Altered smell and taste: Anosmia, parosmia and the impact of long Covid-19

Abstract

Background Qualitative olfactory (smell) dysfunctions are a common side effect of post-viral illness and known to impact quality of life and health status. Evidence is emerging that taste and smell loss are common symptoms of Covid-19 that may emerge and persist long after initial infection. The aim of the present study was to document the impact of post Covid-19 alterations to taste and smell. Methods We conducted exploratory thematic analysis of user-generated text from 9000 users of the AbScent Covid-19 Smell and Taste Loss moderated Facebook support group from March 24 to 30th September 2020. Results Participants reported difficulty explaining and managing an altered sense of taste and smell; a lack of interpersonal and professional explanation or support; altered eating; appetite loss, weight change; loss of pleasure in food, eating and social engagement; altered intimacy and an altered relationship to self and others. Conclusions Our findings suggest altered taste and smell with Covid-19 may lead to severe disruption to daily living that impacts on psychological well-being, physical health, relationships and sense of self. More specifically, participants reported impacts that related to reduced desire and ability to eat and prepare food; weight gain, weight loss and nutritional insufficiency; emotional wellbeing; professional practice; intimacy and social bonding; and the disruption of people’s sense of reality and themselves. Our findings should inform further research and suggest areas for the training, assessment and treatment practices of health care professionals working with long Covid.

Patients’ Perspectives on Qualitative Olfactory Dysfunction: Thematic Analysis of Social Media Posts

“…Theme 1 confirms that the negative emotional and mental health impacts of smell dysfunction, already described in the literature [ 8 , 9 , 18 , 19 ], are prominent in those experiencing parosmia and phantosmia.…”

“…The emotional and mental health impacts of smell disorders was a major topic of discussion in the group. Figure 1 summarizes the psychosocial manifestations, incorporating observations on food issues from Burges Watson et al [ 19 ] showing the interdependence of food issues and emotional effects. Smell loss or change is acutely felt by those suddenly confronted with the way their experience of the world is altered in terms of a lack of pleasure in eating and the absence of reassuring smells of familiar people and places.…”

“… Clinical and psychosocial manifestations of olfactory dysfunction, incorporating conclusions from Burges Watson et al [ 19 ]. …”

“…Some were frustrated with a lack of understanding from others (16) and responses from their physicians, who seemed uninterested (17)(18) and lacked treatment options. Many reported a decline in their mental health (19)(20)(21)(22)(23), and one member was surprised that loss of smell could have such an impact on their mental health (24). Lack of the ability to smell body odor was a worry, as was the inability, from a safety perspective, to smell smoke or gas.…”

A Brazilian multicenter pilot case series on the efficacy of photobiomodulation therapy for COVID-19-related taste dysfunction

“…Among the most common symptoms of COVID-19 is taste dysfunction, which has a ranging clinical presentation 1 , 2 ]. Although its pathophysiology remains to be unclear [ 3 , 4 ], indirect damage to taste receptors by the viral infection of epithelial cells of the tongue and subsequent local inflammation seems to be the key factor [5] .…”