The New York TimesJan 05, 2021 10:13:36 IST
Until March, when everything started to taste like cardboard, Katherine Hansen smelled so strong that she could almost recreate a restaurant dish at home without the recipe. , just by bringing back the smells and the flavors. Then the coronavirus arrived. One of Hansen’s first signs was a loss of smell, and then taste. Hansen can’t get a taste of food and says she can’t even chew. Now she lives mostly on soup and raisins.
“I look like someone who loses sight of as an adult,” said Hansen, a real estate agent who lives outside Seattle. “They know what something should look like. I know what it should look like, but I can’t get there. “
Health worker takes nasal swab sample of man to test for COVID-19 in Ahmedabad, India, on Monday, January 4, 2021. India on Sunday approved two COVID-19 vaccines , paving the way for a major inoculation program to stop the pandemic of coronavirus infection in the second most populous country in the world. Image credit: AP Photo / Ajit Solanki
Decreased sense of smell, known as anosmia, has emerged as one of the reported symptoms of COVID-19, the disease caused by the coronavirus. This is the first symptom for some patients, and sometimes the only one. Often accompanied by inability to taste, anosmia occurs suddenly and severely in these patients, almost as if a reversal has occurred.
Most regain their sense of smell and taste after recovering, usually within weeks. But in a minority of patients like Hansen, the loss persists, and doctors can’t say when or when the sensations will return.
Little is known about how the virus causes chronic anosmia or how it is cured. But things are coming up as the coronavirus spreads all over the world, and some experts fear that the pandemic could leave large numbers of people with permanent loss of smell and taste. The prospect has sparked an urgent scramble among researchers to learn more about why patients are losing these vital sensations, and how to help them.
“A lot of people have been doing olfactory research for decades and not getting much attention,” said Dr. Dolores Malaspina, professor of psychiatry, neuro-science, genetics and genomics at Icahn School of Medicine at Mount Sinai in New York. “COVID is just turning that field upside down. ”
Smell is closely linked to both taste and flavor, and anosmia often makes people enjoy eating. But the sudden presence may also have a major impact on mood and quality of life.
Studies have linked anosmia to social isolation and anhedonia, an inability to feel happiness, as well as a strange sense of separation and loneliness. Memories and emotions are closely linked to smell, and the olfactory system plays an important role in emotional well-being, said Dr. Sandeep Robert Datta, associate professor of neurobiology at Harvard Medical School.
“You think of it as the meaning of an elegant bonus,” Datta said. “But when someone smells a smell, it changes how they perceive the environment and their place in the environment. People’s sense of wellbeing is declining. It can be very stressful and difficult. ”
Many sufferers refer to the loss as very upsetting, even debilitating, especially since it is invisible to others.
“Smell is not something we pay much attention to until it’s gone,” said Pamela Dalton, who studies the connection between smell and psychology and emotion at the Monell Chemical Research Center in Philadelphia. “Then people notice this, and it’s very sad. Nothing is the same. ”
British scientists studied the experiences of 9,000 COVID-19 patients who joined a Facebook support group set up by the charity AbScent between March 24 and September 30. Many members said not only that they lost they enjoy eating but also socializing. The loss weakened their relationships with others, affected close relationships and left them feeling lonely, even away from reality.
“I feel alienated from myself,” wrote a partner. “It’s also the loneliness of the world. Part of me is missing, because I can’t smell and experience the basic emotions of everyday life. “
Another said, “I feel frustrated – like I’m not there. I can’t smell my house and feel at home. I can’t smell fresh air or grass when I go out. I can’t smell the water. ”
Loss of smell is a risk factor for anxiety and depression, so the impact of widespread anosmia is of great concern to mental health experts. Malaspina and other researchers have found that olfactory dysfunction often precedes social deficits in schizophrenia, and social exclusion even in healthy individuals.
“From a public health perspective, this is very important,” said Datta. “If you think worldwide at the number of people with COVID, even if only 10% would have lost a longer-lasting smell, we’re talking about millions of potential people.”
Perhaps the most direct effects are nutrition. People with anosmia can continue to see basic flavors – salty, sour, sweet, sour and umami. But buds taste very sour. Smell complicates the perception of taste through hundreds of scent receptors signaling the brain.
Many people who cannot smell will lose their appetite, putting them at risk of nutritional deficiencies and unexpected weight loss. Kara VanGuilder, who lives in Brookline, Massachusetts, said she had lost 20 pounds since March when her sense of smell was lost.
“I call it the COVID diet,” said VanGuilder, 26, who works in medical administration. “There’s no point in being in brownies if I can’t get a taste of the brownie.”
But while joking about it, she said, the loss has been sad: “For a few months, almost every day, I would shout at the end of the day. ”
Smells are also a primary warning system warning people of dangers in our environment, such as fires or gas leaks. One sense of smell in old age is one reason that older people are more prone to accidents, such as fires caused by leaving burnt food on the stove.
Michele Miller, of Bayside, New York, was caught with the coronavirus in March and has not dropped anything since. Recently, her husband and daughter rode out of their house, saying the kitchen was full of gas.
She had no idea. “It’s one thing not to smell and taste, but it is to survive,” Miller said.
People always scan their environments for odors that indicate changes and potential damage, although the process is not always sensitive, said Dalton, of the Monell Chemical Sensing Center.
Smell warns the brain of the worm, like dirty clothes, and dangerous, like spoiled food. Without this kind of discovery, “people get anxious about things,” Dalton said.
Worse, some survivors of COVID-19 are plagued by unpleasant and often contagious odors, such as the smell of burning plastic, ammonia or dirt, a distortion known as parosmia.
Eric Reynolds, a 51-year-old probation officer in Santa Maria, California, lost his sense of smell when he contracted COVID-19 in April. Now, he said, he often sees deceptive smells that he doesn’t know exist. Diet drinks taste like dirt; soap and laundry detergent smells like lethal water or ammonia.
“I can’t do dishes, it makes me gag,” Reynolds said. It also smells like the smell of corn chips and smells like “the fragrant smell of an old woman.”
It is not uncommon for patients like Reynolds to develop food disorders related to their divided opinions, said Dr. Evan R. Reiter, medical director of the center of smell and taste at the Commonwealth University of Virginia, which has been monitoring the recovery of some 2,000 COVID-19 patients who have lost their sense of smell.
One of his patients is recovering, but “now that he’s coming back, she says that all or almost everything she’s doing will take over. eat the taste or smell of gasoline, ”said Reiter. The lack of smell may be part of the recovery process, as receptors in the nose struggle to reactivate, sending signals to the brain that are abusive or misdiagnosed.
After a loss of smell, “different numbers or subtypes of receptors may be affected to varying degrees, so the signals your brain is used to receiving when eating steak will be distorted. and they could deceive your brain into thinking you’re eating dog poop or something else that can’t be read, ”said Reiter.
Patients who are fond of responses and treatment have tried medications such as odor training: sniffing essential oils or scents with a combination of scents – such as lavender, eucalyptus, cinnamon and chocolate – several times a day in an effort to stimulate the sense of smell. A recent study of 153 patients in Germany found that training could be moderately helpful for those with lower olfactory activity and in those with parosmia.
Dr. Alfred Iloreta, an ear, nose and throat specialist at Mount Sinai Hospital in New York, has begun a clinical trial to see if taking fish oil helps restore the sense of smell. The omega-3 fatty acids found in fish oil could protect cloud cells from further damage or help restore zero growth, he suggested.
“If you don’t smell or taste, you have a hard time eating anything, and that’s a big quality of life issue,” Iloreta said. “My patients, and the people I know who have lost their scent, are completely devastated by it.”
Reynolds feels the worst loss when he goes to the beach near his home for a walk. It no longer smells of the ocean or salt air.
“My mind knows what it smells like,” he said. “And when I get there, it’s not there.”
Roni Caryn Rabin c.2021 New York Times Company