COVID's effect on smell can also make some foods just taste … weird - Press Herald

The same day Diane Hudson’s doctor expressed concern about her cough – a cough Hudson assumed was just a symptom of hay fever – and had her tested for COVID-19, Hudson stopped by the store and bought feta cheese.

That night, she made a beautiful Greek salad and poured a glass of her favorite Greek wine to go with it.

“I sat down to eat it,” the Portland photographer recalled, “and everything tasted like cardboard.” The wine, she added, smelled and tasted “like motor oil.”

As Hudson ate her salad in July 2020, she knew immediately that her COVID test would come back positive the next morning. She had read stories about COVID-19 patients losing their sense of smell and taste, and how the taste of foods is sometimes weirdly distorted after a bout with the coronavirus. Hudson, 75, hoped that her senses would return quickly once she recovered. But today, 14 months after she recovered from the virus, “feta still doesn’t taste right to me,” she said.

Hudson use to prefer stout beers, but since getting COVID she likes IPAs, like Lone Pine’s Tessellation. Shawn Patrick Ouellette/Staff Photographer

The prime rib she used to enjoy eating on dates with her late husband is now flavorless. White wine tastes “like chemicals.” She’s replaced her favorite stout beers with IPAs because stouts taste like nothing now, and she fills her morning cup with coffee because she can no longer taste the Yorkshire black tea she prefers.

She used to hate pizza, but now she likes it, if it has pepperoni or other toppings. She has no idea why.

Hudson, a foodie who frequently eats in local restaurants, has joined the ranks of COVID patients who lost their sense of smell and taste while they were sick. Estimates of how many people have been affected by this condition are “all over the map,” according to Dr. Evan Reiter of the Smell and Taste Disorders Center at Virginia Commonwealth University in Richmond. An early European study suggested the number of COVID patients who lose their sense of smell may be as high as 86 percent, he said, while a more recent study out of the University of San Diego pegged it at about 66 percent.

Reiter and his colleagues have been surveying COVID patients who have lost their sense of smell and are tracking their recovery. So far it looks as if about 80 percent, or maybe even a little higher, eventually get back their normal (or near normal) sense of smell.

“Eighty percent sounds nice,” he said, “but 20 percent of an already massive number is still a lot of people who aren’t necessarily getting to normal.”

Some people may completely lose their sense of smell, while others only partially recover. The condition can also distort smells and tastes, as it did with Hudson and a recent patient of Reiter’s, a coffee drinker who complained that coffee now smells “like poop.”

Sean Cahill, a bartender at the King’s Head Pub in Portland, was exposed to COVID last November when her boyfriend and a roommate tested positive. On the third day of quarantining, she realized she couldn’t taste or smell anything. The virus made her fatigued and gave her lots of headaches, but she considered the damage done to her olfactory system the worst of her symptoms.

Food is one of the things that can lift your spirits when you’re sick, but Cahill couldn’t even tell if what she ate was sweet or salty. It made what was an already miserable quarantine period even worse.

“It was probably around day seven of no smell or taste that I started to actually worry,” Cahill, 25, said in an email interview. “I never realized how much I relied on those senses in day-to-day life, not to mention the joy you get from eating your favorite foods.”

CAN YOU SMELL THAT SMELL?

You might think that the sense of taste is governed solely by the taste buds, which tell us if something tastes salty, sweet, bitter, sour, or has umami, the savory fifth taste we get from foods that contain a high levels of the amino acid glutamate – meats, cheeses, and mushrooms, for example. But our sense of smell is much more responsible for the way we perceive flavors, Reiter said.

“The odor from food goes up into the back of your throat to your nasal passage, and you smell it at the same time it’s hitting your taste buds,” he said. “So with any food in your mouth, your brain is simultaneously getting input from your taste buds and from your smell receptors, and it puts that together, and that’s what your brain takes away as the flavor of food.”

The coronavirus, Reiter said, can directly damage the olfactory epithelium, layers of cells that line the nasal cavity, which contains receptor cells that are important to maintaining the sense of smell. During a COVID infection, he said, the level of smell loss, and how long it lasts, depends on the level of damage that’s done to these cells and how quickly they regenerate. Many people recover in a matter of weeks or months. But in cases where the damage is severe, “you can recover out to a year, year-and-a-half. I’m not saying by any means that everyone will recover, but it is a very slow process.”

When confronted with a disease that can cost them their lives, people sometimes don’t understand the concern about losing smell and taste. Hudson – who suffered from a high fever, uncontrollable diarrhea and difficulty breathing, a combinations of symptoms that left her afraid to sleep at night because she worried she wouldn’t wake up – heard this from some of her acquaintances, who “just look at you like ‘Why are you’re so ungrateful? It didn’t kill you.’”

But there’s a difference between being alive and living, she says. And much of the joy of living is gone when you’ve lost two of your senses. “The people who don’t have this,” she said, “have no idea what it’s like.”

Cahill, the bartender, said eating became just another task to perform, rather than something that gave her pleasure.

“Without taste, certain foods that I loved almost made me feel sick,” she said. “One of my favorite foods, peanut butter, was completely off the menu. It was like eating sticky goo when it had no flavor.”

Diane Hudson, who had COVID-19 over a year ago and lost her sense of taste and smell, in her kitchen in Portland. Shawn Patrick Ouellette/Staff Photographer

Losing the enjoyment in eating can lead to nutritional deficiencies and unexpected weight loss, Reiter said. Patients tend to compensate for the lack of flavor in their food by experimenting with spices or loading up on the hot sauce, he said. And they try to appeal to their other senses by eating foods with different textures and colors “so you’re not feeling like everything is cardboard.”

But the concern over the loss of smell goes deeper than just enjoying the taste of food, Reiter added. It can be a safety issue. People with this condition can’t smell a gas leak, or smoke from a house fire. They have to do things to protect themselves, he said, such as being vigilant about changing batteries in smoke detectors and dating the perishables in the fridge.

“Are those leftovers four days old or four weeks old?” he said. “Is that milk spoiled? Simple things like that can be major problems for someone.”

HERE ONE DAY, GONE THE NEXT

Cahill was lucky – at least luckier than Hudson. She started regaining her sense of taste and smell three to four weeks after she first noticed it was gone. The first thing she could taste was a tortilla chip, “maybe because of the salt content.” But certain smells and tastes were different, and continue to be different, she said, depending on the day. Meat, for example, had “a peculiar and even off-putting smell.”

“Some days I have a hard time smelling still, as well as some days food tastes slightly off to me,” Cahill said. “I haven’t found any rhyme or reason to it, and am also a little surprised it’s not talked about as much in the news.”

She said she’s grateful, though, that in her case, things seem to be getting better.

“You don’t realize how much those senses mean to you until they’re gone,” she said.

Hudson’s journey has taken even longer. The first taste that came back to her, a couple of months after she was diagnosed, was cilantro in a bowl of pho. It was an exciting moment, but didn’t last long because the taste went away again.

Hudson’s daughter, who had come to Maine from Alabama to watch over her when she got sick, took her mother RV camping after Hudson recovered from COVID. “She would build these campfires, and oh, it was heartbreaking,” Hudson recalled. “I couldn’t smell the campfire. And she would buy lobsters and the best meat – she loves good food too – and she’d be cooking these burgers and I couldn’t smell it.”

In October, about three months after she got sick, Hudson decided to pay a visit to her sister and brother-in-law in Arizona. She ended up staying six months because she didn’t want to return to Maine without being vaccinated.

One night her sister bought some Chinese takeout for dinner – shrimp with red and green peppers – and Hudson could smell and taste it “so I started going crazy for Chinese food, which has never been a big favorite.”

Hudson reacts after taking a bite of pizza. “This is so good, this is like Christmas” Hudson said. Shawn Patrick Ouellette/Staff Photographer

Eight months after catching COVID, on the anniversary of her husband’s death, Hudson’s brother-in-law made her a special dinner that he thought would give her some comfort – rack of lamb, one of her favorite foods.

“They surprised me with this beautiful dinner,” Hudson said. “I sat down, and I couldn’t taste it. I burst into tears.”

Over the next few months, Hudson mostly ate only to live. Her senses of smell and taste came and went, and whenever she found something her brain could connect with, she hungrily grabbed onto it. Never one for eating a lot of sugar and carbs – Hudson’s father was diabetic, so she grew up not eating a lot a sweets – she discovered she could taste chocolate ice cream and soon couldn’t get enough of it. She happily added chocolate to her diet, a decision she has no plans on reversing anytime soon. (“I have a feeling the chocolate might stay. And probably the ice cream too,” she said, laughing.)

In the spring and summer, Hudson mourned the loss of the smell of lilacs and beach rose.

“It’s not just food,” she said. “The sense of smell affects so much of your memory. I don’t really get the smell of the ocean yet.”

This summer she occasionally caught a whiff of cut grass before it, too, left her again.

After dinner, Diane Hudson enjoys a walk to the Eastern Prom where she sets up a chair and watches over the waterfront. Shawn Patrick Ouellette/Staff Photographer

Hudson says social media has helped her cope with her loss. She joined a Facebook group for COVID patients in her situation, and whenever someone shares their progress, it gives her hope. Members also share things they’ve done to bring back their senses of smell and taste, but Hudson has only tried one of their suggestions – smelling a set of essential oils, a practice that some people believe will help them recover fully, if it is done regularly.

Reiter said the essential oils practice was developed by a well-regarded smell and taste clinic in Germany. The clinic has done a lot of research showing that, in some cases, it may increase the likelihood of recovery. At the least, it may help people retrain a dysfunctional sense of smell. “I’m not 100 percent convinced it’s fostering regeneration,” he said.

Still, Reiter tells his patients there’s a “small chance” it might work, and that it’s worth a try.

Hudson worked with four essential oils – geranium, lemon, rosemary and lavender – and smelled them religiously every morning and night for weeks. Eventually she found she was able to smell the rosemary, “and when that happened, I thought, ‘Oh my God, there’s hope.'”

Today Hudson says she has recovered more taste than smell. Her favorite Greek wine doesn’t remind her of motor oil anymore, she said, but white wine in general is still a little off-putting. “It doesn’t taste like white wine at all, what I remember white wine to be,” she said. The good news is that red wine is coming back, and she is starting to enjoy an occasional glass again, along with some good Stilton.

Her future, though, still feels uncertain, which is one reason Hudson decided to share her story. She thinks that people don’t consider the long-term effects of COVID-19 as much as they should, and she wants them to learn from her experience.

“I live in fear of it going away completely again,” Hudson said.

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