COVID-19 is a viral illness recognized for its diverse range of symptoms affecting various bodily systems. Beyond the commonly known respiratory and systemic issues, the virus can indeed manifest in the oral cavity, specifically impacting the tongue. These oral changes can be an indicator of the infection, sometimes appearing alongside or even before other more typical symptoms.
Manifestations of COVID-19 on the Tongue
COVID-19 can affect the tongue in several distinct ways, leading to what has been termed “COVID tongue.” Individuals might observe their tongue appearing swollen or inflamed, a condition known as glossitis or macroglossia. This swelling can sometimes be accompanied by visible bumps or open sores called ulcers, which may develop on the tongue’s surface. The tongue might also take on a white and patchy appearance, or it could look unusually red.
Beyond visual changes, sensory alterations are also common. Many people report a complete loss of taste, medically termed ageusia, or an altered sense of taste, known as dysgeusia. This means that foods might taste bland, different from usual, or even unpleasant. A persistent burning sensation in the mouth is another reported symptom.
The tongue’s surface might also feel rough or bumpy, and deep grooves or fissures can appear. In some instances, the tongue may develop smooth, red, patchy surfaces, similar to a condition called geographic tongue.
Mechanisms Behind Tongue Changes
The scientific reasons behind these tongue manifestations involve how the SARS-CoV-2 virus interacts with human cells. The virus primarily gains entry into host cells through a protein known as the Angiotensin-converting enzyme 2, or ACE2 receptor. These ACE2 receptors are present in various tissues throughout the body, with particularly high concentrations found on the epithelial cells of the tongue and in salivary glands. This makes the oral cavity, especially the tongue, a susceptible site for viral infection and replication.
Once the virus binds to these receptors, it can directly infect the cells, leading to localized inflammation and damage within the tongue tissue. Beyond direct viral action, the body’s systemic inflammatory response to the infection also contributes to these symptoms. An overactive immune response can cause widespread inflammation, including swelling of the tongue. Reduced saliva production, known as xerostomia, can also occur, which impacts oral health and can worsen tongue discomfort. While the exact mechanism for taste alteration is still being investigated, direct effects on taste buds or damage to peripheral nerves are considered likely causes.
When to Seek Medical Advice
If you notice unusual changes to your tongue, such as swelling, persistent pain, or difficulty eating or speaking, it is advisable to consult a healthcare professional. While these symptoms can be associated with COVID-19, they can also be caused by other conditions. It is particularly important to seek immediate medical attention if tongue swelling is severe enough to potentially block your airway.
Even if tongue symptoms are mild, it is recommended to get tested for COVID-19, especially if you have other common symptoms like fever, cough, or shortness of breath. Persistent tongue symptoms after recovery from other COVID-19 signs also warrant a doctor’s visit to ensure appropriate management.