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Why Covid-19 patients are suffering from distorted & phantom smells

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https://www.smithsonianmag.com/science-n...180975826/

EXCERPTS: . . . What happened to Pitz is not unique. Of more than 4,000 respondents to a multilingual, international study of people with recent smell loss published in Chemical Senses in June, 7 percent reported parosmia, or odor distortion. Facebook support groups dedicated to parosmia and phantosmia, the clinical names for specific smell disorders, have grown drastically in the past few months. Instead of a scentless world, an increasing number of people who lost their sense of smell because of Covid-19 are complaining that things just don’t smell right.

They no longer wake up and can’t smell the coffee; because of parosmia, their coffee smells like burning rubber or sewage. Parosmia is most often an unpleasant smell, a distortion of an actual odor, making many foods smell and taste revolting. Phantosmia is more random, occurring without a scent trigger, uninvited and unwanted. Phantosmias, which can be fleeting or linger, are also usually foul smells [...] Zara M. Patel ... says, for smell distortions to accompany or follow smell loss. “There are so many viruses that can cause smell loss, not only other coronaviruses, but also influenza viruses and rhinoviruses,” she says.

Smell loss, or anosmia, is such a prevalent symptom of Covid-19 it can be used for diagnosis. [...] “SARS-CoV-2 binds to ACE receptors, which are present in the basal cells, supporting cells and perivascular cells around the neurons in the olfactory epithelium,” says Patel. “So although the neuron itself is not damaged, all the support structure around it is. Those cells that support the regenerative capacity are the ones that suffer ... We also know that nerves do not function very well within an inflammatory environment. So because of all those reasons, it is not surprising this virus causes smell dysfunction.”

The good news, says Nancy Rawson, vice president and associate director at Monell Chemical Senses Center, a non-profit interdisciplinary research institute in Philadelphia, is that cells in the olfactory epithelium can regenerate after they have been damaged. But that regeneration can take time—up to two years, or more. [...] Rawson says that because the brain is receiving incomplete smell information, “when the recovery process is happening in patches, or recovery is partial in different regions, you may go through that stage of parosmia on the way to a fuller recovery.”

The foul smells that characterize parosmia and phantosmia are often triggered by certain foods or smells. According to the first large study of patients with parosmia, published in 2005, the main culprits are gasoline, tobacco, coffee, perfumes and chocolate. For Pitz, coffee, chocolate and red wine smell and taste awful... (MORE - details)
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