Early in the pandemic, anosmia—loss of smell—became a common sign of COVID-19 infection. There have been questions about how long this loss of olfactory function lasts. However, a new study published in JAMA Network Open suggests complete recovery is likely at one year, if not sooner.

Over the course of a year, researchers in France followed a cohort of patients who had COVID-related acute loss of smell. At four months, 23 of 51 patients reported full recovery of olfactory function, while 27 reported partial recovery. Only one person still reported total anosmia. At one year, everyone had recovered, although two patients reported that they still had limited olfactory function.

The authors concluded, “Persistent COVID-19-related anosmia has an excellent prognosis with nearly complete recover at one year. As clinicians manage an increasing number of people with post-COVID syndrome, data on long-term outcomes are needed for informed prognostication and counseling.”

This study is promising for COVID survivors in long term care. As Steven Buslovich, MD, CMD, MSHCPM, a New York-based physician and medical director, says, “Weight loss in institutionalized adults is a frailty deficit that contributes to risk for morbidity and decline. It is important to evaluate the etiology of weight loss, nutritional status, adequacy of nutritional support, and one's ability to absorb nutritional intake, recognizing that anosmia may be persistent as part of post-COVID phenomenon.”

Karl Steinberg, MD, CMD, president of AMDA – The Society for Post-Acute and Long-Term Care Medicine, says, “The good news is that even though loss of smell can last a long time, it eventually returns. The bad news is that for some of our residents, it can contribute to a failure-to-thrive clinical picture, since smell is such an important part of the enjoyment of food, appetite, and taste. For some residents—especially those where other factors like isolation due to visiting restrictions have been such a problem—a year may be too long to wait.”

It is important to consider strategies to encourage residents to eat, even when they have anosmia or a diminished sense of smell. Steinberg suggests, “Encouraging people to eat foods with stronger flavors, like spicy food and salty food, and different textures can be a strategy to make food more interesting and appealing for some residents, even though it may go against what we usually recommend.”

At the same time, Buslovich says, “Those who experience anosmia may respond favorably to temperature and texture, as those senses remain preserved.”