February 23, 2021
Not to be sniffed at:
Agony of post-COVID-19 loss of smell
By John Leicester
The Associated Press
February 23, 2021
NICE, France (AP) — The doctor slid a miniature camera into
the patient’s right nostril, making her whole nose glow red with
its bright miniature light.
"Tickles a bit, eh?" he asked as he rummaged around her nasal
passages, the discomfort causing tears to well in her eyes and
roll down her cheeks.
The patient, Gabriella Forgione, wasn’t complaining. The
25-year-old pharmacy worker was happy to be prodded and poked at
the hospital in Nice, in southern France, to advance her
increasingly pressing quest to recover her sense of smell. Along
with her sense of taste, it suddenly vanished when she fell ill
with COVID-19 in November, and neither has returned.
Being deprived of the pleasures of food and the scents of
things that she loves are proving tough on her body and mind.
Shorn of odors both good and bad, Forgione is losing weight and
"Sometimes I ask myself, ‘Do I stink?’" she confessed.
"Normally, I wear perfume and like for things to smell nice. Not
being able to smell bothers me greatly."
A year into the coronavirus pandemic, doctors and researchers
are still striving to better understand and treat the
accompanying epidemic of COVID-19-related anosmia — loss of
smell — draining much of the joy of life from an increasing
number of sensorially frustrated longer-term sufferers like
Even specialist doctors say there is much about the condition
they still don’t know and they are learning as they go along in
their diagnoses and treatments. Impairment and alteration of
smell have become so common with COVID-19 that some researchers
suggest that simple odor tests could be used to track
coronavirus infections in countries with few laboratories.
For most people, the olfactory problems are temporary, often
improving on their own in weeks. But a small minority are
complaining of persistent dysfunction long after other COVID-19
symptoms have disappeared. Some have reported continued total or
partial loss of smell six months after infection. The longest,
some doctors say, are now approaching a full year.
Researchers working on the vexing disability say they are
optimistic that most will eventually recover but fear some will
not. Some doctors are concerned that growing numbers of
smell-deprived patients, many of them young, could be more prone
to depression and other difficulties and weigh on strained
"They are losing color in their lives," said Dr. Thomas
Hummel, who heads the smell and taste outpatients clinic at
University Hospital in Dresden, Germany.
"These people will survive and they’ll be successful in their
lives, in their professions," Hummel added. "But their lives
will be much poorer."
At the Face and Neck University Institute in Nice, Dr. Clair
Vandersteen wafted tube after tube of odors under Forgione’s
nose after he had rooted around in her nostrils with his camera.
"Do you perceive any smell? Nothing? Zero? OK," he asked, as
she repeatedly and apologetically responded with negatives.
Only the last tube provoked an unequivocal reaction.
"Urgh! Oh, that stinks," Forgione yelped. "Fish!"
Test complete, Vandersteen delivered his diagnosis.
"You need an enormous amount of an odor to be able to smell
something," he told her. "You haven’t completely lost your sense
of smell but nor is it good."
He sent her away with homework: six months of olfactory
rehab. Twice daily, choose two or three scented things, like a
sprig of lavender or jars of fragrances, and smell them for two
to three minutes, he ordered.
"If you smell something, great. If not, no problem. Try
again, concentrating hard on picturing the lavender, a beautiful
purple bloom," he said. "You have to persevere."
Losing the sense of smell can be more than a mere
inconvenience. Smoke from a spreading fire, a gas leak, or the
stink of rotten food can all pass dangerously unnoticed. Fumes
from a used diaper, dog’s dirt on a shoe, or sweaty armpits can
be embarrassingly ignored.
And as poets have long known, scents and emotions are often
like lovers entwined.
Evan Cesa used to relish meal times. Now they’re a chore. A
fish dinner in September that suddenly seemed flavorless first
flagged to the 18-year-old sports student that COVID-19 had
attacked his senses. Foodstuffs became mere textures, with only
residual hints of sweet and saltiness.
Five months later, breakfasting on chocolate cookies before
classes, Cesa still chewed without joy, as though swallowing
"Eating no longer has any purpose for me," he said. "It is
just a waste of time."
Cesa is among the anosmia sufferers being studied by
researchers in Nice who, before the pandemic, had been using
scents in the diagnosis of Alzheimer’s disease. They also used
comforting fragrances to treat post-traumatic stress among
children after a truck terror attack in Nice in 2016, when a
driver plowed through holiday crowds, killing 86 people.
The researchers are now turning their expertise to COVID-19,
teaming up with perfumers from the nearby fragrance-producing
town of Grasse. Perfumer Aude Galouye worked on the fragrant
waxes that were wafted under Cesa’s nose to measure his
olfactory impairment, with scents at varying concentrations.
"The sense of smell is a sense that is fundamentally
forgotten," Galouye said. "We don’t realize the effect it has on
our lives except, obviously, when we no longer have it."
The examinations on Cesa and other patients also include
language and attention tests. The Nice researchers are exploring
whether olfactory complaints are linked to COVID-related
cognitive difficulties, including problems with concentrating.
Cesa stumbled by picking the word "ship" when "kayak" was the
obvious choice on one test.
"That is completely unexpected," said Magali Payne, a speech
therapist on the team. "This young man shouldn’t be experiencing
"We have to keep digging," she said. "We are finding things
out as we see patients."
Cesa longs to have his senses restored, to celebrate the
taste of pasta in carbonara sauce, his favorite dish, and a run
through the fragrant wonders of the great outdoors.
"One might think that it is not important to be able to smell
nature, trees, forests," he said. "But when you lose the sense
of smell, you realize how truly lucky we are to be able to smell