Linda, France – The doctor slid a miniature camera into the patient’s right nostril, causing her entire nose to glow red in its bright miniature light.
“It tickles a bit, huh?” She asked as she poked her nostrils, discomfort causing tears to rise to her eyes and roll down her cheeks.
The patient, Gabriella Forgione, was not complaining. The 25-year-old pharmacy worker was happy to be pushed and pricked in the hospital in Nice, southern France, to advance her increasingly urgent quest to regain her sense of smell. Along with his sense of taste, he suddenly disappeared when he fell ill with COVID-19 in November, and none have returned.
Being deprived of the pleasures of food and the scents of the things you love is having a hard time on your body and mind. Deprived of good and bad smells, Forgione is losing weight and self-confidence.
FAUCI PRECAUTIONS AGAINST EATING OUT, EVEN WHEN VACCINATED
“Sometimes I ask myself, ‘Do I stink?’” She confessed. “Normally, I wear perfume and I like things to smell good. Not being able to smell bothers me a lot.”
One year after the coronavirus pandemic, doctors and researchers are still struggling to better understand and treat the accompanying epidemic of COVID-19-related anosmia (loss of smell), draining much of the joie de vivre of a growing number of long-term sensory frustrated people. sick like Forgione.
Even medical specialists say there are many things about the condition that they do not yet know and are learning as they progress with their diagnoses and treatments. Smell impairment and disturbance 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, olfactory problems are temporary and often improve on their own within weeks. But a small minority complain of persistent dysfunction long after other COVID-19 symptoms have disappeared. Some have reported a continuous partial or total loss of smell six months after infection. The longest, some doctors say, approach a full year.
WOMAN CRIES THE DEATH OF THE FATHER’S NURSING HOME: ‘HE HAD NO ONE WITH HIM’
Researchers working on the haunting disability say they are optimistic that most will eventually recover, but fear that some will not. Some clinicians worry that increasing numbers of smell-deprived patients, many of them young, may be more prone to depression and other difficulties, and that they weigh on strained health systems.
“They are losing color in their lives,” said Dr. Thomas Hummel, who runs the outpatient clinic for smell and taste at the University Hospital in Dresden, Germany.
“These people will survive and succeed in their lives, in their professions,” added Hummel. “But their lives will be much poorer.”
At the Face and Neck University Institute in Nice, Dr. Clair Vandersteen threw tube after tube of scents under Forgione’s nose after poking into his nostrils with her camera.
“Do you smell any odor? Nothing? Zero? OK,” he asked, as she repeatedly and apologetically replied with negatives.
Only the last tube elicited an unequivocal reaction.
“Urgh! Oh that sucks,” Forgione yelled. “Fish!”
Full test, Vandersteen delivered his diagnosis.
“It takes an enormous amount of smell to be able to smell something,” he told her. “You haven’t completely lost your sense of smell, but it’s not good either.”
He fired her with the task: six months of olfactory rehabilitation. Two or three times a day, choose two or three scented things, like a sprig of lavender or fragrance bottles, and smell for two or three minutes, he ordered.
“If you smell something, great. If not, no problem. Try again, concentrating on imagining lavender, a beautiful purple flower,” he said. “You have to persevere.”
Losing your sense of smell can be more than just an inconvenience. Smoke from a spreading fire, a gas leak, or the stench of rotten food can go dangerously unnoticed. Fumes from a used diaper, dog dirt on a shoe, or sweaty armpits can be embarrassingly ignored.
And as poets have long known, scents and emotions are often like intertwined lovers.
THE FDA ADDRESSES CORONAVIRUS VARIANTS IN THE UPDATED GUIDE FOR MEDICAL DEVELOPERS
Evan Cesa used to enjoy meals. Now they are a chore. A fish dinner in September that suddenly seemed bland made the 18-year-old sports student realize that COVID-19 had attacked his senses. The foods became mere textures, with only residual hints of sweet and salty.
Five months later, having chocolate cookies for breakfast before class, Cesa continued chewing without joy, as if swallowing cardboard.
“Eating no longer serves any purpose for me,” he said. “It’s just a waste of time.”
Cesa is among the people with anosmia being studied by researchers in Nice who, before the pandemic, had been using scents in diagnosing Alzheimer’s disease. They also used comforting fragrances to treat post-traumatic stress among children after a terrorist truck attack in Nice in 2016, when a driver pushed his way through the Christmas crowd, killing 86 people.
The researchers are now turning their expertise to COVID-19, partnering with perfumers from the nearby fragrance-producing town of Grasse. The perfumer Aude Galouye worked on the scented waxes that floated under Cesa’s nose to measure her olfactory deterioration, with aromas in 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.”
Exams for Cesa and other patients also include language and attention tests. Nice researchers are exploring whether olfactory complaints are related to cognitive difficulties related to COVID, including concentration problems. Cesa stumbled choosing the word “boat” when “kayak” was the obvious choice in a test.
“That’s completely unexpected,” said Magali Payne, the team’s speech therapist. “This young man should not have language problems.”
“We have to keep investigating,” he said. “We discover things as we see patients.”
CLICK HERE TO SEE THE FULL CORONAVIRUS COVERAGE
Cesa longs to regain her senses, celebrate the taste of pasta in carbonara sauce, her favorite dish, and explore the fragrant wonders of the outdoors.
“One might think that it is not important to be able to smell nature, trees, forests,” he said. “But when you lose your sense of smell, you realize how lucky we are to be able to smell these things.”