Research into restoring loss of smell and taste in COVID patients

Specialist teams at UCLH and UCL are at the forefront of research which could bring hope to people who have been robbed of their sense of smell and taste after suffering the long-term legacy of COVID-19.

Consultant rhinologist Peter Andrews has relaunched the olfactory smell clinic at the Royal National ENT and Eastman Dental Hospitals to investigate patients and health care workers who have been suffering with smell and taste loss following COVID-19 – sometimes with devastating results. The research is part of an international study and leads on from the successful olfactory PhD programme currently ongoing at the UCL EAR Institute.

Some people with COVID-19 lose their sense of smell because the virus damages the olfactory receptor nerve endings or supporting olfactory cells within their nose. It’s not yet known whether the damage will be permanent: potential regeneration could take at least 18 months. The team are also seeing patients who partially recover their sense of smell and taste but instead describe distorted smells and tastes.

In collaboration with the UCL EAR Institute and Professor David Choi UCL Queen Square Institute of Neurology, Mr Andrews will be examining biopsies of damaged olfactory cells following COVID-19 to determine the potential for supporting cells to be transplanted to enable damaged cells to regenerate and reconnect to the central nervous system.

It builds on his success in re-activating olfactory receptors and nerve fibres in the hollow space inside the nose using delicate surgical techniques to straighten the septum which divides the nostrils. This technique hit the headlines seven years ago when one of his patients regained his sense of smell after 40 years.

Peter Andrews said: “Olfaction (the cells which enable us to smell) is the only part of the central nervous system which can regenerate. They usually regenerate every 6 weeks in the nose to replace receptors that have been damaged by pollution and toxic fumes. However, frustratingly following a viral attack such as flu or COVID-19 this capacity to regenerate is sometimes lost.”

“Our aim is to further evaluate this smell loss following COVID-19 infection using cellular techniques and MRI scans. General opinion is that sense of smell and taste is not considered as important as our other senses: however, loss can have far-reaching effects on a person’s quality of life resulting in depression and loss of appetite.”

The smell clinic has recently been relaunched to investigate growing numbers of cases. At the moment there is no cure. Patients are offered steroid sprays or tablets, zinc and vitamin A supplements and smell training therapy.

In smell therapy, patients are encouraged to sniff a selection of everyday items with clear and distinct aromas including coffee, mint, and rose essence, chocolate. They are asked to identify and differentiate between them to help them ‘relearn’ smells. Some patients have total loss of smell (anosmia); others cannot differentiate between different smells. Others – possibly the most unfortunate – smell distorted, disgusting aromas (parosmia).

To access the clinic, patients experiencing post-viral symptoms are encouraged to see their GP and request a referral to UCLH.

Full referral information for GPs

UCLH now has three clinics for patients with long Covid. The main clinic is under respiratory medicine but we also run two specialist clinics for neurological complaints and anosmia.

GPs within North Central London STP can refer through the NHS e-Referral Service and patients will be triaged to the service most suited to help with their symptoms. GPs outside the North Central London STP can use the advice and guidance service on eReferrals. Patients outside North Central London STP can find a clinic closer to home from this list.

To refer a patient to the main clinic on eRS please choose:

·         Specialty – Respiratory Medicine

·         Clinic type – Not otherwise specified

·         Organisation – University College Hospital

·         Service name - Post COVID Multi-specialty Follow Up Service - UCLH RRV

To send an advice and guidance request on eRS please choose

·         Specialty – Respiratory Medicine

·         Clinic type – Not otherwise specified

·         Organisation – University College Hospital

·         Service name - Post COVID Advice and Guidance Service - UCLH RRV

To refer a patient to the Covid Neurology Clinic on eRS please choose:

·         Specialty – Neurology

·         Clinic type – Neuromuscular

·         Organisation – National Hospital for Neurology and Neurosurgery

·         Service name – Neuromuscular – NHNN – UCLH – RRV

To refer a patient to the anosmia clinic on eRS please document anosmia clearly in the referral letter and choose:

·         Specialty – ENT

·         Clinic type – Nose

·         Organisation – Royal National ENT and Eastman Dental Hospital

·         Service name – ENT Nose/Rhinology Service – RNTNE – UCLH – RRV