An ENT specialist can help with loss of smell after COVID by evaluating the nasal passages and olfactory system, identifying possible contributing conditions, and discussing appropriate treatment.
Picture someone who has recovered from the fever, cough, and fatigue of COVID-19. Life begins returning to normal, but morning coffee has no aroma. Favorite foods seem bland. Several weeks later, the sense of smell is still missing. Then, as some odors begin to return, coffee smells burnt, meat smells rotten, and familiar foods have strange chemical odors.
This experience is not unusual. COVID-19 can be followed by anosmia, complete loss of smell; hyposmia, reduced smell; parosmia, distorted smell; or phantosmia, smelling an odor that is not actually present.
For people asking, can an ENT help with loss of smell, the answer is yes. An otolaryngologist can investigate whether the problem is primarily post-viral olfactory dysfunction or whether nasal obstruction, allergies, sinus disease, nasal polyps, a deviated septum, medications, or another condition is also involved.
Why COVID-19 Causes Persistent Loss of Smell
COVID-19 can interfere with smell by affecting cells in the olfactory epithelium and producing changes around the sensory system responsible for detecting odors. This means post-COVID smell loss is not always simply the result of having a stuffy nose.
The olfactory epithelium sits high inside the nasal cavity. It contains olfactory sensory neurons as well as supporting cells called sustentacular cells. These supporting cells help maintain the environment needed for normal olfactory function.
Research has shown that SARS-CoV-2 can affect sustentacular cells and produce changes in the olfactory tissue. Studies of people with longer-lasting post-COVID olfactory dysfunction have also identified inflammatory changes and alterations in olfactory sensory neurons.
This differs from the way a typical cold can temporarily reduce smell. With heavy congestion, swollen tissue and mucus may prevent odor molecules from reaching the olfactory region. With COVID-related olfactory dysfunction, the sensory system itself may be affected.
That distinction helps explain why an evaluation by an ENT specialist may be useful when smell loss persists after COVID-19. Simply opening a congested nose does not necessarily restore normal olfactory function if the sensory system has been affected.
Smell also contributes substantially to flavor. The tongue detects basic taste sensations such as sweet, salty, sour, bitter, and umami, while the olfactory system provides much of the aroma that gives food its character. That is why someone with anosmia may describe food as tasteless even when the tongue is still functioning.
The CDC currently lists changes in smell and taste among symptoms that may persist as part of Long COVID.
Also Read: Mystery Solved: How to Know If It’s Cold, Allergy, or Sinusitis
Self-Care vs. Professional ENT Care: When Should You See a Doctor?
If smell remains significantly reduced for more than 4–6 weeks after COVID-19, or if parosmia develops, an ENT evaluation is reasonable. Some patients improve without treatment, while others have symptoms that require a closer look.
During the first few weeks, gradual improvement can be reassuring. Smell may return unevenly, with certain odors becoming detectable before others. A patient may also notice that intensity changes from one day to the next.
For patients monitoring their symptoms at home, smell training may be considered. It is also reasonable to address nasal congestion or allergies with appropriate medical advice.
An ENT visit becomes more useful when smell remains absent or substantially reduced after several weeks. It is especially worth considering when symptoms include:
- Complete loss of smell
- Markedly reduced smell
- New or ongoing parosmia
- Significant nasal obstruction
- Chronic sinus symptoms
- Nasal polyps
- A history of nasal or sinus surgery
- Recurrent sinus infections
Patients searching for a COVID smell loss specialist in Los Angeles may also want to consider whether their symptoms suggest a nasal or sinus condition in addition to post-viral olfactory dysfunction.
NIDCD notes that smell disorders can have many causes, including upper respiratory infections, sinus conditions, head injuries, medications, smoking, and other medical problems.
Parosmia can be particularly frustrating. A person may regain the ability to detect an odor while perceiving that odor incorrectly. Coffee, meat, onions, eggs, or other foods may smell burnt, rotten, chemical-like, or otherwise unpleasant.
For that reason, parosmia treatment and ENT evaluation may be appropriate when distorted smells are interfering with eating or daily life. An ENT can determine whether there is an additional nasal or sinus problem that should be addressed and discuss available approaches for the olfactory dysfunction itself.
What Patients Are Often Most Surprised By
Many people expect their sense of smell to return all at once, but recovery is often uneven. A few familiar scents may come back before others, and some odors may seem distorted before they begin to smell normal again. This can be frustrating, especially when favorite foods suddenly smell unpleasant or everyday scents seem unfamiliar. While these changes can feel discouraging, they are recognized patterns of post-viral smell recovery and do not necessarily mean improvement has stopped.
How an ENT Specialist Evaluates Post-COVID Anosmia
An ENT evaluates post-COVID anosmia by combining the patient’s medical history with examination of the nose and sinuses and, when indicated, objective smell testing and imaging.
The taste and smell evaluation begins with a consultation and physical examination. The physician reviews medical history, allergies, and medications and may use CT imaging, endoscopic nasal or sinus examination, and olfactory function testing.
The history may cover when the smell loss began, whether it followed COVID-19, whether smell has partially returned, and whether familiar odors have become distorted. The physician may also ask about allergies, nasal blockage, sinus infections, prior nasal procedures, smoking, and medications.
Diagnostic nasal endoscopy provides a direct view inside the nasal cavity. The nasal endoscopy is an examination using a slender fiber-optic instrument that allows the physician to inspect the nasal passages, sinuses, and surrounding structures. It can help identify nasal polyps, nasal blockage, tumors, recurrent sinusitis, and chronic sinusitis.
Formal olfactory testing can provide information that a simple question such as “Can you smell this?” cannot. These tests can establish a baseline and help quantify changes in smell function.
Imaging is not automatically necessary for every patient. If examination findings suggest sinus disease or a structural issue, CT imaging may be appropriate. Dr. Zadeh performs in-office sinus CT imaging as part of its diagnostic services for nasal and sinus conditions.
MRI may be considered in selected cases when a physician needs additional information about the brain or surrounding soft tissues. The appropriate imaging study depends on the symptoms and examination findings.
Also Read: Is It a Cold or Allergies?
Medical & Therapeutic Treatments for Post-COVID Smell Loss
Treatment for post-COVID smell loss depends on the cause, and olfactory training is one of the main non-surgical approaches studied for post-viral olfactory dysfunction. Treatment may also address nasal or sinus inflammation or structural problems when those conditions are contributing.
For people researching post-COVID anosmia treatment, it is important to understand that no therapy guarantees complete recovery. Research continues to identify which treatments are most useful for different types and stages of post-COVID smell dysfunction.
Olfactory retraining therapy, often called smell training, involves repeatedly smelling selected odors according to a structured routine. The purpose is to provide repeated sensory stimulation while the olfactory system recovers.
Research into olfactory training COVID treatment has produced mixed findings. Some controlled studies have reported improvement with olfactory training, while other randomized research has not found training to be superior to control approaches. This means smell training remains a reasonable treatment approach, but patients should not be promised a particular degree of recovery.
A patient may also receive treatment for nasal or sinus inflammation when examination shows that it is contributing to reduced smell. Saline irrigation and prescribed nasal corticosteroids may be used in selected patients.
For someone researching a steroid nasal spray for smell loss, the important distinction is whether there is nasal inflammation or another condition that would respond to topical corticosteroid treatment. A nasal steroid is not a guaranteed treatment for isolated post-COVID injury to the olfactory system.
Research on corticosteroid treatment specifically for COVID-related smell dysfunction remains mixed. One randomized controlled trial found that oral prednisolone did not improve olfactory function compared with placebo when both groups also performed olfactory training.
Similarly, oral medications and supplements should not automatically be considered treatments for post-COVID anosmia. Research has examined nutrients and supplements such as alpha-lipoic acid, vitamin A, and other compounds, but results have not established a universally accepted supplement regimen. One randomized trial found that alpha-lipoic acid did not add a significant benefit to olfactory training.
Emerging treatments are also being studied. PRP, or platelet-rich plasma, has been evaluated in small randomized studies involving patients with long-lasting COVID-related smell loss. One trial reported greater improvement in objective smell measures after PRP than after saline treatment, but the study was small, so PRP remains an emerging treatment rather than an established cure.
Finally, an ENT evaluation may identify a nasal or sinus problem that is contributing to smell impairment. Zadeh MD lists nasal polyps, deviated septum, sinus disease, and other nasal conditions among possible causes of taste and smell disorders. Treatment may include medical therapy or, for selected patients, procedures such as balloon sinuplasty, endoscopic sinus surgery, or treatment of a deviated septum.
This distinction is important: surgery does not repair every case of post-COVID olfactory dysfunction. It may be useful when a separate structural or sinus condition is affecting nasal airflow or contributing to the smell problem.
What to Expect: Recovery Timelines and Long-Term Outlook
A COVID anosmia recovery timeline can range from several weeks to many months, and some patients experience changes in smell for a year or longer. There is no single schedule that applies to everyone.
Many people recover relatively quickly. Others experience ongoing hyposmia, anosmia, or parosmia after the initial infection. The CDC recognizes changes in smell and taste among symptoms that can persist with Long COVID, and notes that symptoms may last months or years in some people.
The olfactory system has the capacity for regeneration, but recovery involves multiple biological processes. The condition of the olfactory epithelium, inflammatory changes, severity of the original dysfunction, age, associated nasal or sinus disease, and other individual factors may influence recovery.
Some people notice meaningful improvement during the first several months. Others continue to experience gradual changes later. Parosmia may also occur as smell function changes during recovery.
Consistency with olfactory training may be useful for patients who choose this approach, although current research does not allow physicians to promise a particular result or recovery date.
A patient with complete anosmia should also take safety precautions. Smell normally helps detect smoke, gas leaks, spoiled food, and other hazards.
Use working smoke and carbon-monoxide detectors in the home. Check expiration dates rather than relying on smell to determine whether food is safe. If a household situation may involve a gas leak or fire, do not depend on your sense of smell to detect the danger.
Also Read: Anosmia Treatment: Can Endoscopic Sinus Surgery Restore My Sense of Smell?
Why Choose Dr. Mani H. Zadeh for Post-COVID Anosmia Care
Dr. Mani H. Zadeh is a board-certified otolaryngologist and rhinologist practicing in Century City, Los Angeles, with in-office and telemedicine appointments. His practice evaluates nasal, sinus, taste, and smell disorders and offers diagnostic services including nasal endoscopy and sinus CT imaging.
For someone searching for a COVID loss of smell doctor in Los Angeles, Dr. Zadeh offers a setting where smell complaints can be evaluated alongside possible nasal and sinus causes.
Dr. Zadeh evaluates patients through medical history and physical examination and may use allergy assessment, medication review, CT imaging, endoscopic examination, and olfactory testing. We’re here for patients looking specifically for an ENT specialist for smell loss in Century City.
Dr. Zadeh also offers telemedicine consultations for appropriate ENT conditions. Virtual consultations can include symptom evaluation, basic medical information gathering, a preliminary medical evaluation, at-home treatment recommendations, and referral for in-person testing when needed.
This approach can be useful for patients who want to discuss their symptoms before deciding whether an in-person nasal examination or smell testing is needed.
CONCLUSION
Losing your sense of smell after COVID can be frustrating, especially when recovery is slower than expected or familiar odors become distorted. While some people improve without medical treatment, persistent smell loss deserves evaluation because post-viral olfactory dysfunction is only one possible cause. An ENT examination can determine whether nasal inflammation, sinus disease, structural problems, or another condition is contributing and help identify the most appropriate next steps based on your individual situation.
If your sense of smell has remained significantly reduced for more than four to six weeks after COVID-19, or distorted smells are affecting your daily life, contact us to schedule an evaluation with Dr. Mani Zadeh to discuss your symptoms and treatment options.
FAQs
How long does COVID-19 loss of smell usually last?
COVID-19-related smell loss can last several weeks, several months, or longer. Many people recover relatively quickly, while others experience ongoing anosmia, hyposmia, or parosmia.
Can an ENT doctor actually fix loss of smell after COVID?
An ENT may be able to treat a condition contributing to smell loss, but there is no guaranteed cure for post-COVID anosmia. An evaluation can determine whether sinus disease, nasal polyps, inflammation, a deviated septum, or another condition is contributing and whether treatment is appropriate.
Why did I lose my sense of taste if COVID only affected my nose?
Smell contributes substantially to flavor, so losing smell can make food seem tasteless. The tongue continues to detect basic tastes, but the loss of aroma removes much of the sensory information that makes foods distinctive.
What is parosmia, and why does food smell foul or burnt after COVID?
Parosmia is a distortion of smell in which familiar odors are perceived differently. Coffee, meat, eggs, onions, and other foods may smell burnt, rotten, chemical-like, or otherwise unpleasant. Parosmia can occur after viral infections, including COVID-19.
Is post-COVID smell loss permanent?
Post-COVID smell loss is not necessarily permanent. Some people recover within weeks or months, while others experience symptoms for much longer.
How does an ENT test my sense of smell during an office visit?
An ENT may use a standardized smell test to measure olfactory function. Tests such as UPSIT and Sniffin’ Sticks can provide objective information about odor identification and other aspects of smell.
What is nasal endoscopy, and why is it needed for smell loss?
Nasal endoscopy allows an ENT to directly examine the inside of the nasal passages and surrounding structures. Dr. Zadeh describes the procedure as a fiber-optic examination that can help identify nasal polyps, blockage, tumors, and sinus disease.
Will over-the-counter nasal decongestants restore my smell?
Nasal decongestants may temporarily relieve congestion but do not repair post-viral dysfunction of the olfactory system. If nasal blockage is contributing to reduced smell, treating that blockage may help. Decongestant sprays should also be used only as directed because prolonged use can cause rebound congestion.
How does olfactory retraining therapy (smell training) work?
Olfactory retraining involves repeatedly smelling selected odors on a regular schedule to provide repeated stimulation to the smell system. Research in COVID-related smell loss continues to produce mixed results, so patients should view it as a treatment approach rather than a guaranteed cure.
Can steroid nasal sprays or rinses help recover my sense of smell?
They may help when nasal or sinus inflammation is contributing to impaired smell, but they do not guarantee recovery from post-COVID olfactory dysfunction. A physician can determine whether a nasal corticosteroid or medicated rinse makes sense based on the examination and symptoms. Research on corticosteroids for COVID-related smell loss remains mixed.
Are there any oral medications or supplements that help post-COVID anosmia?
No oral medication or supplement has been established as a universally reliable treatment for post-COVID anosmia. Studies have investigated several supplements, but results vary. One randomized trial found no additional benefit from alpha-lipoic acid when added to olfactory training.
What is the difference between anosmia, hyposmia, and parosmia?
Anosmia means complete loss of smell, hyposmia means reduced smell, and parosmia means distorted smell. Phantosmia is different because it involves sensing an odor when there is no identifiable odor source. NIDCD provides definitions and information about these smell disorders.
When should I see an ENT specialist for smell loss after COVID?
Consider an ENT evaluation when smell remains significantly reduced beyond 4–6 weeks, when the loss is severe, or when parosmia develops. An earlier visit may be appropriate when there is significant nasal blockage, chronic sinus disease, nasal polyps, recurrent sinus infections, or another nasal symptom.
What safety precautions should I take while I have no sense of smell?
People with anosmia should not depend on smell to detect smoke, carbon monoxide, gas leaks, or spoiled food. Keep smoke and carbon-monoxide detectors working, check food expiration dates, and ask someone else to assess questionable food or household odors when necessary.
Does insurance cover an ENT evaluation for post-COVID smell loss?
Insurance coverage depends on the patient’s plan, medical necessity, diagnostic testing, and the services provided. Patients should contact their insurer and our office before the appointment to confirm benefits, network status, testing coverage, and expected out-of-pocket costs.