When covid won’t leave you
Goodbye, sense of smell
Door Marjanne van der Bijl
By Marjanne van der Bijl
Last summer, Daan Hooiveld (23) started getting intense headaches and muscle pains. He got tested just to be sure and unfortunately, he had corona. He felt crappy for a few days, spiking a fever during one of them. Ten days later, his symptoms had abated, the whole thing over with. Or so he thought. Another two weeks went by, and suddenly he couldn’t smell anything anymore.
He still hasn’t recovered his sense of smell. He says it’s exhausting. ‘If I want to smell a freshly baked cake, I practically have to put my nose in it.’
Half of the people who got ill with corona were unable to smell or taste anything afterwards. Nearly a tenth of those people are experiencing a permanent loss or altered sense of smell. That might not sound like a large part, says medical oncologist Jacco de Haan, but because so many people contract the virus, it is a large number of people.
Impact
As an oncologist, De Haan isn’t necessarily an expert on viruses. Yet he’s currently studying the impact of corona-induced loss of smell and taste. ‘Cancer treatments, the most well-known of which is chemotherapy, can also alter people’s sense of smell and taste’, he explains. When this turned out to be such an important symptom of covid, it was only logical to study them as well.
I practically have to put my nose in a cake to smell it
During his studies at the UMCG, De Haan found out how much an altered sense of smell and taste affected his patients. ‘There’s one man I will always remember’, he says.
The patient had skin cancer that had metastasised, but immunotherapy had completely eradicated the disease. It sounds like a great success. But the man had also completely lost his sense of taste, when he loved good food and drink. ‘I may have cured his cancer, but he wasn’t happy at all.’
Work group
This led him to study the phenomenon, because he wanted to know how often this happened and whether he could help these people. He found out that people from many different hospital departments were working on the problem.
The kitchen was cooking delicious foods for patients suffering the symptoms, dieticians were brainstorming how to improve their counselling, and radiation therapists studied whether patients who received radiation in the throat area produced saliva differently and suffered from dry mouth.
‘We put all these people together’, says De Haan, ‘creating a work group that focuses on the impact of an altered sense of smell and taste.’
Long-term problems
Together with his colleagues, De Haan is currently working on two studies into covid-induced loss of smell and taste. They mainly focus on the long-term problems.
The first study is part of COVID-home, a UMCG study. They disseminate questionnaires to people who’ve tested positive for the coronavirus but who weren’t ill enough to be admitted to hospital. Did their sense of smell and taste change, and how has this been developing?
People eat under the cooker hood; they can’t stand the smell
For the other study, they posted a questionnaire in a Facebook group for people with persistent changes to their sense of smell and taste after a covid infection in an effort to find out how this affects their daily lives.
This latter group consists of thousands of people. ‘These are people who seek out this place so they can talk about it to other people who know what they’re going through’, says De Haan. It’s easier to talk to people suffering from the same problem than to people who can still smell or taste everything. ‘They don’t always understand how much it can impact your life.’
Social activity
A large part of our sense of taste is determined by our sense of smell. So if you can’t smell things anymore, your sense of taste is also affected. When a covid infection eradicates your sense of smell, it’s usually because your olfactory cells, which process the smells and send the data to your brain, are damaged.
This has severe consequences. ‘Eating is a social activity’, De Haan explains. It’s when people get together to discuss their day, and that is now disrupted. ‘I’ve heard of people eating their food under the cooker hood, because they can’t stand the smell of it.’
The group is working hard to figure out how to help and coach these people. No two people suffer the exact same symptoms. Some people completely lose their sense of smell and taste, other people say everything tastes like cardboard, and some people report things smelling sour. ‘That’s why counselling should be done on an individual basis’, says De Haan.
Smell training
One of the things the ear, nose, and throat doctors are using is smell training: people are made to smell intense things every day to train their sense of smell. This should stimulate your olfactory organ and your brains. Daan hasn’t started on the training yet: ‘I’m not really looking forward to sticking my nose in a piece of dog poop just to smell something.’
I’m not looking forward to sticking my nose in dog poop
But his frustrations have been mounting. He noticed some improvement in the beginning and assumed that his sense of smell would return, but his faith has been faltering. ‘It’s such a shame when someone cooked a nice meal and I can’t smell it.’
But he also can’t smell it when he’s left the stove on. ‘That can be dangerous, for instance when there’s a gas leak.’ He also doesn’t like the idea of not being able to smell fire. ‘The chance of something happening is small, but when it does happen, I’m toast.’
Daan says he’ll wait and see for a bit longer. But if his sense of smell doesn’t improve soon, he might just decide to train it.