More than five years after the onset of the COVID-19 pandemic, a new longitudinal study indicates that over 50% of patients who experienced initial smell loss continue to suffer from persistent olfactory dysfunction.
This research, published in the journal Otolaryngology–Head and Neck Surgery, suggests that recovery rates plateau significantly after two years.
For millions, the loss of smell has evolved from an acute symptom into a chronic, life-altering condition. VCU Health reported that while early pandemic data suggested most patients regained their olfactory function within weeks, a sub-group continues to experience partial recovery or total anosmia, the complete loss of smell.
Clinical Realities of Olfactory Dysfunction
- Recovery Plateau: Data shows that if a patient has not recovered their sense of smell within two years of infection, the likelihood of significant improvement after five years is statistically minimal.
- Age as a Factor: Younger patients (under 40) demonstrate a higher capacity for cellular regeneration, with a 61.7% complete recovery rate compared to just 34% in older demographics.
- Quality of Life Impact: Persistent dysfunction often leads to secondary health issues, including nutritional deficiencies, unhealthy weight loss, and depressive symptoms, as the inability to perceive odors affects both appetite and safety.
Five-Year Recovery Trends
The research team at Virginia Commonwealth University’s School of Medicine tracked a cohort of adults who reported smell loss following a positive COVID-19 test. In their latest survey conducted in late 2025, 44.2% of the 419 respondents reported complete recovery, while 48.4% reported only partial recovery. About 7.4% reported no recovery at all, a figure consistent with data collected at the two-year mark.
Previous findings published in PubMed Central corroborate the difficulty of long-term recovery. In a study analyzing participants with at least two years of follow-up, 38.2% reported full recovery, 54.3% partial, and 7.5% no recovery.
“Our data shows that many people are still experiencing the health impacts of COVID-19 even several years later, and they are still looking for help for their symptoms,” said Richard Costanzo, Ph.D., a professor emeritus in the Department of Otolaryngology at the School of Medicine.
| Recovery Status | 2-Year Post-Infection | 5-Year Post-Infection |
|---|---|---|
| Complete Recovery | 38.2% | 44.2% |
| Partial Recovery | 54.3% | 48.4% |
| No Recovery/Worsened | 7.5% | 7.4% |
Olfactory Training and Neuroprosthetic Development Offer Potential Treatments
Current clinical approaches remain limited, primarily focusing on olfactory training. This involves the repetitive sniffing of distinct scents—such as peppermint, lemon, and peanut butter—to stimulate neural pathways and encourage the brain to “re-learn” odors. Beyond these behavioral interventions, Costanzo and Daniel Coelho, M.D., are currently working on the development of a neuroprosthetic nose designed to bypass damaged tissue and restore sensory input.
Distorted Smell Causes Emotional Distress and Nutritional Issues
“Even partial recovery or distorted sense of smell can cause emotional distress,” Evan Reiter, M.D., medical director of VCU Health’s Smell and Taste Disorders Center, told VCU Health. “When meals suddenly begin to smell and taste foul, people can experience loss of appetite, nutritional deficiencies, unhealthy weight loss and depressive symptoms.”
References
- PubMed Central: Recovery from Covid-19 smell loss: Two-years of follow up
