Is Phantom Smell a Symptom of Long COVID? Experts Weigh In
It was during Ganesh Chaturthi of 2020, when she lit an incense stick that Vidhi realized something was wrong. She couldn't smell it.
She tried smelling different perfumes, and even a strong pain balm. Nothing.
A couple of days later, Vidhi was diagnosed with COVID 19, and both her smell and taste wouldn't be back for another few days.
Many who have been infected with COVID will have similar anecdotes of their own.
But while most people like Vidhi get their lost smell and taste back within a couple of weeks, not everyone is so lucky.
A number of people who lost their sense of smell when they were infected are now reporting a distorted sense of smell long after they have recovered from COVID. And they’re never pleasant.
While some people talk of ‘phantom smells’ of gas leaks or specific foods being cooked when there isn’t any, others talk of a lingering constant smell that they can’t shake off.
While a distorted smell might not seem like a symptom that would garner a lot of worries, especially in contrast with all the other symptoms of long covid that we are discovering, for some it can be a nightmarish experience —being followed by the strong pungent smell of garbage, or rotten eggs wherever they go, and having everything and everyone in their lives doused with it.
What causes parosmia in covid patients? Is this a cause for worry? FIT speaks to experts to understand the phenomenon.
What is Parosmia?
Dr Anshu Rohatgi, Senior Consultant Neurology, Sir Ganga Ram Hospital, New Delhi breaks it down for us.
“Parosmia refers to a distortion in smell and Phantosmia refers to olfactory hallucinations.”Dr Anshu Rohatgi, Senior Consultant Neurology, Sir Ganga Ram Hospital,
“These are opposed to Anosmia, which is the total loss of smell and hyposmia is the partial loss of smell,” he adds.
These can be caused due to local nerve damage in the nasal canal, or because of lasting damage to the central nervous system like in the case of some seizures, head injuries, and Parkinson’s.
Parosmia usually follows anosmia, or the total loss of smell, and it is typically a sign of the sense of smell returning, even if it might be stumbling on the way.
But in the case of COVID, it's the lack of information and not knowing how long it will last, that makes it so worrisome.
The Connection Between COVID and Smell
Dr Rohatgi explains that previously COVID was not thought to affect the nervous system, but as we get to know the virus more, we are discovering that it does.
The theories for why this may be, are still largely hypotheses.
Dr Rohatgi says that one explanation for COVID affecting the olfactory sense could be because the virus enters through the nasal cavity and causes structural changes in the nose, causing nerve damage in the process. This is common in the case of other viral infections as well.
In June 2020, loss of smell and taste were added to the symptoms of COVID-19 infection. And these symptoms are so common among patients of COVID that they came to define the illness, often being used to diagnose it.
But, Dr Suranjeet Chatterjee, Internal medical specialist at Apollo hospital, New Delhi explains how parosmia and anosmia are also common symptoms of a number of other viral infections.
“Half of the viral infections are not even tested or diagnosed and because of the pandemic and the attention that the covid virus has got, its symptoms like these get associated with this infection.”Dr Suranjeet Chatterjee, Internal medical specialist, Apollo hospital
The symptom is specifically associated with covid “because, in the case of covid, we have been studying the virus more carefully, we have found more association, and so it became part of the group of manifestations of the illness,” he says.
Dr Suranjeet Chatterjee also talks about how these olfactory symptoms seem to appear randomly with no recognisable pattern or predisposition. “We are seeing different sets of populations being affected by it without any real predisposing causative factor,” he says.
'COVID Is Not a Normal Virus'
Dr Rohatgi agrees that the reason the symptom has specifically been attached to covid is merely because we’re keeping a close eye on this virus, unlike others.
A number of viral infections cause local nerve damage of the olfactory cavity. “But,” he adds, “Covid is not a normal virus.”
As explained, parosmia and phantosmia are usually caused due to either local nerve damage of the nasal cavity—as in the case of your regular viral infections, or because of damage to the central nervous system. The former is temporary and resolves itself with the infection, and the latter is irreversible.
“In the case of COVID it's difficult to say which of the two is the actual cause,” he says.
“We now know that COVID affects the nervous system to some extent, but our experience with the virus has been short term and we really don’t know how long it will take for the olfactory sense to be fully restored.”Dr Anshu Rohatgi, Senior Consultant Neurology, Sir Ganga Ram Hospital
How Can You Cope?
While the experience can be horrific, at this point in time, experts are not too worried about this symptom of COVID.
While parosmia caused by viral infections usually fades with time without any intervention, certain exercises to nudge it forward may help.
Carl Philpott, Professor of Rhinology and Olfactology, University of East Anglia, recommends smell training.
“Smell training involves sniffing different smells, and strong odors like coffee, perfumes, or certain essential oils as a way of triggering the olfactory senses,” explains Dr Rohatgi. But as he says it, he isn’t too optimistic of its outcome.
He explains how with parosmia and even anosmia, the issue usually resolves itself when the nerve damage heals. “While one could try smell training, there isn’t any proven foolproof cure for this.”
We’ve barely scratched the surface of what the virus does to our bodies when we are infected, but ‘Long COVID’ or the ramifications of the infection in the long run is a whole other beast we’re yet largely unfamiliar with.
These symptoms can be a result of various interrelated causes, most of which are, as of now, still just hypotheses. Until further research is done to understand it, the best way to fight covid and its byproducts remains protecting yourself from being infected altogether.
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