No right answer to regaining sense of smell

KARACHI: “Have I lost my sense of smell and taste permanently after contracting the COVID-19?” is one of the common questions asked by people from otolayrngologists (ear, nose and throat ENT specialists) and neurologists these days, but nobody has the right answer yet.

Some of them believe both the senses would return with the passage of time, while others fear these are lost permanently.

“A lot of people are coming to me and other ENT specialists with complaints that they are unable to taste food and smell even after several months after contracting the COVID-19. These are mostly asymptomatic patients, who lost both senses i.e. smell and taste after contracting COVID-19 but never regained them”, says Prof. Atif Hafeez Siddiqui, an ENT specialist associated with Dow University of Health Sciences (DUHS), Karachi.

Prof. Atif Siddiqui who regularly examines patients and perform surgeries at Dr. Ruth K.M Pfau Civil Hospital Karachi, says the number of patients complaining of loss of sense of smell and taste is growing.

“This is definitely related to COVID-19 and happening to those patients who contracted the disease but remained asymptomatic. We have launched a research on such patients but we can’t divulge the details unless it is published”, Dr. Siddiqui said.

He said no treatment was available at the moment to help such patients but they were advising people with lost smell and taste to start smelling essential oils, take steam and use some vitamins, which may help them regain their lost senses of smell and tastes.

“I advise people to smell essential oils, clove oil, coffee beans and use tablets to overcome Vitamin-E deficiency, which would hopefully help them regain their sense of smell and taste. It is likely that some of the people would be unable to get either or both of their senses back”, he opined.

Vice Chancellor Jinnah Sindh Medical University (JSMU) Prof. Tariq Rafi, who is also an ENT specialist, said around 15 to 20 percent people who recovered from COVID-19 claimed even after six months and more that they had lost their sense of smell and taste, for which no explanation was available.

“In addition to the loss of smell and taste, some people feel a bad smell all the time whether it is a perfume or a strong foul smell.

Similarly, some people say they have acquired a metallic taste of everything they eat. This is quite unusual and new thing for us. There is no explanation for this phenomenon yet”, Prof. Tariq Rafi said.

Another ENT specialist Prof. Sameer Qureshi also confirmed seeing patients with lost smell and taste and feared that they would not be able to regain these senses.

“Smell and taste go together. Of course, I have seen such patients who have not regained their smell and taste. Mouthwatering is common after smelling some delicious food. So if anybody loses their sense of smell, it is quite likely that they would lose their sense of taste too although their receptors are different”, Prof. Qureshi explained.

“The olfactory nerve is instrumental in our sense of smell while the chorda tympani is a branch of the facial nerve that originates from the taste buds in front of the tongue, runs through the middle ear, and carries taste messages to the brain”, he said, adding that local edema (swelling) or damage to these two nerves was probably resulting in loss of smell and taste among people. To a query, he said although no research paper had been published on this aspect of COVID-19, such cases were being reported from the entire world by the ENT specialists.

He said use of short-term steroids in the early stage of edema (swelling) caused by the COVID-19 could help restore the sense of taste and smell but he had not tried it on the patients.

“It is high time that health experts take this issue seriously and try to resolve it with medications”, he added.

Responding to another query, he said use of Vitamin-C, Vitamin-B complex and calcium tablets could help in this condition but made it clear that it was not a definite treatment.

Eminent neurologist and health expert Dr. Muhammad Wasay, who is associated with Aga Khan University (AKU) Karachi, believes that loss of smell and taste is though becoming very common among asymptomatic COVID-19 patients, these conditions are ‘reversible’ with the passage of time.

“Loss of smell and taste are neurological complications of COVID-19. They are usually reversible in six months but may take longer”, he said, adding that no medications were needed as people would regain their lost senses on their own with passage of time.