NICE, France 鈥� The doctor slid a miniature camera into the patient鈥檚 right nostril, making her whole nose glow red with its bright miniature light.
鈥淭ickles a bit, eh?鈥� he asked as he rummaged around her nasal passages, the discomfort causing tears to well in her eyes and roll down her cheeks.
The patient, Gabriella Forgione, wasn't complaining. The 25-year-old pharmacy worker was happy to be prodded and poked at the hospital in Nice, in southern France, to advance her increasingly pressing quest to recover her sense of smell. Along with her sense of taste, it suddenly vanished when she fell ill with COVID-19 in November, and neither has returned.
Being deprived of the pleasures of food and the scents of things that she loves are proving tough on her body and mind. Shorn of
鈥淪ometimes I ask myself, 鈥橠o I stink?'" she confessed. 鈥淣ormally, I wear perfume and like for things to smell nice. Not being able to smell bothers me greatly.鈥�
A year into the coronavirus pandemic, doctors and researchers are still striving to better understand and treat the accompanying epidemic of COVID-19-related anosmia 鈥� loss of smell 鈥� draining much of the joy of life from an increasing number of sensorially frustrated longer-term sufferers like Forgione.
Even specialist doctors say there is much about the condition they still don't know and they are learning as they go along in their diagnoses and treatments. Impairment and alteration of smell have become so common with COVID-19 that some researchers suggest that simple odor tests could be used to track coronavirus infections in countries with few laboratories.
For most people, the olfactory problems are temporary, often improving on their own in weeks. But a small minority are complaining of persistent dysfunction long after other COVID-19 symptoms have disappeared. Some have reported continued total or partial loss of smell six months after infection. The longest, some doctors say, are now approaching a full year.
Researchers working on the vexing disability say they are optimistic that most will eventually recover but fear some will not. Some doctors are concerned that growing numbers of smell-deprived patients, many of them young, could be more prone to depression and other difficulties and weigh on strained health systems.
鈥淭hey are losing
鈥淭hese people will survive and they'll be successful in their lives, in their professions,鈥� Hummel added. 鈥淏ut their lives will be much poorer.鈥�
At the Face and Neck University Institute in Nice, Dr. Clair Vandersteen wafted tube after tube of
鈥淒o you perceive any smell? Nothing? Zero? OK,鈥� he asked, as she repeatedly and apologetically responded with negatives.
Only the last tube provoked an unequivocal reaction.
鈥淯rgh! Oh, that stinks," Forgione yelped. 鈥淔ish!鈥�
Test complete, Vandersteen delivered his diagnosis.
鈥淵ou need an enormous amount of an odor to be able to smell something,鈥� he told her. 鈥淵ou haven鈥檛 completely lost your sense of smell but nor is it good.鈥�
He sent her away with homework: six months of olfactory rehab. Twice daily, choose two or three scented things, like a sprig of lavender or jars of fragrances, and smell them for two to three minutes, he ordered.
鈥淚f you smell something, great. If not, no problem. Try again, concentrating hard on picturing the lavender, a beautiful purple bloom," he said. 鈥淵ou have to persevere."
Losing the sense of smell can be more than a mere inconvenience. Smoke from a spreading fire, a gas leak, or the stink of rotten food can all pass dangerously unnoticed. Fumes from a used diaper, dog's dirt on a shoe or sweaty armpits can be embarrassingly ignored.
And as poets have long known, scents and emotions are often like lovers entwined.
Evan Cesa used to relish meal times. Now they're a chore. A fish dinner in September that suddenly seemed
Five months later, breakfasting on chocolate cookies before classes, Cesa still chewed without joy, as though swallowing cardboard.
鈥淓ating no longer has any purpose for me," he said. "It is just a waste of time.鈥�
Cesa is among the anosmia sufferers being studied by researchers in Nice who, before the pandemic, had been using scents in the diagnosis of Alzheimer鈥檚 disease. They also used comforting fragrances to treat post-traumatic stress among children after a truck terror attack in Nice in 2016, when a driver plowed through holiday crowds, killing 86 people.
The researchers are now turning their expertise to COVID-19, teaming up with perfumers from the nearby fragrance-producing town of Grasse. Perfumer Aude Galouye worked on the fragrant waxes that were wafted under Cesa's nose to measure his olfactory impairment, with scents at varying concentrations.
鈥淭he sense of smell is a sense that is fundamentally forgotten," Galouye said. "We don鈥檛 realize the effect it has on our lives except, obviously, when we no longer have it.鈥�
The examinations on Cesa and other patients also include language and attention tests. The Nice researchers are exploring whether olfactory complaints are linked to COVID-related cognitive difficulties, including problems with concentrating. Cesa stumbled by picking the word 鈥渟hip鈥� when 鈥渒ayak鈥� was the obvious choice on one test.
鈥淭hat is completely unexpected," said Magali Payne, a speech therapist on the team at the C么te d鈥橝zur University's CoBTeK lab. 鈥淭his young man shouldn鈥檛 be experiencing linguistic problems.鈥�
鈥淲e have to keep digging,鈥� she said. 鈥淲e are finding things out as we see patients.鈥�
Cesa longs to have his senses restored, to celebrate the taste of pasta in carbonara sauce, his
鈥淥ne might think that it is not important to be able to smell nature, trees, forests," he said. 鈥淏ut when you lose the sense of smell, you realize how truly lucky we are to be able to smell these things.鈥�
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Follow AP鈥檚 pandemic coverage at https://apnews.com/hub/coronavirus-pandemic, https://apnews.com/hub/coronavirus-vaccine and https://apnews.com/UnderstandingtheOutbreak
John Leicester, The Associated Press
