Loss of smell drives Covid-19 survivors to get creative in the kitchen

Emergency physician Dr. Alex Yeats had just whipped up what seemed like an appetizing dinner option when his wife let him know she wasn’t having anything to do with it.

“It was black bean pasta with almonds and turmeric chunks and I was like ‘I’m not eating that, it’s disgusting,'” said Sarah Yeats, 31, an emergency nurse from Atlantic Beach, Florida.

The couple both work at a hospital in Jacksonville, Florida, and she had contracted Covid-19 at work and brought it home in August.

Like many people who have gotten the coronavirus, they noticed shortly after testing positive that they’d lost much of their sense of smell and taste.

For weeks, they’d been coaxing any sensation they could muster from foods by dousing chicken in lemon juice, throwing fistfuls of fresh herbs at soups and salads and getting daring with textures in an attempt to bring some excitement to the table.

The day Sarah noticed she no longer found turmeric chunks acceptable atop pasta, she said, was when she realized her sense of taste might be rebounding.

Anosmia — a condition known as “smell blindness,” or loss of smell — is a common symptom of Covid-19 (and other viruses), and can severely impact people’s ability to taste, since the senses are intertwined.

“It appears that loss of smell or taste are some of the most specific indicators of Covid-19, in particular early indicators,” said emergency physician and CNN Medical Analyst Dr. Leana Wen. “Even without having any other symptoms, including congestion, (Covid-19 patients) report that they cannot smell or taste.”

And while most people regain their sense of smell or taste within days to weeks, Wen said, “there are still many who have not regained their sense of smell after months.”

People still need to eat, of course, and they’re modifying their meals as a result.

Putting new flavor combinations on the table

A few days after testing positive for the virus in mid-December, Althea Mullarkey, 53, suddenly realized she could no longer smell the strong gardenia scent of her shampoo.

She tore through the house, sniffing everything she could find, and realized her sense of smell had vanished.

The self-described foodie who lives in New York’s Hudson Valley said she no longer likes the mouthfeel of eggs, since she can’t taste them. And she doesn’t want to waste her blunted sense of taste on a good piece of blue cheese, a former favorite.

Recently, Mullarkey said, she ate leftover “spicy-sweet coleslaw with pulled pork” for breakfast. Her go-to dinner has become lemon-dill hummus squeezed with more lemon, a side of pitted kalamata olives and a piece of toasted naan slathered with spicy oil.

“I can taste the salt and pepper and lemon and I like the crispy textures,” Mullarkey said, but none of the layers of flavors she used to love experimenting with in the kitchen are coming through.

There is a simple explanation for that, said Dr. Marta Becker, an otolaryngologist with Philadelphia-based BergerHenry ENT Specialty Group, who’s part of a team developing an app for long-haul Covid-19 patients to track their symptoms.

“Some sensations of our food — spicy hot pepper, mintiness — are things we experience with the hot and cold sensors of our mouth,” she said. “You can get the acid, heat, even saltiness, but not the layers of things like cilantro and chipotle.”

Most of our sense of what we think of as taste, Becker said, isn’t really taste at all.

“All the interesting things about our food that we use to identify things like cheese and fruits and chocolate and coffee are not done with our mouth,” she said. “They’re done with our nose.”

“We don’t think it’s very common for people to actually lose their sense of taste (with Covid-19). If you really drill down, it’s the olfactory function in the nose that’s not working.”

That might explain why texture, color and even rituals around cooking have become more important to some people right now.

“Texture has become a lot more important to me,” said Alex Yeats, 42. He and Sarah eat salmon several times a week because it has a fuller, more umami body and a better mouthfeel than a flaky white fish, which “just tastes dry.”

“I wanted to make sure there was green in everything,” Sarah said. “Foods that are white and gray, they’re just so unappealing now.”

Immersing in the processes of cooking and meal planning each week also helped her keep interested in food prep. “Having Covid inspired us to use our raclette oven because it’s a process for cooking that makes it fun.”

When odd odors are a promising sign

Phantom smells are a common topic in online Covid-19 support groups.

Even months since their diagnoses, the couple have gotten whiffs of jet fuel and cigarette smoke where there was none. Mullarkey said she has smelled such intense phantom smoke and ash odors, they’ve nearly made her gag.

According to Becker, that’s promising news.

“A lot of people get trash, or smoke, something rotten or burning rubber,” Becker said of phantom smells her patients have noted. “It’s really gross, but it’s usually a good sign things are trying to sort themselves out. When recovery happens, sometimes the wires can get crossed.”

While it’s still unknown why people lose their sense of smell with Covid-19, Wen said “it’s thought that the coronavirus doesn’t affect nerve cells that control smell but rather the cells around them.”

That, too, is considered good news for recovery, since supporting cells regenerate easier than neurons.

“When the cells grow back, it might take some time and retraining to get back to normal,” she said.

Scent training can help

Retraining her sense of smell is something that Kaya Cheshire — who said she’s still missing 90% of her sense of smell since contracting a mild case of Covid-19 last July — has been trying out, along with adding far more herbs and spices than usual to her food.

“I really miss smell,” said Cheshire, 28, who lives in London and is head of marketing for WorkClub. She said she’d have Covid-19 “five times” to get her smell back.

“It’s so nostalgic to smell food cooking,” she said. “Adding lemon or cloves and those aromatic things enhance everything and make me feel like I’m not missing out as much — even though I know I am.”

At her doctor’s suggestion, Cheshire recently began “scent training,” using things like rose, lemons, cloves, garlic, eucalyptus and menthols that have a really strong smell to retrain her brain.

“I’m trying to think about how things used to smell so I can remember them and recognize that scent again,” she said.

Becker said it’s a tactic she recommends to patients since there is no cure for anosmia.

“Retraining your brain to what things smell like so you can remember is a bit mysterious,” she said. “But using the memory to retrain the neurons can work in both directions. The memory can help you smell, and the smell can help you remember.”

And you don’t need a fancy essential oils kit, she said. “Just use the things you have to match that smell up with the memory of your smell.”

That could be something aromatic and nostalgic for dinner, too.

Sarah Yeats — who has recovered most of her sense of smell and taste, but not all — recently made a bowl of ramen brimming with cilantro and green onions in a rich broth.

“I’m trying to serve foods that seem more flavorful and look prettier,” she said.

For her husband, Alex, the dish was a form of memory itself.

“Since I remember what it smells and tastes like, I can imagine it, and it’s helpful,” he said.