The Impact of Olfactory Dysfunction on Social and Mental Health

An estimated one million Canadians have experienced olfactory dysfunction associated with COVID-19 in the past 18 months. Though typically short-lived, a substantial minority COVID-19 patients report long-lasting olfactory problems. Olfactory dysfunction is related to a range of social and emotional impairments, including elevated rates of depression, anxiety, social isolation, and relationship difficulties. Although these links are well documented, we know relatively little about why and how these problems are linked. Our first aim is to capitalize on this rare opportunity to examine the pathways linking olfactory loss to social and emotional problems. We will recruit adults online reporting recent onset of olfactory dysfunction and no other flu-like symptoms (N=300) as well as a control cohort (N=100). Participants will monitor their olfactory ability, social interactions, and mental health for 8 weeks, covering the typical period of olfactory recovery in COVID-19 patients. These data will provide a first-ever look at how within-person changes in olfaction relate to changes in social behavior and emotional wellbeing. Moreover, given that COVID-19 associated smell disorders are likely to exist for many years to come as this illness becomes endemic, mitigating the impacts of olfactory dysfunction is an emerging health priority. Our second aim is to develop a brief, scalable, online intervention to mitigate the emotional and social consequences of olfactory loss. We will conduct a randomized pilot trial on a subset of participants (n=100) who receive two tailored 3-week behavioral interventions focused on bolstering social support and mitigating social avoidance. Patient engagement and satisfaction will inform intervention refinement, with the eventual goal of offering the web modules freely and publicly. Our findings will inform future efforts to improve mental health for people with olfactory dysfunctions, including those dealing with sudden onset due to COVID-19.