NICE, France (AP) – The doctor slid a miniature camera into the patient’s right nostril, causing her entire nose to glow red with miniature light.
“Tickles a little, huh?” he asked as he combed his nasal passages, the discomfort causing tears in his eyes and rolling down his cheeks.
The patient, Gabriella Forgione, was not complaining. The 25-year-old pharmacy worker was happy to be nudged and nudged at the hospital in Nice, in the south of France, to move forward in her increasingly urgent quest to regain her sense of smell. Along with her taste buds, he suddenly disappeared when she fell ill with COVID-19 in November, and neither returned.
Being deprived of the pleasures of food and the scents of the things she loves is proving difficult for her body and mind. Stripped of good and bad odors, Forgione is losing weight and self-confidence.
“Sometimes I ask myself, ‘Do I smell bad?'”, She confessed. “I usually use perfume and I like things to smell good. Not being able to smell it bothers me a lot. “
A year after the coronavirus pandemic began, doctors and researchers are still struggling to better understand and treat the COVID-19-related anosmia epidemic – loss of smell – draining much of the joy of living from a growing number of frustrated patients sensorially long-term sufferers like Forgione.
Even medical experts say there is a lot about the disease that they still don’t know and are learning as they progress in their diagnoses and treatments. Deficiency and impaired sense of smell have become so common with COVID-19 that some researchers suggest that simple odor tests could be used to screen for coronavirus infections in countries with few laboratories.
For most people, olfactory problems are temporary, usually improving on their own in weeks. But a small minority are complaining of persistent dysfunction long after other symptoms of COVID-19 have disappeared. Some reported continuous total or partial loss of smell six months after infection. Longer ones, say some doctors, are now approaching a year.
Researchers working with the annoying disability say they are optimistic that most will eventually recover, but they fear not. Some doctors are concerned that an increasing number of odor-deprived patients, many of them young, may be more prone to depression and other difficulties and weigh on tense health systems.
“They are losing the color of their lives,” said Dr. Thomas Hummel, who runs the odor and taste clinic at the University Hospital in Dresden, Germany.
“These people will survive and be successful in their lives, in their professions,” added Hummel. “But their lives will be much poorer.”
At the Face and Neck University Institute in Nice, Dr. Clair Vandersteen spread tube after tube of odors under Forgione’s nose after he searched his nostrils with the camera.
“Do you notice any smell? Nothing? Zero? OK, ”he asked, while she repeatedly and apologetically responded with negatives.
Only the last tube caused an unmistakable reaction.
“Urgh! Oh, that stinks, ”Forgione shouted. “Fish!”
After testing, Vandersteen made the diagnosis.
“You need an enormous amount of an odor to be able to smell something,” he said. “You haven’t completely lost your sense of smell, but it’s also not good.”
He sent her away with homework: six months of olfactory rehabilitation. Twice a day, choose two or three scented things, like a bouquet of lavender or pots of fragrances, and smell them for two or three minutes, he ordered.
“If you smell something, great. If not, there is no problem. Try again, concentrating a lot on imagining lavender, a beautiful purple flower, ”he said. “You have to persevere.”
Losing your sense of smell can be more than a mere inconvenience. Smoke from a spreading fire, a gas leak or the stench of rotten food can go dangerously unnoticed. Vapors from a used diaper, dog dirt in a shoe or sweaty armpits can be embarrassingly ignored.
And as poets have known for a long time, smells and emotions are often like intertwined lovers.
Evan Cesa used to savor mealtimes. Now they are a chore. A fish dinner in September that suddenly seemed tasteless first signaled to the 18-year-old sports student that COVID-19 had attacked his senses. The foods have become mere textures, with only residual notes of sweet and salty.
Five months later, having breakfast with chocolate chip cookies before school, Cesa still chewed happily, as if she swallowed cardboard.
“Eating has no purpose for me anymore,” he said. “It’s just a waste of time.”
Cesa is among the anosmia carriers studied by researchers in Nice who, before the pandemic, used scents to diagnose Alzheimer’s disease. They also used comforting fragrances to treat post-traumatic stress among children after a terrorist truck attack in Nice in 2016, when a driver plowed through holiday crowds, killing 86 people.
The researchers are now turning their experience to COVID-19, in partnership with perfumers from the fragrance-producing city near Grasse. Perfumer Aude Galouye worked on the scented waxes that floated under Cesa’s nose to measure his olfactory impairment, with aromas in varying concentrations.
“The sense of smell is a fundamentally overlooked sense,” said Galouye. “We don’t realize the effect it has on our lives, except, obviously, when we no longer have it.”
Tests at Cesa and other patients also include language and attention tests. Nice researchers are exploring whether olfactory complaints are linked to cognitive difficulties related to COVID, including concentration problems. Cesa stumbled when choosing the word “ship” when “kayak” was the obvious choice in a test.
“This is completely unexpected,” said Magali Payne, the team’s speech therapist. “This young man shouldn’t have any language problems.”
“We need to keep digging,” she said. “We are discovering things as we see patients.”
Cesa longs to have her senses restored, celebrate the taste of pasta with carbonara sauce, her favorite dish, and a run for the fragrant wonders of the outdoors.
“One might think that it is not important to smell the nature, the trees, the forests,” he said. “But when you lose your sense of smell, you realize how lucky we really are to be able to smell these things.”
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