Cold symptoms and loss of smell: what to know

A cold can swell the lining of the nose and prevent scent molecules from reaching the smell receptors. Mucus, congestion and reduced airflow may make food taste less vivid as well. Loss of smell is also a recognised presentation of COVID-19, which can occur with or without a blocked nose. Allergic rhinitis may cause similar nasal swelling, while chronic sinusitis can keep the nose inflamed for longer.

The symptom itself does not identify one cause. Notice whether it began with congestion, whether it improves as the cold settles, and whether fever, facial pressure, cough or breathing symptoms are present.

Rest, drink enough fluid to avoid dehydration, and use gentle measures that relieve congestion, such as saline nasal rinsing when suitable for you. Avoid inserting objects into the nose and avoid smoke or strong irritants. Follow local advice about testing for COVID-19 when relevant to your symptoms or recent exposure. Do not use decongestant sprays longer than the product directions allow.

Keep track of when your sense of smell returns. If nasal symptoms improve but smell remains reduced, arrange a GP review; the clinician can examine the nose and discuss sinus or allergy-related causes.

Seek urgent medical help for severe difficulty breathing, confusion, fainting, swelling of the face or throat, or a sudden severe headache. Arrange prompt medical advice for severe facial pain, swelling around an eye, a high or persistent fever, or symptoms that are worsening rather than easing. Book a routine review when loss of smell continues after the other cold symptoms have settled, keeps returning, or affects eating and safety.

Could nasal swelling, an allergy, sinusitis or a viral infection explain this change? Should I test for COVID-19? What signs would mean I need an examination or follow-up?