COVID Can Take Your Sense of Smell, and It Doesn't Always Give It Back

Tracy Messina knew something was wrong the day she couldn't smell her tea. She asked her husband, Marcus, to make a cup of apple cinnamon, but when he brought it over, she couldn't pick up any of the usual scents. "I thought maybe he made me chamomile, which had no smell," Messina tells PS. "He's like, 'No, it's apple cinnamon.'" In a panic, she asked him to grab her an Oreo, but when she bit down, she detected none of the typical chocolate flavor. That's how she realized that her taste and smell were both completely gone.

At the height of the pandemic, loss of smell was known to be a common sign of COVID-19. "If we think about four years ago, 70 percent of people lost their sense of smell [due to COVID]," says Valentina Parma, PhD. But according to a 2023 study from Mass Eye and Ear in Boston, about 21 percent of people with this particular symptom, known as anosmia, experienced only partial recovery, and about 3 percent never recovered any of their sense of smell.

That means "we have millions of people that, over the last four years, have lost their sense of smell and taste, and a portion of them lost it permanently," confirms Dr. Parma. She believes as many as 5 to 10 percent of people may still be dealing with complete anosmia as a result of COVID.

Valentina Parma, phD, is a psychologist, chair of the Global Consortium for Chemosensory Research, and assistant director of the Monell Chemical Senses Center. She is currently researching how smell, taste, and chemesthesis are affected by COVID-19 and other respiratory disorders.

This may seem like a small percentage initially, but Dr. Parma points out that 5 percent of all those infected with COVID is actually a massive number. "If you count the millions of people that, worldwide, have been infected with COVID-19 and you take 5 percent of them, we're talking about double digits of millions of people," she says, noting this doesn't even account for people affected by more recent variants. So where is the support for all those who haven't been able to smell properly since COVID?

In 2019, Chrissi Kelly founded Abscent, a UK-based charity to support those affected by smell disorders. Once COVID hit, she remembers how people rushed to find help. "We were immediately flooded. I mean thousands and thousands of people," Kelly says, putting the number at close to 35,000 for the COVID-19 group, and 22,000 for the parosmia group (smell distortion). "Everybody [was] saying, 'Where are the doctors? We need the doctors. We want ENTs. I want to get an appointment with my ENT.' And I'm sitting there thinking, you can have all the appointments with the ENT that you like. There is nothing that the ENT could do for you."

Although it's clear that COVID is affecting the olfactory nerve on some level (which is responsible for smell), the connection isn't fully understood yet, which makes most treatment for post-COVID smell loss quite novel. "We do know that COVID has an effect on some of the cells in the olfactory epithelium that support the olfactory sensory neurons," Dr. Parma says. She explains that, in essence, COVID seems to attack these cells (called sustentacular cells), depleting the olfactory sensory neuron of nutrients, and making it more difficult to convert chemical information into electrical information that the brain can process as smell.

Because smell loss is still in the early stages of research, Dr. Parma also notes that many patients struggle to be taken seriously both in their personal lives and by the medical system. "[You're] almost treated like you're crazy. And if somebody believes you, then they say, 'Well, it could have been worse. It could have been hearing, it could have been vision,'" she says. "But the people who lose their sense of smell, they're really more depressed. We do see this in the data. They're more anxious and they tend to have a poorer diet quality."

To this point, Messina and Marcus both contracted COVID in February of 2020, and subsequently dealt with fatigue, muscle pain, and a myriad of other symptoms, including anosmia. They lived without their sense of smell for three years — a loss that affected their mental health and general wellbeing, given that Messina was running a restaurant in Chicago at the time. "I had to rely on the people that I worked with to be like, 'Here, tell me if this tastes right,'" Messina says. "Textures became a really important thing for us because with no taste and smell, we needed color and texture all the time."

Messina remembers double checking for any expired food because neither she nor her husband would be able to smell if something went bad. "I almost burned our house down," she says; while making bacon one morning, she took a break to brush her teeth, but forgot the bacon was in the air fryer. "I can't smell that there's smoke in the house," she tells PS.

Messina and Marcus also both experienced sporadic "phantom smells." "Mine were burning hair and mildew. For Marcus, it was burning hair," Messina says. "Foods changed and it wasn't specific foods. It was just random. But pistachios and the smell of popping popcorn made me ill for the first year."

On an emotional level, anosmia takes a heavy toll — something Kelly has seen in her work, and through her own experience with smell loss. "I went into a profound depression and complete change in my personality, and it was very frustrating because loss of smell is an indescribable set of circumstances," she says. "There's still not enough awareness and there's still not enough support." Some of Dr. Parma's patients ask questions like, "What if I forget the odor of my child?" or worry about losing the smell tied to a specific memory. "This really opens up to a much deeper relationship between the sense of smell and one's emotional world," Dr. Parma says.

Messina and Marcus describe cherished traditions, like their family's Italian Christmas morning, turning completely bland. They could no longer smell the homemade raviolis wafting in from the kitchen; their family members were left waiting for reactions that would never come. "We bake a cake so we can blow out [the candles on it] in front of you, but we can't smell or taste the cake," Messina says.

After trying for months, Messina and Marcus finally convinced a doctor to perform a stellate ganglion block to see if it would help their anosmia. Although the procedure itself is not new (usually used to help nerve injuries and chronic pain), it had never been used to treat post-COVID smell loss. However, working in a pain clinic, Marcus knew that ganglion blocks had been used to help cancer patients with smell loss, and he was willing to take a chance if it meant regaining his sense of smell. "[Marcus was] like, 'Just do it and I'm going to be your guinea pig,'" Messina says. "'But if it works, you're going to do it on my wife.'"

The stellate ganglion block is essentially an injection of anesthetic medication into a bundle of nerves on either side of the neck. Marcus had his first injection in March of 2023, and for the first time in years, he was able to smell. "I think I was at like 50, 55 percent. But after three years and not eating at all — to be able to taste or smell 50 percent?! I'll fucking take that," he says.

Messina had the procedure just a month later, testing her sense of smell with a fresh package of Oreos. In a viral TikTok, Messina is seen clutching the box closer in disbelief, emotional over the fact that she can finally smell the very first food she was ever unable to taste. "Can you smell it, really? Eat it, fucking eat it," Marcus cheers in the background. "I know this is experimental for long COVID patients, but it's working. Literally a life changer," Messina wrote in the caption. "Sorry for the ugly cry, but it's tasting everything all over again for the first time."

As researchers continue to explore the connection between COVID and smell, existing treatment includes smell training (exposing yourself to different smells multiple times a day), and counseling for the mental and emotional repercussions.

But the bottom line is that, if your smell still isn't quite the same as it was pre-pandemic, you're not alone, and it's not all in your head. "You're not crazy if you think you have smell loss or if you have smell distortions," Dr. Parma says.

"This is a condition that exists. It touches millions of people."

Chandler Plante is an assistant editor for PS Health & Fitness. Previously, she worked as an editorial assistant for People magazine and contributed to Ladygunn, Millie, and Bustle Digital Group. In her free time, she overshares on the internet, creating content about chronic illness, beauty, and disability.