Prolonged Smell Loss After COVID-19 Linked to Increased Depression and Anxiety: Study
According to a new research by University of Mons researchers in Belgium, among COVID-19 survivors, loss of smell for six months or longer show higher levels of depression and anxiety compared to those without this dysfunction. This study published in Journal of Otolaryngology - Head & Neck Surgery identified that individuals with chronic long-term olfactory dysfunction (OD) after COVID-19 infection experience much greater levels of psychological distress, such as symptoms of depression and anxiety. The research was undertaken by Manon L. and colleagues to determine the mental health load of prolonged smell loss that has endured for more than six months.
The study compared individuals with OD with those who have no loss of smell and paid special attention to assessing their olfactory function and mental health by using well-established clinical measures. The study validates the requirement for mental health assessment in otolaryngology patients reporting sensory dysfunctions persisting with COVID.
The research consisted of 220 OD patients with a duration greater than six months and a control group of 102 asymptomatic subjects. They were consecutively enrolled from August 2023 to January 2024. Olfactory function was evaluated by both subjective (Olfactory Disorder Questionnaires - ODQ) and objective assessment (TDI – Threshold, Discrimination, and Identification). Psychological well-being was assessed by the Generalized Anxiety Disorder-7 (GAD-7) and the Patient Health Questionnaire-9 (PHQ-9), which assess anxiety and depression, respectively. The Sino-Nasal Outcome Test-22 (SNOT-22) was also employed to assess nasal symptoms. The two groups were compared on both psychological and olfactory measures.
Key Findings
• The mean duration of OD in patients was 31.1 ± 25.1 months, which suggests chronic symptoms.
• OD patients scored significantly higher on GAD-7 for anxiety and PHQ-9 for depression compared to those without OD (P < 0.008).51.2% of the patients with OD suffered from mild-to-severe depression, as opposed to 44.1% in the asymptomatic group.
• 39.5% of the OD patients suffered from mild-to-severe anxiety, as opposed to 32.4% in non-OD patients.
• Severe anxiety symptoms were strongly correlated with anosmia (loss of smell).
• Female patients had greater scores for depression and anxiety than male patients.
• Depression severity (PHQ-9) and anxiety severity (GAD-7) were significantly correlated with OD severity (ODQ scores) and nasal symptom burden (SNOT-22 scores).
This research concludes that persistent smell loss following COVID-19 has a close correlation with psychological distress, particularly the symptoms of anxiety and depression. Although the direction of causation is unclear, the results draw attention to the pressing need for the evaluation and management of mental health in this patient population. Identification and counseling of these individuals may enhance both their emotional states and their global recovery from long COVID.
Reference:
Louvrier M, Saussez S, Lechien JR. Psychological Distress in Patients with Long-lasting COVID-19 Olfactory Dysfunction. Journal of Otolaryngology - Head & Neck Surgery. 2025;54. doi:10.1177/19160216251328960
