Problems in smell and taste by Covid affect people around the country

Pharmacist Vanessa Santos has been having problems with her sense of smell and taste for more than a year, since she first contracted Covid-19. “Is very [difícil] you can’t smell anything or eat and not taste it”, he says.

For people like her, medicine has yet to find effective ways to reverse this health problem. In Brazil, researchers carry out studies to understand how much these senses are affected by the coronavirus and also develop treatments.

“Altered smell or taste is one of the most common symptoms reported by people who have tested positive for Covid”, says Marilia Mesenburg, researcher at the postgraduate program in epidemiology at the Federal University of Pelotas.

She is one of the authors of a study that analyzed national data on the prevalence of the main symptoms caused by the disease. Regarding changes in the ability to smell or taste, it was seen that 56 out of 100 people who tested positive for coronavirus reported some change.

There are different diagnoses for changes in smell. Anosmia is the total loss of sense, and hyposmia is partial. When the patient changes the smells of the elements, it is called parosmia.

Taste problems also have some variations. Ageusia consists of not having the sense of taste anymore, and dysgeusia is the partial complication of taste.

Typically, someone who is infected with Sars-CoV-2 regains consciousness between 2 and 3 weeks after symptoms begin. But sometimes the case lasts longer.

One such example is that of retired Silvana Monteiro, who contracted Covid-19 in March last year, had problems smelling and tasting and was unable to fully regain her senses.

“The sense of smell even feels something, but the taste I think is worse”, he says. Regarding the taste, she says she can only differentiate between sweet or salty in a generic way. As for smells, it only smells a little of the strongest, like vinegar.

Monteiro has already resorted to three types of treatment: medication, olfactory training and laser application in the nostrils and tongue by a speech therapist. However, he says that “it is still too far away for [recuperar no mínimo] 80%” both ways.

Usually, the use of medication and training are enough to recover the sense of smell and taste, says Fabiana Cardoso, professor in the department of ophthalmology, otorhinolaryngology and head and neck surgery at USP’s Ribeirão Preto School of Medicine.

The use of drugs is mainly indicated to reduce an inflammation called edema, which prevents the arrival of the molecules that cause the smells to the region of the olfactory neurons. “If I have a blocked nose because of an infection, I can’t get the odor to [os nervos]”, Explain.

The training, on the other hand, has the purpose of exercising the understanding of smells so that “the nose gets used again with the essences that it was already used to and had the reference”.

Cardoso was one of the researchers of a study that involved different cities in the country to understand how long it took for a person to regain their sense of smell, especially following patients with problems after contracting Sars-CoV-2.

In total, 150 patients completed the survey, which had a first screening to assess the loss of sense. After 30 and 60 days, participants underwent tests to identify substance smells while blindfolded.

“More than 30% [dos participantes do estudo] still maintained some degree of smell alteration even 60 days after the diagnosis and the treatments that had been instituted for Covid”, he says.

The situation of people who lose their sense of smell for more than six months also caught the attention of Ronaldo Carvalho, an otorhinolaryngologist and professor at the University Hospital of the Federal University of Sergipe. He plans a surgery that could help these patients get a normal life back.

Carvalho explains that these individuals have a damaged olfactory nerve and, therefore, an intervention would be necessary to regenerate it.

“[Em outras áreas da medicina] there is a surgical technique called nerve transfer, where fascicles are taken [conjunto de células nervosas] of a functioning nerve and we divert these fascicles to the regions of diseased nerves. these fascicles […] make the nerve that is sick to regenerate and work again”, he says.

For the procedure he plans, a nerve transfer will be done from the supraorbital nerve, which is above the eye socket. “We make a small incision in this nerve and we are going to try to ‘throw’ it into the base of the skull, which is where the olfactory neuroepithelium is. [onde se localizam os nervos responsáveis por interpretar os aromas e suas células de suporte]”.

The expectation is that this transfer will help to regenerate the damaged olfactory nerve or that these relocated fascicles will fulfill its function.

At the moment, there are more than 20 people scheduled for surgery. One of these is pharmaceutical Vanessa Santos, who first contracted the coronavirus in June 2020.

She reports that, when eating a snack, she realized that she was not feeling the taste. So, she took a test and the exam showed that she had Sars-CoV-2.

After a month of failing to smell and taste, she sought medical help. The pharmaceutical company went through three otolaryngologists who indicated treatments with different drugs, olfactory training and even an ozone therapy that has no proven effectiveness.

He felt an improvement with the aroma training, but it was still a very small result. Therefore, he sought Carvalho’s help. “He explained to me about the procedure and asked if I was interested, and I said yes,” he says.

Awaiting the surgery, Santos was again infected by the coronavirus. “Before, I could still […] differentiate, sometimes, the issue of flavor, but after I had it for the second time it became much more complicated.”

The pharmacist sees surgery as the last opportunity to regain consciousness. “It’s a light at the end of the tunnel, because I was in the dark and this is a light that came to take away this anguish I feel.”