When will my sense of smell come back after a COVID infection?

For many people over the past couple of years, it was an early sign that something was wrong. Perhaps you couldn’t catch a whiff of your favorite meal — or the fragrance had mysteriously disappeared from your herbal-scented shampoo. It’s called anosmia, and about 80% of people who catch COVID-19 end up with a nose that isn’t quite doing its job, according to UC Davis Health.

“Loss of smell — and taste, too — has become one of the main criteria we use for diagnosing COVID-19,” says Steven Furr, MD, a family doctor in Jackson, Alabama. Dr. Furr is also a spokesperson for the American Academy of Family Physicians. “That can happen with other viral illnesses too, even a common cold. But the sheer number of COVID cases means we’ve been seeing anosmia a lot,” he says.

Experts are learning more about the effects of COVID all the time, including the way it impacts the sense of smell. Here, we’ll answer your most pressing questions — and help you get your sniffer back in good working order.

What exactly is anosmia, and why does it happen with COVID?

If you’ve ever had a garden-variety cold, you know what it’s like to have a stuffy nose. Nasal swelling and mucus keep odors from getting inside your nose, making it hard to smell.

With COVID, though, it’s different. You don’t usually get a stuffy nose with the virus, so there isn’t any mucus to physically block smells.

Instead, when the nerve cells in your nose (called olfactory sensory neurons) detect the coronavirus in the body, a rush of immune cells is triggered. That sets off inflammation to help fight the virus. And because your nose is so close to your brain, those immune cells just keep on fighting. As they do, they trigger changes in your olfactory neurons, putting your sense of smell out of commission.

(From at-home tests to at-home care, Optum’s COVID-19 resource center is here for you.)

Can anosmia affect my health?

Yes, in some surprising ways. First, your inability to smell also impacts your ability to taste. That’s because the taste buds on your tongue work together with your olfactory neurons. So sometimes people with COVID-19 experience ageusia (an inability to taste). Or they may have parosmia (a distorted sense of smell). When that happens, things that used to smell good suddenly have an unpleasant or metallic odor.

Changes such as these can affect your appetite and lead to health problems. One 2021 review study reported that people with anosmia ate more salt, sugar and fat. That may complicate conditions such as high blood pressure, diabetes and cardiovascular disease.

People without the ability to smell are also more likely to be depressed. And anosmia can be a safety issue, too, putting you in danger if you can’t detect warning signs such as smoke or leaking gas.

If you think you might have COVID-19, our providers are standing by to help. Schedule a virtual appointment as soon as today and get guidance on testing, how to treat your symptoms and when to seek in-person care.  

How long will this last?

That depends, experts say. “The vast majority of patients get their smell back within 2 weeks,” says Dr. Furr. But for some people, it can go on longer, or even indefinitely. “Some 15% have symptoms for 6 months or so, and 5% have long COVID.” That can make you lose your sense of smell for months, or even years. Doctors still aren’t quite sure. But the good news: Around 95% of people who lose their sense of smell due to COVID-19 eventually regain it.

I’ve heard about smell training — is that a real thing?

Yes. Olfactory training can help stimulate the nerve cells in your nose and help you regain your sense of smell. And you can try it at home.

Working with 4 essential oils, take whiffs of each one for about 30 seconds. As you do, try to think of a memory associated with it. It can also help to look at a picture at the same time — a lemon, say, if you’re smelling lemon oil. Give your nose a 1-minute break between scents. Do this in the morning and evening for 3 months.

“Be persistent,” advises Dr. Furr. “Breathe in deeply a few times a day to retrain your nerves.” In a recent study, about 64% of people who trained for 28 days saw an improvement in their ability to smell. And about 73% of people who stuck with the program longer experienced a bigger change.

When should I see my doctor?

“If you have persistent symptoms, it’s a good idea to see your family doctor,” advises Dr. Furr. “A checkup can make sure there isn’t something else going on, such as a sinus infection or nasal polyps.” Researchers are looking into treating anosmia with oral steroid medications alone and in combination with olfactory training. And while some studies have shown positive results, Dr. Furr says that the jury is still out. Your best bet is to trust your doctor. Be patient and give your nose plenty of time to recover.

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Additional sources
COVID and smell: UC Davis Health (2022). “UC Davis researchers dissect COVID-19’s impact on sense of smell”
Anosmia and diet: American Journal of Otolaryngology (2021). “Onset and duration of symptoms of loss of smell/taste in patients with COVID-19: a systematic review”
Smell training statistics: Journal of Medical Internet Research (2021). “Olfactory training and visual stimulation assisted by a web application for patients with persistent olfactory dysfunction after SARS-CoV-2 infection: observational study”