It has been more than a year since Eleanor was diagnosed with Covid-19, and she still can't smell or taste.
Eleanor says she has started to accept her loss of smell might be permanent. Photo: Supplied/Eleanor Cowell
"It's not great - I used to look forward to every meal, but food has lost its interest to me," she said.
"The thing I miss the most is smell. I haven't smelt fresh air in a year."
The 24-year-old from Melbourne tested positive to the virus in early July last year after catching it from a family member.
She experienced severe fatigue, a cough and a complete loss of smell and taste.
While her symptoms have mostly resolved, her senses of smell and taste have only slightly returned.
"I can't taste curry or spices, but I can tell whether food is savoury or sweet, and some veggies have more of a taste," she said.
"I can sense when there is a smell - I ask people if there's a smell, and they say there is, but I can't tell what it is.
"But other than that, it's the same as when I was Covid-19 positive."
Eleanor said on the other hand, she had occasionally been overcome with a "horrific" scent, which she thinks is her body responding to the smell of smoke.
"The smell of smoke is really disgusting to me," she said.
"It makes me retch - the best way to describe it is like burnt meat that has gone off."
But she said she had no choice to accept this reality - she has been told there is no treatment for this long Covid-19 symptom.
"It's still such a new thing in the world, and there's nothing I can do about it," she said.
"It's already been a year - I'm a bit more resigned to the fact this might be more permanent than I thought."
Epworth rehabilitation medical director John Olver said while studies varied, they generally showed about half of patients with Covid-19 experienced lost, reduced, or a distortion of smell.
These conditions are known as anosmia, hyposmia and parosmia.
He said the symptoms could present differently depending on the patient, but can be seen in people of all ages, even with mild cases of Covid-19.
"A lot patients don't recognise they've lost their sense of smell - they recognise, however, that food tastes different or more bland," he said.
"Other patients feel that when they're smelling a familiar smell like roses, they're actually getting quite a different smell, such as smoke."
While he said it was not entirely clear why this happened in patients who have had Covid-19, it was thought to be due to inflammation of the nasal passages which then can impact taste.
Professor OIver said overseas studies showed about 90 per cent of people recover by themselves within six months to a year after reporting symptoms.
However, he said some don't see any improvement - especially those suffering from a complete loss of smell.
'Still a lot of work to be done'
Olver said the Epworth's Olfactory Impairment Clinic was initially set up to treat patients with lost or distorted smell caused by conditions such as Parkinson's disease and traumatic brain injuries.
But the clinic has recently started to see Covid-19 patients, and Olver said he expected the number to rise.
Professor Olver said patients with impaired smell or taste were diagnosed via a test with 40 smells to determine the degree of the symptoms.
"But regrettably, there isn't much treatment - we're just waiting for the natural recovery process to help them," Olver said.
"There's still a lot of work to be done on this one symptom, because obviously, people with long Covid-19 are more focused on the fatigue, the breathlessness and the thinking problems."
Professor Olver said the clinic offered practical support and counselling for those who suffer from the sometimes "distressing" symptoms.
"We've got to give people strategies," he said.
"If you've lost your sense of smell and taste, you're in potential danger from leaking gas, you've possibly got problems with hygiene, and with knowing that food might be a few days overdue.
"And some patients can be psychologically affected - one patient that had another condition used to be comforted by the smell of their grandmother's house and then could never smell that again.
"There's a lot of issues we can counsel them about."
Smell training can help
Melbourne ENT Group surgeon An Pham, who specialises in rhinoplasty, said "olfactory training" could help, but was not a guaranteed solution.
Research is revealing why it takes some people so long to get their sense of smell back after Covid-19 - and they say it might even be a useful, non-invasive screening tool.
"For olfactory training, you take four strong smelling things - for example, rose, lemon, eucalyptus and cloves," Pham said.
"You smell those things twice a day for several months, and it can sometimes help the smell come back.
"But it's not a guarantee - it's just something that's safe and easy to do at home when there's nothing obvious causing the hyposmia."
Pham said there are other small things that could help, including topical steroids.
But she said anyone who has had a sudden loss of smell or taste should see a doctor as there may be another condition causing the symptoms and specialised treatment available.
-ABC