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Effects of COVID-19 on Smell

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One of the distressing portions or parts of COVID that I see in my office quite a bit are patients who come in after having had the disease and say that they can't smell. Now, it is one of the initial symptoms that patients get and by and large, 95% of patients will get their smell back over a six month period of time. In fact, the great majority of patients will get their smell back over the course of one to two weeks. But I see those patients, what are called "the walking wounded" and these are patients who are unable to smell going forward. Now there's no obvious wounds on the outside of the body, are there? But as a result of inability to smell, this can adversely affect your quality of life significantly. What happens is that the smell nerves are affected not by the virus itself, but by the feeding, what we call the sustentacular cells, that feed the nerves. There normally is an attachment there, and that attachment becomes disrupted. When the attachment is disrupted, you can no longer smell. Now in some patients, they'll have what we call parosmia, where when the smell nerves attach to the feeding cells, they get mixed up and as a consequence, patients will have adverse smells, meaning that your morning coffee may smell like metal or even worse than that.

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