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‘Coronavirus patients with loss of smell are prone to depression’

Warning against downplaying symptom follows study of health workers at the Whittington Hospital

05 February, 2021 — By Tom Foot

Professor Peter Andrews: ‘The sense of smell is so embedded in so many aspects of the brain. It can make you depressed to lose it’

COVID patients who lose their sense of smell are struggling to cope, a professor has warned, after a study of health workers at the Whittington Hospital found they are almost twice as likely to develop the unpleasant symptom.

UCL Associate Professor Peter Andrews, who is also a consultant at the Royal National ENT and Eastman Hospitals, warned against any downplaying of the symptom, as people lost their appetite and suffered depression.

For some, when smell returns it comes back in a “distorted fashion”, a phenomenon medics call parosmia.

“It really does affect you as a whole person,” said Mr Andrews. “The sense of smell is so embedded in so many aspects of the brain. It can make you depressed to lose it.

“People have been eating food that is very rich. Without smell, you feel detached from the world you’re used to. It is not just you can’t smell important things, like gas leaks and rotten food. You can get comfort from a familiar smell during winter.

“It may sound silly, but body odour – which is often unpleasant – human beings want to smell it.”

Whittington Hospital

On the development of parosmia, Mr Andrews said that at least sufferers were showing signs of some recovery, but he added: “We’ve heard of patients smelling their coffee and instead smelling faeces.

“It is causing patients absolute havoc. Imagine your Friday night takeaway curry is bland and your glass of wine is just a red-looking drink, which smells like acid. It’s like your nose is getting crossed wires basically.”

He has researched the impact of the virus on 78 staff at the Whittington between May 26 and June 10 last year. It was a collaboration with his wife Dr Julie Andrews, who is a consultant microbiologist at the Highgate hospital.

More than two thirds of the staff who had been infected with Covid reported temporary smell loss – a far higher proportion than has been reported in the general public.

Mr Andrews said: “We had access to the healthcare workers at the Whittington who had tested positive – it was a broad range of healthcare workers right across the hospital. We found 70 per cent had a loss of smell and taste.

Compared to the general public it is nearly double, which is a really interesting finding. It is the first big study in the UK at this time to highlight the high prevalence in healthcare workers.”

One theory is that there is more “viral load” in hospitals and this makes the symptom more likely.

Smell evolved in humans to help them “avoid nasty things”, said Mr Andrews, and for many Covid patients it has been the most unsettling part of the illness.

The NHS offers advice and treatments and smell retraining therapy and vitamins.

His main interest in the field is the regenerative ability of the nose, which is the only part of the central nervous system that regularly heals itself of its own accord.

He said: “The reason for that is the nose has so many nerve fibres that are connected to the outside world, it doesn’t take much to knock them out, the human nose is programmed to keep on regenerating every six weeks – it is remarkable.”

He is also interested in dog’s noses, which he says are “incredible” with 400 million receptors compared to a typical human’s six million.

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