A Change in Smell After COVID-19 Infection: What You Need to Know - University of Utah Health Care

There are no guaranteed treatments for post-COVID-19 parosmia. However, some therapies may help some patients. These include:

  • Olfactory retraining is the process of retraining your nose to smell. It involves smelling strong scents (citrus, cloves, eucalyptus) every day while thinking about what they smell like to try to help reform normal responses to your nose and brain. Research has shown it can improve parosmia in long COVID patients. It often takes about 6 to 12 weeks to notice an impact and up to 24 weeks for maximal impact.
  • Intranasal steroids (fluticasone or mometasone) are low-risk nasal spray therapies. Studies have shown that these therapies can improve sense of smell in about 10-25 percent of patients.
  • High-volume saline irrigations or sinus rinses (Neilmed, Netipot, Navage) help improve inflammation in the nose after an infection and may improve recovery after infection.
  • Neuromodulating medications alter the way nerve cells send signals. Limited research has shown some improvements in olfactory dysfunction. These medications, such as gabapentin and amitriptyline, are also used to control chronic pain or headaches. Due to side effects, they are mostly used in patients with severe symptoms.
  • Lifestyle modifications can help improve a patient's quality of life, such as:
    • Eating simpler or bland meals: The more complex the aroma, the more likely it seems to trigger parosmia.
    • Eating food cold or at room temperature: Steam is what carries that sense of smell to your nose, which can trigger parosmia.

Other therapies like stellate ganglion blocks, alpha-lipoic acid, and plasma-rich plasma (PRP) injection are being investigated as potential treatments for COVID-induced parosmia. The risks or potential benefits are not yet known.

Home or natural therapies are becoming increasingly common, but DO NOT try these without talking to your doctor first. What you put in your nose could be absorbed in your bloodstream, which could potentially be dangerous to your health.

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