The Silent Struggle of Long COVID's Smell Loss

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Author: Anneswa Das

Olfactory dysfunction (OD) means reduced or decreased smell sensation. Also it is most recognized symptoms of COVID‐19. There's a term called "long COVID". In May 2020, Dr. Elisa Perego used the term "#LongCovid" on twitter to describe the symptoms that stayed with her even after she recovered from the main COVID-19 infection. Many other people who felt the same way started using the term too. It became common in online support groups before doctors and researchers began using it in medical studies. So in a simple way, Long COVID refers to a range of symptoms that continue for weeks, months, or even years after the initial COVID-19 infection has resolved.

Recovery isn’t always recovery. Long COVID can steal the sense of smell, turning flowers into silence
Photo by Alexander Grey on Unsplash

Losing the sense of smell or taste has become one of the symptoms people most commonly associated with COVID-19. In the early days of the pandemic, nearly half of those who caught the virus said they suddenly couldn't smell or taste things. Sometimes this was even a very first sign that something was wrong. Early studies suggested that most people got these senses back within 5 to 7 days, which sounded hopeful. But over time, it became clear that many people do not recover quickly. A significant number continue to have problems (called olfactory dysfunction) for months or even years, which can seriously affect their quality of life.

Doctors now understand that losing or having changes in smell and taste can be one of the long-lasting effects of COVID-19. For many people, these problems don't go away when the infection does. They can linger for months, sometimes even longer. By March 2023, around 1.9 million people in the UK were still dealing with long COVID symptoms. This shows just how common long COVID is and how long its symptoms can last.

The Story of Recovery

How Recovery Happens:

  • Most people regain their sense of smell and taste within the first few weeks to months. Studies estimate that around 95% report some recovery by six months, but objective testing often finds higher rates of lingering problems.

  • Recovery can continue for years, particularly for those who experienced severe loss initially. Women and older adults may experience slower recovery.

  • Some people develop qualitative changes, like parosmia (distorted smells) or phantosmia (smell hallucinations), which often appear weeks or months after infection.

Why Smell Loss Persists:

  • COVID-19 targets support cells in the nose rather than the smell neurons themselves. If these support cells recover quickly, smell returns. If not, damage to neurons may occur, requiring months or years for regeneration.

  • Persistent inflammation and changes in olfactory neurons can lead to ongoing smell and taste problems, including distorted or fluctuating sensations.

Assessment and Treatment:

  • Self-reported recovery often differs from objective testing, highlighting the importance of both types of assessment.

  • Olfactory training that is exposing the nose to different smells regularly. It can help improve recovery, especially in long-term cases.

Hope for Recovery:
Even when smell loss persists for a long time, research and patient reports show that slow but steady improvement is possible, sometimes taking years. Awareness among clinicians is increasing, which helps patients feel more supported and informed about their prognosis.

Long-term smell and taste loss after COVID-19 is real, life-altering, and often misunderstood. While it can take a long time to recover, there is hope that ongoing research and olfactory training provide pathways to gradual improvement, and support from healthcare providers and patient communities can make a big difference in coping with these changes.

Conclusion
Losing your sense of smell or taste after COVID-19 can be incredibly frustrating and disruptive, affecting everything from enjoying food to feeling safe in daily life. The good news is that most people recover within six months, and for those who don’t, there’s still hope that recovery can happen even years later. By better understanding what makes some people slower to recover, how these changes happen in the body, and how the condition evolves over time, doctors can provide more personalized support. Ongoing research into the causes of these smell and taste problems may one day lead to new treatments that make recovery faster and more complete.

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