Persistent Smell Loss After COVID: When Should You Seek Specialist Help?
- Jul 3
- 3 min read
Loss of smell became one of the most widely recognised symptoms of COVID-19 during the pandemic. While many patients recovered within a few weeks, others continue to experience persistent smell dysfunction months or even years later.
For some people, smell gradually returns over time. For others, symptoms remain incomplete, distorted, or absent altogether.
As a Consultant ENT Surgeon specialising in rhinology and smell disorders, Mr Karan Jolly assesses patients with persistent smell loss and offers specialist management options, including newer treatment approaches where appropriate.
Why Does COVID Affect the Sense of Smell?
The sense of smell depends on specialised nerve cells located within the upper part of the nasal cavity known as the olfactory system.
COVID-19 is thought to affect this system through inflammation and damage to the supporting cells around the olfactory nerves.
This can lead to:
complete loss of smell (anosmia)
reduced smell (hyposmia)
distorted smells (parosmia)
For many patients the olfactory system gradually recovers, but in some cases symptoms persist long after the original infection.
How Long Does Recovery Usually Take?
Many patients notice improvement within:
a few weeks
several months
or several years
However, recovery can vary significantly between individuals.
If smell loss persists beyond three months, specialist assessment may be helpful to determine whether there are:
ongoing inflammatory issues
sinus problems
nasal polyps
persistent olfactory dysfunction
How Can Persistent Smell Loss Affect Daily Life?
Loss of smell can have a major impact on quality of life.
Patients often report:
reduced enjoyment of food
altered taste
difficulty detecting smoke or gas
social withdrawal
anxiety around recovery
Parosmia, where smells become distorted or unpleasant, can be particularly distressing.
What Treatments Are Available?
Treatment depends on the underlying cause and severity of symptoms.
Management may include:
smell training therapy
nasal steroid treatment
treatment of sinus inflammation
management of nasal polyps
newer regenerative approaches such as PRP therapy in selected patients
Research into smell disorders has developed rapidly in recent years, particularly following the COVID-19 pandemic.
What Is Smell Training?
Smell training involves repeated exposure to a series of scents over time to help stimulate recovery of the olfactory system.
This is commonly recommended as part of treatment for post-viral smell loss and may help improve recovery in some patients.
A Specialist Approach to Smell Disorders
Persistent smell loss can be complex and sometimes requires specialist rhinology assessment.
This may involve:
nasal endoscopy
assessment for sinus disease or inflammation
discussion of emerging treatment options
personalised management planning
As understanding of smell disorders continues to evolve, specialist centres are increasingly able to offer more tailored treatment approaches.
Frequently Asked Questions
Can smell loss after COVID become permanent?
Some patients experience long-term smell dysfunction, although many people continue to improve gradually over time.
What is parosmia?
Parosmia is a condition where smells become distorted or unpleasant following viral infection or smell loss.
When should I see a specialist about smell loss?
If symptoms persist for more than three months, particularly if they significantly affect quality of life, specialist assessment may be beneficial.
Can PRP help smell recovery?
PRP therapy is an emerging treatment being explored in selected patients with persistent smell loss. The evidence base is growing and shows promising results in a select cohort of patients who have true post viral smell loss.
Book a Consultation
If you are experiencing ongoing smell loss, distorted smell, or persistent symptoms after COVID-19, a consultation with Mr Karan Jolly can help assess the cause and explore available treatment options.