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Medicine United States

Coronavirus Patients Lose Senses of Taste, Smell -- and Haven't Gotten Them Back (wsj.com) 143

Posted by BeauHD from the that-stinks dept.
An anonymous reader quotes a report from The Wall Street Journal: Clinicians racing to understand the novel disease are starting to discern an unusual trend: one common symptom -- the loss of smell and taste -- can linger months after recovery. Doctors say it is possible some survivors may never taste or smell again. Out of 417 patients who suffered mild to moderate forms of Covid-19 in Europe, 88% and 86% reported taste and smell dysfunctions, respectively, according to a study published in April in the European Archives of Oto-Rhino-Laryngology. Most patients said they couldn't taste or smell even after other symptoms were gone. Preliminary data showed at least a quarter of people regained their ability to taste and smell within two weeks of other symptoms dissipating. The study said long-term data are needed to assess how long this can last in people who didn't report an improvement.

Anyone who has had the sniffles knows a stuffy nose impedes smell and taste; the novel coronavirus's ability to break down smell receptors is puzzling because it occurs without nasal congestion. One theory is that the "olfactory receptors that go to the brain -- that are essentially like a highway to the brain -- commit suicide so they can't carry the virus to the brain," said Danielle Reed, associate director of the Monell Chemical Senses Center. "It could be a healthy reaction to the virus. If that doesn't work, maybe people do get sicker," she said. "It might be a positive takeaway from what is obviously a devastating loss to people."
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Coronavirus Patients Lose Senses of Taste, Smell -- and Haven't Gotten Them Back More

Coronavirus Patients Lose Senses of Taste, Smell -- and Haven't Gotten Them Back

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  • and you may be able to get SSDI out of it! and under Trump's plan you may need it to get around the Preexisting black list.

  • And this is one long term effect (Score:4, Insightful)

    by hattig ( 47930 ) on Tuesday June 02, 2020 @09:14AM (#60135182) Journal

    There are others - persistent exhaustion, long term dizziness, liver/heart/lung damage, and maybe more.

    This is why policies that result in lots of people catching the disease (even with the vulnerable shielded) are not ideal - you might not have to lockdown as hard, and thus save the economy a bit more, but there are going to be significant long-term conditions that will need treatment, therapy and more.

    • What's your plan? You can't do a global lockdown until a hoped-for vaccine/cure is available.

      Sometimes the best available option is not ideal. It is simply best available.

      • Re: And this is one long term effect (Score:5, Insightful)

        by hey! ( 33014 ) on Tuesday June 02, 2020 @09:50AM (#60135338) Homepage Journal

        First, you establish the facts. Then you use those facts to guide your plan. You can't dismiss facts because you haven't planned for them. And when new, inconvenient facts arise you have to adjust your plans accordingly.

        Unending lockdown everywhere is a weak straw man. With very few exceptions, political leaders across the spectrum are charting some kind of middle ground between perpetual lockdown and pretending the problem has just gone away.

        • Unending lockdown everywhere is a weak straw man. With very few exceptions, political leaders across the spectrum are charting some kind of middle ground between perpetual lockdown and pretending the problem has just gone away.

          What middle ground? The virus is binary - either you get it or you don't. There is no middle ground. Any plan results in lockdown until ~70% of the population getting the virus, or a vaccine being developed. There is simply no mathematical way around it. The only thing the lockd

          • The "70%" thing is kind of nonsensical. All the evidence so far is that immunity might only last a few years, and any realistic 70% project is going to take 10+ years, because if we'ce learned anything its that 1% of the population sick at the time is more than enough to so comprehensively overwhelm the medical system that deaths shoot up as high as 11-16%.

            Think of what Covid did to new york at just under a percent of the population sick.

            So clearly the *only* way to get to 70% is very slowly with rolling on

            • Think of what Covid did to new york at just under a percent of the population sick.

              By 'sick' do you mean had COVID? Or sick that they had symptoms and/or needed hospitalization? Because there were WAY more than 1% of New Yorkers that contracted COVID.

            • I agree with your sentiment, but I think the numbers are a bit off. Antibody tests show that NYC has about 20% infected. New York State as a whole is about 10%. So my guess is that the 10-20 million is more like 3 million. Quoting from myself a month ago (https://slashdot.org/comments.pl?sid=16261272&cid=60000302)

              New York State (not just NYC) has a current death toll attributed to COVID-19 of about 0.1% of the entire population (22000 / 19 million). The fact that there are a large number of unattributed deaths and deaths that haven't yet happened (people who are currently sick and will die of the illness) means that number is likely going to be higher even if there were no new COVID-19 cases.

              With estimates of 10% infected (20% or so in NYC), it isn't implausible that 1% could die if we let the virus go completely uncontrolled. A 1% rate for the US as a whole would imply 3 million or so, so based on the data that I see, 2.2 million isn't implausible (there are without a double large errors in my estimates).

              Note: I agree that we shouldn't just let the virus rip. 3 million is far, far too many. ESPECIALLY given the news that there are many serious (and likely long-term) problems for survivors, some

            • Re: (Score:2)

              by tlhIngan ( 30335 )

              There's a lot of history to look at previous infections.

              Spanish flu is one (though it's really apparently Kansas flu, or German Flu, if you really want to attach a geographical location to it - the reason we call it Spanish flu is because the Spanish media was free to report on it so it appeared Spain was an epicenter, when really Kansas, Germany and other countries simply censored news).

              There's also Polio, which took many years to come up with a vaccine, and kept coming in waves every year in the summer/fa

          • Re: (Score:3)

            by hey! ( 33014 )

            There are various levels of restriction which run from full lockdown (e.g. shelter in place) to status quo ante, and rational plans move through that hierarchy depending on what your data tells you.

            For example, check out this overview of one plan [mass.gov].

          • Re: And this is one long term effect (Score:4, Insightful)

            by Ambassador Kosh ( 18352 ) on Tuesday June 02, 2020 @12:19PM (#60136010)

            You could do what has worked very well in Germany. First you do a lockdown to contain the spread and ensure wide compliance. This reduces your cases down to only a handful. Then you can slowly reopen with things like masks and distance required. ALL employers required to give their workers protective gear and heavy fines if they are not done and used.

            After that you can do contact tracing for any new cases and test everyone they were in contact with to make sure the virus does not spread. Finally, you have everyone work from home that can work from home to reduce the contact points. This is why Germany started to reopen a while ago and the virus has remained under control.

            You won't get herd immunity from infecting people from this virus. So far it looks like the time to infect enough people is far greater than the time immunity lasts. The virus also has a lot of weird side effects and research is ongoing to see how serious this is long term. Aiming for herd immunity for a new virus by infecting people where you don't even know what the virus does is utterly insane.

            • So far it looks like the time to infect enough people is far greater than the time immunity lasts.

              How would we have reliable, long term data to tell us how long immunity lasts for a disease that has barely been around six months?

              • We don't have reliable long term data yet but we do know of similar viruses with similar structures and how long immunity for them usually lasts.

                The more important part is that unless we KNOW for sure that immunity is long term chasing herd immunity is idiotic.

                You don't make a decision like that with a deadly disease without understanding it first. It is safer to assume the immunity is short term and plan for that.

                • Yes we do have data like you said for similar viruses, SARS 1.
                  And many survivors to SARS one still have antibodies 17 years later.

                  Also, very recent studies seem to indicated that those anti-bodies block SARS-CoV-2. Though this is preliminary and only done in lab dishes so far.

                  We know this virus mutates quite slowly, and most experts predict antibodies would last at least a few years, if not more. And as we know that SARS one antibodies last, so far, up to 17 years, there is a very good indication immunity i

          • The 70% threshold is needed for herd immunity with an R0 of about 3 (the percent is calculated from 1 - 1/R0). (R0 is the average number of new infections caused by each case). Note that this equation implies that "herd immunity" can be achieved just by having R0 less than 1.

            R0 is not a constant for a disease. It is dependent upon how people behave. We don't have to have full lockdown to make R0 less than 1. Testing/tracing/isolating can reduce R0. Masks can reduce R0. Social distancing can too.

            So, basicall

            • Re: (Score:2)

              by fintux ( 798480 )
              Yeah. This is what we refer to as the new normal. We need to learn with the fact that the virus can pop up, and there is a delay in the detection. So we will likely have some clusters of the disease, but due to precautions, those should be of manageable size. Say, for example, we live in a way that R0 would be 1.5, but with testing and tracing we can still keep it at below one (eventually it will be probably roughly 1 over a long time, but that is not an issue if the average daily amount is very small, some

          • Middleground is what Denmark is doing.
            Opening the schools already, but halving the class size and spreading the students out. Reducing hours, have in morning grades 1 - 3 and in the afternoon grades 4 - 6. Split the school yard into areas with tape, shift the breaks so not all run down the floor same time.
            Etc. p.p.

            • Re: (Score:2)

              by fintux ( 798480 )

              Has there been discussion about face masks in Denmark? If so, what kind?

              In Finland, we have had a pretty heated discussion. Our government had a study made, but it was 1) for droplet spread, not aerosols, 2) from the point of view how the masks protect the wearer, 3) not accounting for asymptomatic spread. So it was a useless study. The scientific consensus starts to be that the masks are useful. However, the original stance was that they're not useful (as they're not _that_ useful in influenza, but even th

              • I have no idea about that, what I wrote above was a summary from german news.

                Regarding Masks, I think they might help preventing spreading it if you have it. But I doubt they have any effect on helping you not getting it. Aka, I mean: your mask protects others - if you are sick but don't know it - but it does not protect you.

                Bottom line everyone wearing a mask might have a good effect on the general public, though.

          • Or you could continue the lockdown, a vaccine is never developed, and we remain mired in an economic depression forever thanks to the new birth rate (a bit more than 10k/day for the U.S.) exceeding the virus new infection rate (currently about 20k a day for the U.S.), meaning we'll never reach 70%.

            Those numbers assume nobody ever dies.

          • The virus is binary - either you get it or you don't.

            Negative - disease severity is, in most patients, directly proportional to the viral load of exposure. Superspreaders are an orthogonal response, so it's at least a two-dimensional problem.

            Cross-immunity with cold betacoronaviruses has been established in some people, so variolation with either may be a workable strategy. S and K strains have different impacts on ACE-2. The insertion location of the polybasic furin cleavage site may represent a weak po

            • In addition, there are reports of many different mutations. Most of the mutations are believed to be less severe and some people claim that the mutated forms spread more rapidly. If a weak mutated form is contracted, it may provide immunity to the original form. This means that herd immunity to the original COVID-19 could be achieved either without most people getting COVID-19 or without vaccine being used.

        • Re: (Score:2)

          by kbahey ( 102895 )

          First, you establish the facts. Then you use those facts to guide your plan. You can't dismiss facts because you haven't planned for them. And when new, inconvenient facts arise you have to adjust your plans accordingly.

          Well said, thank you ...

          I am sick of the rigid minded idiots (conservatives?) who spout stupid things like: "You can't change the rules in the middle of the game"! NO! WE HAVE TO CHANGE THE RULES to adapt to what is actually happening, and tune it as we go ...

      • The Bay Area has a strong plan, but it hasn't been publicized widely [imgur.com]. The result is low-information people (like yourself) haven't heard about the plans. Make sure hospitals are prepared, use masks in public, keep social distancing, have tests, keep R0 at or below 1. These are things that have worked in other countries so we know they can work here.

      • What's your plan? You can't do a global lockdown until a hoped-for vaccine/cure is available.

        You set up testing and tracing regimes that allow you to transition to targeted quarantine instead of general quarantine. Duh. I thought you were way smarter than me.

    • All what we know are just short and medium-term consequences. Viruses can do lots of weird things in the long term as well. For example it was recently discovered that HPV, which has been known for many decades, increases cancer risk.
       
      Another effect of coronavirus that's coming out as more autopsies are done is blood clots. There are theories that the blood clots are what causes the organ damage, as when a blood clot lodges in an organ it's likely to do damage there.

    • liver/heart/lung damage, and maybe more.

      Kidneys highly express ACE-2 and are a major site of damage. NYC is officially out of dialysis machines. Some patients who survive may require lifelong dialysis or kidney transplant, both of which have a poor general prognosis for additional complications (especially with the anti-rejection drugs being made in China).

  • ... this smells like a pretty sensationalized story. So yes, many temporarily lose olfactory sensations - but how many have lasting effects like that?

    • Re: (Score:2)

      by Rob Y. ( 110975 )

      Well, chalk me up as one of the ones that has these lasting effects. My flu-like symptoms have been gone for a month and a half (and were never very bad - I had the proverbial 'mild' case), but my sense of smell is still spotty. The weird thing is that it 'comes back' every few days (not completely, but definitely to the point where I start thinking, "finally it's gonna be over"), but then recedes again. And my nasal passages go back to feeling kind of raw at the same time. So, I'm not sure if this is j

      • Re: (Score:2)

        by Xest ( 935314 )

        For what it's worth, when I was still a fairly new diver I stupidly ignored the advice about never diving when you have a cold and did my deep diving training certification with one.

        I got to about 5 metres and felt a bit of a pain in my soft palate at the top of my mouth, so I tried to ascend to free it and it wouldn't clear so I tried descending again, I descended a bit further and although that made it hurt, it then went away and I continued the dive down to 40 metres (I got narc'd that dive but that's a

  • Paywall warning? (Score:3)

    by jenningsthecat ( 1525947 ) on Tuesday June 02, 2020 @09:36AM (#60135266)

    Come on eds, I'm getting tired of trying to read TFA only to discover I need to be a subscriber. Kindly save my carpal tunnel syndrome the extra clicks and give me a heads-up when an article is paywalled...

    • Re: (Score:2)

      by spth ( 5126797 )

      I'd assume the article is based on some study. So it would be even better to link to the original study.

      We can still hope for a comment providing such a link.

  • On the one hand, avocado toast. But on the other hand, ass.

  • Non-paywalled source (Score:4, Informative)

    by jenningsthecat ( 1525947 ) on Tuesday June 02, 2020 @09:47AM (#60135324)

    I couldn't read the WSJ article so I can't be sure of informational equivalency, but those of you blocked by WSJ's paywall may want to try this link:

    https://www.independent.co.uk/life-style/health-and-families/coronavirus-symptoms-respiratory-anosmia-smell-taste-loss-ent-asymptomatic-a9418151.html

    Interestingly, the article linked above advises self-isolation at the first sign of anosmia, even in the absence of other symptoms

    “We were in communication with ENT UK, our advisory body, who confirmed they’d had reports of this themselves and they’ve put out advice that they think anosmia could be related to Covid,” Ms Brookes stated. “If I developed a sudden loss of sense of smell, with or without a mild upper respiratory type symptoms, I would definitely self-isolate at the moment.”

  • Yes dear. (Score:3)

    by PPH ( 736903 ) on Tuesday June 02, 2020 @09:57AM (#60135362)

    I will have a second helping of your delicious leftovers.

  • Not only do people lose their sense of taste and smell, while they're being treated they could experience seizures, stroke and/or paralysis [cnn.com].

    Also, similar to taste and smell, some people continue to have issues with balance or basic bodily movements long after they are discharged.

    • Not only do people lose their sense of taste and smell, while they're being treated they could experience seizures, stroke and/or paralysis.

      And lots of other stuff, too.

      ACE2, the target of SARS-CoV2, is involved in blood pressure regulation and mediating transport of uncharged amino acids across the cell membrane. Lots of it is on the cells of nearly all organs and it needs to be there and working. So once the virus gets into the blood it can cause all sorts of havoc.

  • Anectdotal... (Score:4, Interesting)

    by The Angry Mick ( 632931 ) on Tuesday June 02, 2020 @10:59AM (#60135600) Homepage

    ...but my wife caught a flu-like virus last year - around January of 2019 - where she lost both her sense of taste and smell. Neither have fully returned. Couldn't have been Covid, so it makes me wonder if there's some combination of symptoms from different viral strains coming into play here.

    • Re: (Score:2)

      by ffkom ( 3519199 )
      The immune response to any viral infections can cause all sorts of adverse side effects, but luckily does so only in rare cases. I think it's way too early to say if Sars-Cov-2 is anything special in this regard.

    • When I saw this story, my first thought was to wonder whether the quinine-based drugs which were such a prevalent part of COVID-19's treatment for a while might be the cause.

      I used to work with a group of scientists who did field work in the Amazon Basin. A couple of them had side effects from the medication they were given - including losing their sense of taste for a very long time (something like a year).

      But while I can't read the paywalled story, I can't imagine the people looking into this would miss s

    • Of course it could have been covid.
      No one knows if the "first cases in China" actually have been the first cases.

      When you have a winter cold, you are usually infected by quite a bunch of viruses. It is rarely just a flu and nothing else.

  • commit suicide so they can't carry the virus to the brain

    Can't they just theorize that the virus damages or destroys them? Cells just don't commit suicide AFAIK. That implies it can think or it is like a lemming.

    • Re: (Score:2)

      by ffkom ( 3519199 )
      Cellular "suicide", called apoptosis, is a well known and useful mechanism. But interpreting some higher purpose such as "... so they can't carry the virus to the brain" into this sounds unscientific at best.

      • Re: (Score:2)

        by sjames ( 1099 )

        It's just a lot easier to speak of a functional purpose than to say "over millions of years evolution has stumbled upon an apoptosis mechanism where the nerve cells associated with smell trigger apoptosis in response to a virus because individuals with that trait were less likely to be killed of seriously impaired due to the virus reaching their brain".

        It's a lot easier to just say the nerve cells commit suicide to keep the virus from reaching the brain.

    • Re: (Score:2)

      by msauve ( 701917 )
      "That implies it can think or it is like a lemming."

      Like a lemming. You do know that lemmings don't jump off cliffs or commit mass suicide, don't you? Disney threw them off a cliff to get film.

    • Re: (Score:2)

      by ceoyoyo ( 59147 )

      Cells do commit suicide, and often in a calculated way. There are many genes programming cell death, and some of these are checkpoints that detect problems that could lead to cancer or other problems, and trigger apoptosis instead.

      The olfactory nerves are also argubly part of the brain, the only part that is directly exposed to the environment. It wouldn't be surprising if they have antiviral mechanisms to protect the brain. It wouldn't even be that much of a stretch for there to be some higher level mechan

  • And it was Big Sriracha that did it!
  • The optical nerves go directly to the brain and are not affected. People don't go blind. Coronavirus can enter through the eyes also.

    • Unlike olfactory receptors, the retina is on the inside of the enclosed eye, well protected from the virus.

      It's much more likely that any virus that lands on the eye enters the body through the moist tissues surrounding the outside of the eye.

      • Re: (Score:2)

        by ceoyoyo ( 59147 )

        The retina is well protected, sealed inside your eye, and even then has some unique immune properties. The olfactory nerves are exposed to the uncontrolled environment. They're also some of the only nerves in the body that routinely regenerate.

    • Re: (Score:3)

      by sjames ( 1099 )

      You don't actively inhale virus laden droplets into your eyes, now do you. Also, temporary or long term loss of sight is significantly more likely to impair survival. That would be why natural selection didn't favor a similar response by the optic nerves.

  • This is not specific to Covid. I lost my sense of taste and smell in 2013 when I had either strep throat or flu. It took months to get it back. Lost it again now in March...

  • Perfect Sense (Score:3)

    by ledow ( 319597 ) on Tuesday June 02, 2020 @01:19PM (#60136322) Homepage

    And thus we move closer to the world in the movie Perfect Sense.

    Well worth a viewing if you're stuck at home still.

  • I had COVID-19 verified with a DNA/RNA nucleoprotein test in early March, which was one of the first handful of cases in Houston. The mainstream swap test showed I was negative and that was in late February. I didn't trust it, so I paid extra for a DNA/RNA one and joined a study on the accuracy of the swab test.

    My symptoms:

    Fake fever (feeling hot) / two weeks
    Chills and heavy sweating like fever breaking / two weeks
    Heavy chest pressure /w no mucus / four weeks
    Fatigue / twelve weeks (still going on..)
    Headache

  • I think I've had COVID-19 but, I didn't lose my sense of smell. On the contrary, everything smelled incredibly vivid and, almost every smell made me want to vomit immediately.

  • There is only 5 basic senses of taste (bitter, sour, sweet, salty and umami). The variety is brought by smell. Losing the sense of smell would narrow the ability to distinguish tastes to only the basic 5.

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