If you’re still experiencing smell problems months after a COVID-19 infection, a recent systematic review helps explain what to expect and why recovery takes the time it does.
Researchers analysed a large number of studies involving people who continued to experience smell problems for at least three months after COVID-19 infection. Their aim was to understand how smell loss progresses over the longer term.
Most people recover, but not everyone
The overall picture from the review is cautiously hopeful. Most people do eventually recover their sense of smell, but a significant minority continue to experience problems long after their infection. These can include hyposmia (a reduced ability to smell), anosmia (a complete loss of smell), or parosmia, where familiar smells become distorted and often unpleasant. Some people also experience phantosmia: phantom smells that are not actually present.
Recovery can take much longer than expected
One of the clearest findings is that recovery often continues well beyond the first few weeks after infection. Many patients improve gradually over months, and some continue to recover for up to two years. This is an important point because people are sometimes told that if their smell has not returned within a few weeks, it probably will not. That is not what the evidence shows.
Who is more likely to struggle
The review found that people with more severe or prolonged smell loss early in their illness were generally less likely to recover fully. Age and sex may also play a role, though the evidence across studies is not always consistent. More research is needed to understand exactly why some people recover quickly while others do not.
Why smell loss deserves to be taken seriously
A key message from the review is that smell loss should not be dismissed as a minor symptom. Smell plays an important role in detecting danger (such as smoke or gas), enjoying food, and maintaining quality of life. Persistent smell disorders can affect nutrition, mood, and social wellbeing.
The authors conclude that long-term smell dysfunction remains an important part of post-COVID illness, and that healthcare providers should continue monitoring affected patients and exploring treatments such as smell training. You can read the full systematic review on PubMed Central. If you would like to understand more about how smell training works, the CKOS guide to smell training after COVID is a good place to start.
Key Takeaway
Most people with long-term smell loss after COVID-19 do eventually recover, but recovery can take up to two years and is not guaranteed for everyone. If you are still experiencing smell problems months after infection, you are not imagining it, and it is worth continuing with smell training and raising it with your GP.
