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Parosmia After COVID-19: What Is It and How Long Will It Last?

One of the signs of COVID-19 disease is a loss of taste and smell. While most patients recover from this, some report an unpleasant new symptom following COVID-19 infection called parosmia. It’s a condition where otherwise normal smells now smell and taste unpleasant or even disgusting. For example, to someone with parosmia, coffee or fruit smells like garbage, rotten meat, eggs, or ammonia.

What is parosmia?

“Parosmia can be caused by a number of things, such as respiratory infections, seizures, and even brain tumors,” says Richard Orlandi, MD, an ear, nose, and throat physician and professor in the Department of Surgery at University of Utah Health. “Since the pandemic, COVID-recovered patients have reported this symptom.”

The loss of smell is not a new phenomenon. Before COVID-19, it was most associated with the common cold and influenza. While it’s not known exactly what triggers parosmia, it compares to the smell disruption that’s common with other viral illnesses such as these.

To better explain this, think of your sense of smell like a piano—it has a number of different keys, or receptors. The way we smell is by activating those keys and the strings attached to them to play a chord. Following COVID-19 infection, those keys and strings can get damaged. When that happens, those chords may not play the right notes. Similarly, the receptors in your nose may not perceive smell correctly due to damage that may have occurred.

“Your sense of smell is important,” Orlandi says. “It’s what helps you enjoy food and sense danger, as in the case of smoke. It’s connected to our memories, such as the way your mom or grandma’s perfume smells. Depending on the severity, this condition can range from an annoyance to a frustrating and anxiety-inducing symptom.”

How long does parosmia last?

The good news is parosmia improves with time in most cases. People report a change to their sense of smell about three to four months after infection. 65 percent of those people regain their taste and smell 18 months after infection. About 80 to 90 percent get these senses back within two years.

Is there a treatment for parosmia?

While there is no known treatment for COVID-19-induced parosmia, some believe smell therapy may help. This process involves smelling strong scents such as citrus, perfume, cloves, or eucalyptus each day to re-train the brain to “remember” how to smell. More study is needed to know how impactful this therapy is for patients experiencing parosmia.

Kristine Smith, MD, a rhinologist and assistant professor in the Division of Otolaryngology (Head and Neck Surgery) at U of U Health, recommends lifestyle modifications to her patients to help improve their quality of life, such as:

  • Eating simple or bland meals: The more complex the aroma, the more likely it seems to trigger parosmia.
  • Eating food cold or at room temperature: Steam is what carries that sense of smell to your nose, which can trigger parosmia.

“Parosmia can be very disruptive to a person’s life, but don’t lose hope,” Smith says. “It does seem to get better for the vast majority of people over time.”

Smith advises those who are experiencing a loss of smell following COVID-19 infection to be seen for their symptoms. “Often people who aren’t experiencing this condition don’t understand the severity of symptoms that comes with parosmia,” she says. “Having the chance to talk about it with a specialist can validate what a patient is experiencing.”