{"doi":"10.1126/scitranslmed.add0484","title":"Persistent post–COVID-19 smell loss is associated with immune cell infiltration and altered gene expression in olfactory epithelium","abstract":"SARS-CoV-2 causes profound changes in the sense of smell, including total smell loss. Although these alterations are often transient, many patients with COVID-19 exhibit olfactory dysfunction that lasts months to years. Although animal and human autopsy studies have suggested mechanisms driving acute anosmia, it remains unclear how SARS-CoV-2 causes persistent smell loss in a subset of patients. To address this question, we analyzed olfactory epithelial samples collected from 24 biopsies, including from nine patients with objectively quantified long-term smell loss after COVID-19. This biopsy-based approach revealed a diffuse infiltrate of T cells expressing interferon-γ and a shift in myeloid cell population composition, including enrichment of CD207 + dendritic cells and depletion of anti-inflammatory M2 macrophages. Despite the absence of detectable SARS-CoV-2 RNA or protein, gene expression in the barrier supporting cells of the olfactory epithelium, termed sustentacular cells, appeared to reflect a response to ongoing inflammatory signaling, which was accompanied by a reduction in the number of olfactory sensory neurons relative to olfactory epithelial sustentacular cells. These findings indicate that T cell–mediated inflammation persists in the olfactory epithelium long after SARS-CoV-2 has been eliminated from the tissue, suggesting a mechanism for long-term post–COVID-19 smell loss.","journal":"Science Translational Medicine","year":2022,"id":232862,"datarank":0.0,"base_score":0.0,"endowment":0.0,"self_citation_contribution":0.0,"citation_network_contribution":0.0,"self_endowment_contribution":0.0,"citer_contribution":0.0,"corpus_percentile":null,"corpus_rank":null,"citation_count":160,"citer_count":0,"citers_with_citation_signal":0,"citers_with_endowment":0,"datacite_reuse_total":0,"is_dataset":false,"is_dataset_confidence":0.9508,"is_data_producer":false,"deposit_databanks":null,"is_oa":true,"file_count":0,"downloads":0,"has_version_chain":false,"published_date":"2022-01-01","fair_score":null,"fair_percentile":null,"algorithm_id":"datarank_citation_only_1hop_v6","ranking_scope":"data_only","authors":[{"id":231547,"name":"David H. Brann","orcid":"0000-0001-8844-8886","position":1,"is_corresponding":false},{"id":106316,"name":"Ralph Abi Hachem","orcid":"0009-0000-4007-8505","position":2,"is_corresponding":false},{"id":810297,"name":"David W. Jang","orcid":"0000-0003-4200-7174","position":3,"is_corresponding":false},{"id":810296,"name":"Allison D. Oliva","orcid":"0000-0002-8357-6552","position":4,"is_corresponding":false},{"id":844265,"name":"Tiffany Ko","orcid":"0000-0002-5006-6345","position":5,"is_corresponding":false},{"id":810298,"name":"Rupali Gupta","orcid":"0000-0003-0527-2200","position":6,"is_corresponding":false},{"id":844266,"name":"Sebastian A. Wellford","orcid":"0000-0002-2535-6893","position":7,"is_corresponding":false},{"id":257660,"name":"E. Ashley Moseman","orcid":"0000-0002-6064-6116","position":8,"is_corresponding":false},{"id":420695,"name":"Sophie S. Jang","orcid":"0000-0002-8074-5058","position":9,"is_corresponding":false},{"id":108270,"name":"Carol H. Yan","orcid":"0000-0003-1934-4922","position":10,"is_corresponding":false},{"id":106317,"name":"Hiroaki Matsunami","orcid":"0000-0002-8850-2608","position":11,"is_corresponding":false},{"id":106309,"name":"Tatsuya Tsukahara","orcid":"0000-0002-6928-8562","position":12,"is_corresponding":false},{"id":106321,"name":"Sandeep Robert Datta","orcid":"0000-0002-8068-3862","position":13,"is_corresponding":false},{"id":106319,"name":"Bradley J. Goldstein","orcid":"0000-0002-9612-1696","position":14,"is_corresponding":false},{"id":448832,"name":"John B. Finlay","orcid":"0000-0002-3038-1276","position":0,"is_corresponding":true}],"reference_count":54,"raw_metadata":null,"created_at":"2026-07-19T00:21:18.683916Z","pmid":"36542694","pmcid":null,"fwci":null,"citation_percentile":null,"influential_citations":0,"oa_status":null,"license":null,"views":0,"total_file_size_bytes":0,"version_count":0,"fair_f":null,"fair_a":null,"fair_i":null,"fair_r":null,"fair_zscore":null,"fair_rationale":null,"fair_model":null,"fair_agent_version":null,"fair_fulltext_source":null,"fair_has_llm":null,"fair_computed_at":null,"clinical_trials":[],"software_tools":[],"db_accessions":[],"linked_datasets":[],"topics":[]}