently (even as so many others, including one of my own colleagues, have struggled to access this necessary care). In addition, I am able to work from home, which helped ensure I didn't inadvertently pass the virus on to anyone else.
And perhaps most fortunately, my symptoms never progressed beyond loss of taste and smell. But nearly four months later, those senses have not returned. I am a Covid-19 "long-hauler"—and I am certainly not alone.
What we know about Covid-19-related anosmia
Research indicates that a significant portion of Covid-19 patients experience some form of anosmia, or the loss of sense of smell. For instance, CDC's website cites a study that found anosmia (loss of the sense of smell) and ageusia (loss of the sense of taste) occur in one-third of Covid-19 patients, and that these symptoms are most common among women and younger or middle-aged patients. Other research places anosmia prevalence higher, in about 50% of Covid-19 patients, and at least one meta-analysis found that up to 77% of Covid-19 patients report some form inability to smell. But most of those patients regain their sense of smell after a few days or weeks.
The Covid-19 long-hauler population is far smaller, with one study estimating 10% of Covid-19 patients experience prolonged symptoms after they have fully recovered from their mild or severe cases of Covid-19. However, at least one study on the lingering symptoms long-haulers experience found that the most common long-hauler symptoms were anosmia, fatigue, ageusia, and labored or difficulty breathing (dyspnea).
Researchers are still exploring why some patients fully recover and others have prolonged symptoms, but initial data tie Covid-19-related anosmia to two things: congestion that causes the naval cavity to temporarily swell or damage to cells that support the olfactory sensory neurons, which are responsible for sending signals to the brain when we smell something. The cell damage can take longer to repair.
And because smell and taste are linked, losing the ability to smell also impacts the taste of food. Research has shown that the tongue can taste salty, sweet, bitter, sour, savory, and fatty. But some flavors, like strawberry and chocolate, are experienced through retronasal smell, which requires the mouth and nasal cavity to work in harmony.
The good news is researchers say both findings indicate Covid-19-related anosmia is not permanent, even if it takes a long time for the cells to repair and the olfactory sensory neurons to resume their normal functions. But going without the ability to smell or taste for months on end is not without its consequences.
How anosmia impacts patients—and how I learned to cope
If I am being honest, I never paid much attention to the big role smells play in both my emotional and physical wellbeing before I lost that sense. Physically, smell is there to help keep us safe; a whiff of smoke can warn us about a fire, while the scent of spoiled food can protect us from food poisoning. (And without my own sense of smell, I've had to outsource these benefits: I've made a habit of checking our fire alarms' batteries—and I've had to rely on my spouse to sniff questionable chicken or milk nearing its expiration date.)
But research also shows smells are linked to memories, emotions, and overall mental health. One study found an association between Covid-19-related loss of smell and an increased risk of anxiety or depression. The New York Times' Alyson Krueger reported that anosmia and parosmia, a condition that causes odors of certain things or people to be distorted, can also cause people to feel socially isolated and detached from loved ones.
While there is no official treatment for anosmia, some experts recommend "smell training," in which you repeatedly sniff a few aromas each day to fire up your olfactory sensory neurons. Many patients also have turned to online support groups for Covid-19 long-haulers where they can share their experience with others.
So far, I have yet to experiment with smell training or burnt oranges, but I have found my own support group among several friends who also lost their senses of smell and taste. And until my smell returns (and I continue to hope it returns in full with no distortions), I am focusing on finding joy and making memories through my other senses, whether that be experimenting with textures in food instead of flavor or feeling the soft strands of my daughter's hair against my cheek.