Elena Pérez found out, like many before her, that she had Covid because she stopped smelling the food. One day in January 2021 she started to feel unwell. At first she thought she had bronchitis, until she realized that she had completely lost her taste and smell. “It was the most common symptom then, everyone identified it as proof that you had covid,” recalls the 55-year-old from Madrid. What she could not imagine is that to this day, almost three years after that diagnosis, she would still not recognize most of the most basic smells with which she has been familiar since childhood. “Everything smells like sewers, tobacco or burning. Other times I smell things that don’t exist,” she explains.
Like Pérez, it is estimated that in 5.6% of patients infected with covid, the olfactory alteration persists beyond six months, according to a scientific review from the University of Singapore. Anosmia and ageusia—respectively, the loss of smell and taste—are two common consequences of persistent covid, the disease suffered by people who have passed the infection, but continue to have some symptoms even years later. “It is not correct to talk about after-effects, because in this case the effects are maintained over time and do not decrease in intensity,” says Jordi Matías-Guiu from the San Carlos Clinical Hospital in Madrid.
The neurologist explains that unlike the demographic profile of people who have had the disease in the acute phase, patients with persistent covid are usually between 30 and 60 years old, which means that the day-to-day consequences are more serious. because it can even prevent you from working. This is the case of José Méndez, a 50-year-old economist, who was fired while he was on sick leave due to persistent covid, which he has been carrying since May 2021. In addition to the incessant fatigue — for example, he can barely talk on the phone while walking because He’s short of breath—he hasn’t recovered his sense of smell either.
“Anosmia is something that does not limit you as much as other symptoms, but it can have very serious repercussions, even ending your life,” acknowledges Méndez, who is also the president of the Madrid Association of Persistent Covid. “If something burns I don’t smell it. If there is a fire, even if it were behind me, I wouldn’t notice. A few months ago I left the gas on at home and I didn’t find out until my wife returned. Luckily, the window was open and nothing serious happened.”
The exact causes that lead to some patients still not recovering their sense of smell so many months after infection are still unknown. “It seems that the covid virus has a specific affinity to infect the cells of the olfactory epithelium and its neurons, which directly affects smell and taste,” explains Joan B. Soriano, epidemiologist at the Hospital La Princesa in Madrid and who was WHO consultant in the working group that defined persistent covid. In a autopsy study of patients who died from acute covid and persistent covid published in the journal Naturethe virus has been detected in the olfactory bulb.
Soriano estimates that, since the outbreak of the pandemic, the percentage of patients who have alterations in smell and taste in the acute phase is 40%. However, in most cases this loss is temporary and is completely recovered within a few days or weeks. “In our persistent covid outpatient clinic, more than 700 patients have been followed, some since April 2020, and less than 10% have lasting alterations in taste or smell,” acknowledges the epidemiologist. However, although anosmia affects a minority of the population and cannot be considered one of the most disabling symptoms, the doctor warns that it can lead to serious emotional problems, and even depression and anxiety. “It may cause discomfort or self-consciousness, especially around meals. It is essential that patients seek medical guidance to investigate the underlying cause and seek solutions,” adds Soriano.
Olfactory retraining
Carmena Zamora (56 years old) comments that she has been trying to remember what a beef steak tastes like since the first wave of Covid. Her entire family fell ill, but only she and her daughter still have not recovered their sense of smell and taste. “You have the memory of how it tasted like you. But when she tries it and it doesn’t taste like anything, she gets very angry. You can’t enjoy meals with friends, or foods that you used to like and that now smell horrible,” Zamora laments. She has been doing aroma therapy for years, but she assures that she does not notice any type of improvement. “The worst thing is that sometimes you forget that you have certain limitations. On occasion, I have heated up some food that I had left out of the refrigerator, and I have eaten it without realizing that it was bad. You don’t smell it. It’s very frustrating”.
Today, olfactory retraining is the only therapy that is proven to have any effect, says otorhinolaryngologist Blanca Mateo, who works with patients with persistent covid at Hospital La Paz in Madrid. There are not many advances in the field of medicines either. An antiviral drug that the Japanese pharmaceutical company Shionogi, which is currently in phase two of the clinical study, has proven to be effective in accelerating the recovery of smell and taste, but only if taken in the first days of the infection.
Olfactory rehabilitation treatment is very simple, but requires a lot of patience. “The results can be very different depending on the type of patient. Some are going to do well no matter what they do. Others are highly motivated and successful. However, there are also those who try for a long time without improving and get tired,” explains Mateo. Four essences are chosen from the four different groups of smells – menthol, critical, aromatic and floral – and twice a day you have to do some exercises to be able to recognize the aromas with your eyes closed. Once you have managed to memorize these essences, you choose new ones and start again.
Soriano warns, however, that if anosmia is related to damage to the olfactory system in the brain or to the olfactory cells in the nose, full recovery may be impossible. “Apart from treating nasal infection with antibiotics or nasal obstruction with corticosteroids, there are no specific drugs to restore smell. It should be remembered that vaccination and revaccination is one of the few protective factors against the appearance and worsening of persistent covid,” he indicates.
You can follow EL PAÍS Health and Wellbeing in Facebook, x and instagram.
#years #definitive #treatments #torture #living #smell #due #persistent #covid