One of the most distinctive symptoms of COVID-19, the disease that can arise from the SARS-CoV-2 virus, is loss of taste and smell. This symptom can even affect people for weeks and months after they have developed the disease. Now, new research provides some insight into why this is the case. Originally thought to be related to damage of the olfactory nerves, the decreased or altered sense of smell is called olfactory dysfunction. However, according to the new research published this week in The Laryngoscope, loss of smell due to COVID-19 may also be because of swollen and blocked nasal passages. “Initially, we noticed a pattern in patients with COVID-19 that they lost their sense of smell and taste. We noticed these findings could be used as an indicator of whether or not a patient had COVID-19, but we thought it had to do with the olfactory nerve,” said Dr. Anjali Bharati, an ER physician at Lenox Health Greenwich Village in New York, NY. However, the researchers discovered that a contributing factor of the loss of smell and taste is due to the tissues instead of nerves. The good news is that cells recycle and heal much more easily than nerve damage. “Nerve damage is a more serious thing. The question becomes ‘does it recover?’” said Bharati. “This news involves the physical makeup of the nose, like the nasal passage and the back of the throat. Nerve damage is part of the brain, which is more disconcerting than the nasal passages.” *Image credit: Photo by doTERRA International, LLC via Pexels
While the majority of people who contract COVID-19 recover within 3-4 weeks following infection, there are some who experience lingering symptoms for months afterwards. These symptoms, which can include shortness of breath, loss of smell and taste, brain fog, headaches and fatigue, are referred to collectively as 'long Covid'. Now, research has shown that this so-called long Covid seems to more severely impact women's cardiovascular and lung function than men. According to researchers at Indiana University, Bloomington, women with COVID-19 who had mild-to-moderate illness during the acute phase showed a slower decline in their heart rate after the 6-minute walk test than the participants in the control group. This difference was more pronounced in women actively experiencing long COVID symptoms. Study lead author, Dr. Stephen Carter, a professor at Indiana University, said: “A puzzling feature of post-acute COVID-19 syndrome is the variable presentation of symptoms that appear to be independent of initial illness severity. The present work shows even those with mild-to-moderate initial symptoms can be affected with underlying cardiac-related irregularities with the potential to affect exercise tolerance and/or activities of daily living.” “It’s also plausible that lingering symptoms, particularly muscle/joint pain and/or shortness of breath, may trigger a maladaptive pattern that accelerates systemic deconditioning. However, further research is needed.” The study appears in the journal Experimental Physiology. *Image by StockSnap from Pixabay
Before the COVID-19 pandemic, ear, nose and throat (ENT) specialist Dr Clair Vandersteen might have treated around 10 patients a year for anosmia, the inability to smell. But fast-forward to today and Dr Vandersteen has seen demand for his services increase significantly. Now, the majority of his patients are those recovering from COVID-19, up to 15 a week, in fact, at the doctor’s clinic in the Centre Hospitalier Universitaire de Nice. Loss of smell is a symptom in eight out of 10 COVID-19 cases and can the effects can sometimes linger for months after the patient has recovered from the disease. “We have seen a very large increase in patients since this time a year ago,” Dr Vandersteen said. The ENT specialist says studies show that 20% of people who lost their sense of smell still had not regained it and it’s younger individuals that appear to be worst affected. “The patients we see suffering from a loss of smell are relatively young. It is predominantly a problem that affects people in their 30s and 40s.” While for some people it might seem little more than an inconvenience, Dr Vandersteen warns the condition can make patients anxious and depressed. “The loss of smell can lead to psychological problems – 30% of people who have lost their sense of smell due to Covid are suffering from some kind of psychological damage. We love eating, especially here in France, so when chocolate tastes like cigarettes, for example, it can lead to people feeling unhappy or anxious. “If you can’t enjoy the smell of your newborn baby, or the smell of your home, it can be unsettling. It can also be dangerous – if you can’t smell gas or smoke, for example.” Dr Vandersteen’s team has come up with a three-pronged approach to help. First, patients see Dr Vandersteen, who determines their level of smell loss. Then, they are seen by Auriane Gros, a doctor of neuroscience and a speech pathologist, who helps re-educate the brain to recover the perception of smells. The final step is therapy with child psychiatrist Louise-Emilie Dumas, who runs group workshops around odours. “The team has had positive results,” Dr Vandersteen says. *Image courtesy of Dr Clair Vandersteen
We’ve written previously about a lesser known COVID-19 symptom to look out for. But as experts learn more about COVID-19, new symptoms of the infection are coming to light. In addition to fever, coughing and difficulty breathing, plus a sudden loss of smell or taste (as per our above-referenced post), some people with COVID-19 have also presented with less typical symptoms, including nausea, diarrhea, delirium, chickenpox-like lesions, and more. Indeed, according to a study by Stanford Medicine, which analyzed the medical records of 116 patients who had tested positive for COVID-19, almost a third displayed digestion related symptoms, including loss of appetite, nausea, vomiting, and diarrhea. Meanwhile, a study in Italy that looked at 88 patients who has tested positive for COVID-19 found that approximately 20% displayed skin symptoms, including a red rash, widespread hives, or chickenpox-like lesions. While people with atypical COVID-19 symptoms may also develop more classic symptoms too, not all will. And then there are the individuals who contract the virus and don’t have any symptoms at all i.e. are asymptomatic. This is why it is useful to spread awareness about some of the less common COVID-19 symptoms, so that people can potentially spot if they or someone they know develops the disease.
While fever, tiredness and a dry cough are the most common symptoms associated with COVID-19, the respiratory illness caused by the new SARS-CoV-2 coronavirus, evidence is beginning to show that a sudden loss of smell or taste could also be a sign. The latest researchers to report that a loss of smell and taste could be associated with COVID-19 are a team from King’s College London. They looked at responses from more than 400,000 people with suspected COVID-19 symptoms who entered how they were feeling into an app. Of the people who had tested positive for COVID-19 (579 individuals), three-fifths (59%) reported a loss of smell or taste. While a loss of smell or taste have not yet been added to the official list of COVID-19 symptoms published by the NHS or Public Health England, it is important to note that the current situation is rapidly evolving and this could change at any time. The King’s College researchers say that a loss of smell or taste should not be used on their own, but could be useful when considered alongside other important symptoms such as a dry cough and fever. Speaking about their findings, lead researcher Professor Tim Spector said: “When combined with other symptoms, people with loss of smell and taste appear to be three times more likely to have contracted Covid-19 according to our data, and should therefore self-isolate for seven days to reduce the spread of the disease.” [Related reading: Why social distancing is crucial for reducing the spread of COVID-19]