Managing long covid: don’t overlook olfactory dysfunction

Loss of smell and taste is one of the most prevalent symptoms of covid-192 and the best predictor of covid status.23 A substantial proportion of patients experience at least partial recovery of their loss of smell, but 10% report persistent loss eight weeks after onset.4 Parosmia—distortion of the sense of smell that can severely impair appetite owing to familiar foods triggering a foul smell—also seems to be prevalent in patients with covid-19. A patient led project evaluating covid-19 recovery with a survey found that loss of smell and taste was reported by more than 50% of respondents; loss of appetite and nausea even more frequently.7 The terminology used in such surveys, “loss of smell or taste,” probably underestimates the extent and health consequences of parosmia. Recent smell loss is the best predictor of COVID-19: a preregistered, cross-sectional study.