Freshly brewed coffee, sautéed garlic and onions, and barbeque meat cooked on the grill are some of the aromas that many find pleasing. Imagine smelling one of those common smells and being filled with complete disgust. More than a nuisance, the parosmiaproblem related to the destruction of olfactory nerve cells, causes a distortion of odors: aromas that once aroused interest, now seem absolutely repulsive.
This is what happened to designer Paholla Marquezini, 37. She says she was infected with the Covid-19 In mid-2021, he developed a mild version of the disease, without the need for hospitalization, but the sequelae lasted more than six months, affecting his routine and requiring daily care to try to reverse the situation.
During the infection, the designer completely lost her sense of smell and also changed her sense of taste. When her senses began to return, she began to smell unusual odors, which led her to seek medical attention to identify the problem she knew little about.
“ENT diagnosed the parosmia. I can’t eat meats, foods seasoned with garlic and onions, anything that smells stronger. That was six months ago, and since then I have seen several other doctors. I follow up with a nutritionist and an endocrinologist because since I can’t eat certain things, I have to adapt my diet according to what I can eat and also supplementation.
“Because of the parosmia, I ended up developing depression too. I can’t go to someone else’s house and eat something. I can’t go to a restaurant properly”
“It was complicated at Christmas and New Years, people were having a barbecue and I had to stay in another room because the smell of everything bothered me,” says Paholla.
Cases are usually reversible, but require specific care. Corticosteroids can help in the early stages of inflammation, but when symptoms persist, scent therapy is usually recommended. In practice, this consists of inhaling a few aromas to try to recover the good olfactory memory.
Paholla is specifically inspired by 10 different products every day at hourly intervals. “It’s very common to use certain essential oils, which have a stronger scent. Besides, I’ve also done acupuncture,” he says.
Although it can also be caused by other viral infections, parosmia has become much more common after the onset of the disease. Covid-19which in its early versions showed symptoms such as a decrease or loss of smell and, therefore, taste, almost as a rule.
Price analyst Bruno Henrique Jardim, 33, has been infected with the virus three times since the start of the pandemic. The first was in June 2020, and it even led to pneumonia.
“I felt bad that time. I immediately lost my sense of smell and taste, and it took me seven months to come back. Then when I got infected again, I lost it. lost again, but it came back after a week. I only liked some things, but not others. It might be the most bitter thing, which was unnoticeable. Today, luckily, everything is normal.
The change in smell and, therefore, taste, is called hyposmia when it is only a diminution of these senses. When the loss is total, it is called anosmia, which includes retired Sandra Maria dos Anjos Martins, 54, who was infected with the virus in January this year. At the time, her husband and daughter were also infected.
She confirms that she has already taken the three doses of vaccine against covid-19, and assesses that the immunizing agent made all the difference in preventing more severe cases of the disease. “And if I have the fourth, the fifth, or whatever, I’ll take it.” Vaccination is what saves.
However, even after presenting with the mild form of the infection, some symptoms, such as loss of smell and taste, persisted even after a month of infection.
“I am hypertensive, I was very worried, because I am afraid of the post-covid period. I am always attentive to anything out of the ordinary”
Civil servant Eliene Coelho Moreira Scaramella, 61, also suffers from persistent symptoms. She was infected at the end of 2020 and, until July last year, remained completely odorless and tasteless.
“The taste came back first and the smell, to this day, hasn’t completely come back. I smell some things more intensely, especially food. Perfume, for example, I still don’t smell. I went at the otolaryngologist and they told me to do olfactory therapy, which I was already doing at home and I continued it, ”she says.
The treatment is the same as that indicated for cases of parosmia, which also develops during the process of recovery of the senses, when the cells themselves regenerate spontaneously, as observed by the otolaryngologist Sérgio Ramos.
In some cases, the damage caused by the coronavirus to these cells causes confusion in the sending of signals between nerve endings in the nasal region and the brain, confusing basic olfactory memories.
“There is a distortion of olfactory memories. You smell a different smell than it should. You approach food, for example, and you smell garbage. The coffee suddenly doesn’t smell the same either.
THE PATIENT MUST BE EVALUATED BY A DOCTOR WHO WILL INDICATE THE TREATMENT
The main symptom of parosmia is the temporary olfactory disorder, which leads to difficulty in recognizing or perceiving aromas as they really are, making smells previously considered pleasant smells strange or unbearable. The condition, however, must be diagnosed by a doctor, usually an otolaryngologist or general practitioner, who will assess the case and confirm the cause of the problem, then prescribe the appropriate treatment for each case.
Ear, nose and throat specialist Bernardo Faria Ramos notes that there is no known drug with a very large margin of effectiveness, although corticosteroids can help reverse or lessen the overall inflammatory process.
“What has also helped, in the medium and long term, is olfactory therapy, which is a physiotherapy of the sense of smell. It is not the most appropriate term, but it consists precisely of training, exposing the olfactory epithelium to different types of specific aromas to facilitate the process of nerve recovery.”
Generally, the olfactory formation is based on a few main essences, such as cloves and cinnamon, mint and mint, rose and lemon, and essential oil with these aromas can be used.
“In these smells, we’ve been able, in general, to coat a lot of the particles that we have in contact with in the smell to help them come back. That’s the treatment that usually brings results, but it’s not something that happens in the short term.”
However, he warns that certain practices should be avoided. In some cases, the problem makes the patient anxious and the individual starts doing various things to check if they really smell or in the hope of fixing the smell dysfunction. “There are people who smell of alcohol, acetone, kerosene, and sometimes they end up smelling them because they are more important, but in fact it can even make the inflammation of the olfactory epithelium worse. .”
OTHER CAUSES BEYOND COVID
Bernardo Faria Ramos notes that there are other causes for the change in sense of smell, that is, it is not just Covid-19 that causes parosmia, anosmia or hyposmia, although the virus has made the appearance of patients with these conditions much more frequent in clinics. .
“All of these problems existed before the virus, often occurring after viral infections. Covid-19 has a specific tropism (it has the ability to specifically infect some cells and not others), and it often causes these changes in smell and, therefore, taste.
“In the process of recovering the sense of smell, the patient often begins to perceive this distortion. Parosmia, in particular, can be an indication that the nerve is regaining its functioning late, so it is not uncommon for it to appear some time after coronavirus contamination “
The neurologist Daniel Escobar, coordinator of the neurology department of the Unimed Vitória Hospital, notes that this happens because the damage to the cells, caused by the virus, causes a whole reorganization of the neural network that can cause this temporary alteration of the smell.
“Most of the time, the decrease or loss of sense of smell and parosmia can be reversible, but sometimes it can take a while for everything to resolve. Some patients progress faster, others slower and ENT follow-up is recommended.
THE PROBLEM CAN TRIGGER EMOTIONAL DISORDERS
Escobar notes that the delay in the recovery of these senses should also be a point of attention, since, in some cases, the disorders caused by parosmia can also trigger emotional disturbances due to changes in routine.
“If all of a sudden this food that gives pleasure becomes unpleasant, disgusting, suppresses hunger, it can certainly shake the person.
Neurologist Mariana Lacerda Reis Grenfell points out that there are several cases where coronavirus contamination affects the mental health of the individual, and that although parosmia is not due to damage to the central nervous system, it can trigger parallel problems.
“It can end up triggering an emotional problem, or even a psychiatric illness, like anxiety, depression. There are several post-covid situations that lead to this, depending on how the illness has affected the individual. Having gone through a very particular situation, such as parosmia, having lost a loved one, or being very afraid, for example.
THE BEER SOMMELIER TECHNIQUE CAN HELP
In her doctoral project, scientist Amanda Reitenbach, PhD in neuroengineering, studied a technology that stimulates sensory education and olfactory training, aimed at students of the beer sommelier course.
The technique involves identifying certain aromas, such as hops, woods, spirits, wine, tea, coffee and flowers. Students or patients are given 10 concentrated vials of these scents and should take short 5 second and long 8 second inhalations, up to 3 times a day. To stimulate the sense of smell, it is important to intertwine the aromas of each day, as reported in G1.
“It’s the result of years of scientific research. During my studies, I realized that people had a lot of trouble recognizing certain types of aromas. So I started doing sensory training with large olfactory families to create a memory of aromas and flavors.”
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