A recent study conducted by a team of scientists from the United Kingdom discloses that loss of taste and smell sensation after infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the causative pathogen of coronavirus disease 2019 (COVID-19), negatively impacts the quality of life and psychological wellbeing of those that recover but experience persistence of this symptom. The study is currently available on the medRxiv* preprint server.
Malfunctioning of the olfactory system is a common consequence after viral infections. Studies have shown that about 56% of patients develop abnormal smell sensations, including parosmia (distorted smell detection) and phantosmia (smelling odors that are not actually present), after viral infections. Such smelling distortions are known to disrupt the overall quality of life, as most patients experience unpleasant or bad odors persistently.
Loss of smell and taste sensation has also been recognized as a common symptom in COVID-19 patients. Although the majority of COVID-19 patients regain the sensation within weeks of infection, about 10% of patients report having long-term complications, including phantosmia, parosmia, dysgeusia (distorted taste sensation), and altered chemesthesis (chemical sensitivity).
As a coping measure to reduce the emotional distress related to loss of smell/taste sensation in COVID-19 patients, the UK charity AbScent, ENT UK, and the British Rhinological Society have developed certain useful resources, including the COVID-19 Smell and Taste Loss Facebook group.
Current study design
To address the impact of COVID-19 related olfactory and gustatory dysfunction, the current study scientists enrolled a total of 9,000 members of the online Facebook community. The study was conducted from March 24 to September 30, 2020.
The scientists initially analyzed Facebook posts and comments of all participants and subsequently asked the participants to log their personal experiences about altered sensory perception.
Problems in understanding, explaining, and managing the symptom
Strikingly, the study’s findings highlighted the extensive impact of a loss of smell/taste sensation on the overall quality of life and psychological wellbeing of a large number of COVID-19 recovered individuals. The majority of the participants reported having difficulty in understanding, explaining, and managing the altered smell/taste sensation. The most puzzling fact was the sudden onset of such symptoms. Many participants felt like living with “invisible illness,” which significantly disrupted their routine daily activities. For some patients, there was day-to-day variation in the symptom intensity.
As mentioned by many participants, one of the biggest challenges was to explain the emotional aspects of loss of smell/taste sensation to others. This is partly because of the invisible nature of the symptom. Hence, many participants reported experiencing a lack of empathy and support from others. They even reported not having any medical assistance or support from healthcare professionals. However, by the end of the study period, most participants mentioned that the Facebook group significantly helped them gather valuable information about loss of smell/taste sensation and found ways to cope with the situation.
Altered eating behavior
As reported by the participants, the most significant problem related to the symptom was ingestion of food and eating enjoyment. Anosmia, parosmia, and phantosmia were found to be the major factors for altered eating behavior. Such altered eating behavior influenced the participants in two ways. For some participants, it increased the intake of food, especially junk foods/unhealthy snacks. In contrast, some participants reported having intense apathy about eating food, which in turn led to a significant loss of body weight.
Because eating and sharing food with family and friends brings a lot of pleasure and strengthens social bonding, many participants with altered eating behavior reported having a lack of pleasure in social engagement and altered social intimacy.
Altered connection to the surroundings
Because smell is one of the major senses that connect human beings to their surroundings, to other people, and also to themselves, the altered olfaction was found to significantly impact the lived experiences of the participants. They reported experiencing a feeling of loneliness, social and personal detachment, and unreality. Another important aspect was that many participants reported not being able to detect immediate dangers, such as not sensing smoke or other toxic odors.
Based on these findings, the scientists believe that the loss of smell/taste should not be considered a mild symptom in COVID-19 survivors. Given the significant impact of the symptom on the overall quality of life, extensive measures should be taken by the concerned authorities to provide widespread awareness and support systems. Moreover, healthcare personnel should be more attentive and supportive to COVID-19 sufferers so that they can overcome the shortcomings of altered sensory perception.
medRxiv publishes preliminary scientific reports that are not peer-reviewed and, therefore, should not be regarded as conclusive, guide clinical practice/health-related behavior, or treated as established information.