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Although COVID-19 cases are starting to decline in the United States, millions of people are still battling the virus – and are struggling to sift through their symptoms in the process. In recent months, the Centers for Disease Control and Prevention has added new symptoms to its information page, including loss of smell / taste and congestion. But now anecdotal reports have kicked off a new one, which has earned the nickname the ‘COVID language’.
Reports, many posted on Facebook, describe symptoms such as a swollen tongue, one with a scalloped appearance, or a “hairy surface” of the tongue. Still, COVID-19 experts say it’s too early to link them. So what is really going on? Here’s what you need to know.
Some patients on social media say they have felt linguistic reactions
In the COVID-19 Survivor Corps Facebook group, a grassroots organization of COVID-19 patients, many shared oral symptoms that they said coincided with their positive test for the coronavirus. Carol Van Der Spuy, head of marketing in Cape Town, South Africa, said she noticed the symptoms when she tested positive for COVID-19 a second time. “I had big patches on [my tongue] that were a different color, ”she said. “It almost looks like he’s been ‘burnt clean’.”
New Yorker Martha Barrera says she developed symptoms two weeks after receiving COVID-19 in March. “My tongue swelled up,” she tells Yahoo Life. “It was painful and so sensitive and I couldn’t tolerate anything cold or hot. It was also white … no matter how many times I brushed it, the color was different. The doctor didn’t know what to do, so he prescribed thrush medication for three weeks. Ten months later, my tongue suddenly swells. I still have problems. “
There has been little research to suggest symptoms are linked to COVID-19
Two small studies analyzed COVID-19 and oral symptoms, neither conclusive. One is from researchers at La Paz Hospital in Madrid, who examined the records of more than 600 patients with COVID-19 and found that 25% of them had some type of tongue reaction. “We found changes in the language that until then had not been linked to Covid,” Dr Almudena Nuño González said in a press release. “The tongue is enlarged, it looks swollen, the teeth marks are visible and… with small gashes in the back where the taste buds are flattened.
Another report was published in The Egyptian Journal of Otolaryngology in mid-January, but contained less detail on potential symptoms. In it, the researchers simply said that the symptoms shouldn’t be overlooked. “It is crucial for ENT [ear, nose and throat] physicians must have a high index of suspicion to identify these COVID 19 patients with atypical presentations, ”the authors write.
US experts say they haven’t seen the reaction
According to several experts who spoke with Yahoo Life, there is not enough evidence at this point to link tongue symptoms to COVID-19. Experts at the Mount Sinai Health System Post-COVID Care Center – the first recovery center for survivors in the United States – have not seen a “single case” involving the COVID tongue among the “thousands of patients” treated.
Doctors at Ohio State University’s Wexner Medical Center agreed, saying tongue reactions are also not a disease they treat. “I can’t say I’ve encountered anything like this, and it’s not something we’ve discussed as a group,” says Dr. Jeffrey Horowitz, professor of medicine and director of the pulmonary division, intensive care and sleep medicine.
Otolaryngologist says symptoms could be unrelated
Dr Nina Shapiro, director of pediatric ear, nose and throat at UCLA Mattel Children’s Hospital and professor at UCLA’s David Geffen School of Medicine, says none of the symptoms described in studies are not uncommon, which means they could arise for other reasons. “Have any of these people [these symptoms] anyway, and because they’re so closely followed, they find it? she asks. “It’s hard to know.”
She notes that oral symptoms can be caused by things like a cold or other illnesses, as well as reactions to certain drugs that weaken the immune system, like steroids. Dexamethasone, a corticosteroid, has been identified as an “effective” treatment for COVID-19.
The symptoms themselves are less mysterious than they seem
Shapiro breaks down exactly what goes into the strange descriptions of the studies. “Some of these photos [in the studies] look like what’s called ‘geographic tongue’, which makes the tongue look like a map with small islands and a whitish discoloration, ”she says. “It has been linked to colds and other types of illnesses, but it is not a worrying condition in itself.” The Mayo Clinic describes geographic tongue as “an inflammatory but harmless condition affecting the surface of your tongue.”
Sores or other injuries on the tongue can be a sign of another infection, she says. “Tongue lesions such as ulcers can be associated with viral disease,” she says. “It could be due to a secondary viral infection, like herpes, or to other types of viruses that develop in the mouth and throat like the Coxsackiev virus. So there could certainly be a viral association.
A woolly-looking tongue, Shapiro says, is probably candida. “Hairy tongue, where it almost looks like a small, long-haired rug, is usually just a fungal infection,” she says. “If your immune system is weakened for some reason – which could just be due to the stress itself or some of the treatments they use – then you can develop secondary infections such as candida in the mouth.
And what about the scalloped look? Also nothing to worry about. “Some irregularities in the edges of the tongue could be from a lot of things,” she says. “Many patients described [in the studies] had pneumonia and therefore may have been intubated or on oxygen and severely dehydrated or congested. “
Overall, Shapiro says, oral problems are usually secondary and not the “primary problem.” They are also probably not related to the loss of smell and taste, which comes from the olfactory nerves. So aside from antifungal drugs or other targeted drugs, she says, the best way to treat them is to get rid of the underlying infection. “They should resolve themselves as the disease subsides.”
For the latest news and updates on the coronavirus, follow to https://news.yahoo.com/coronavirus. According to experts, people over 60 and those with compromised immune systems continue to be at greatest risk. If you have any questions, please consult the CDC and WHO resource guides.
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