Individuals with COVID-19 can experience oral manifestations, including sores. These oral symptoms can appear at different stages of the illness, sometimes before or concurrently with other common COVID-19 symptoms. The presence of such lesions highlights the wide range of effects the SARS-CoV-2 virus can have on the body.
Oral Sores and COVID-19 Presence
Oral sores have been observed in individuals with COVID-19, with varying prevalence. Some studies suggest that around 29% of patients may experience oral manifestations, with specific types of lesions appearing in a smaller percentage. These oral changes present in diverse forms, including small blisters, ulcers, and red or white patches.
Common locations for these sores include the tongue, inner cheeks, gums, and palate. Ulcers resembling canker sores (aphthous-like lesions) are reported, appearing as round or irregular shapes with a red border and a white or yellowish center. Other observed lesions include herpes-like eruptions, geographic tongue (characterized by irregular, red, smooth patches on the tongue), and plaque-like changes. While these manifestations can be painful, many tend to heal within about 10 days without leaving scars.
Underlying Causes of Oral Sores
Oral sores in COVID-19 can stem from several underlying mechanisms. One primary cause is the direct effect of the SARS-CoV-2 virus on oral tissues, through its interaction with ACE2 receptors found in the oral cavity, including on the tongue and in salivary glands. This allows the virus to enter and replicate within host cells, potentially leading to tissue damage and lesion formation.
The body’s immune response also plays a role, as the virus can trigger a significant inflammatory reaction, sometimes leading to a “cytokine storm” where excessive inflammatory mediators are released. This inflammation can contribute to tissue damage and ulcer formation within the mouth. Additionally, a compromised immune system due to COVID-19 or its treatments can lead to secondary infections, such as fungal infections like candidiasis, or the reactivation of latent viruses like herpes simplex, which manifest as oral sores. Factors like dehydration and medication side effects associated with severe illness can further contribute to oral discomfort and the development of lesions.
Managing Oral Discomfort at Home
Managing oral discomfort from mouth sores often involves home care strategies to alleviate pain and promote healing. Rinsing the mouth with a warm saltwater solution several times a day can help cleanse the area and reduce inflammation. A common recommendation is to dissolve about half a teaspoon of salt in a glass of warm water.
Maintaining good oral hygiene is also beneficial, including gentle brushing with a soft-bristled toothbrush to avoid further irritation. Avoid foods that might irritate the lesions, such as spicy, acidic, or very hot items. Staying well-hydrated by drinking plenty of water can help maintain oral moisture and overall comfort. Over-the-counter pain relievers, like acetaminophen or ibuprofen, can help manage discomfort, while topical gels specifically designed for oral sores can provide localized relief by creating a protective barrier or numbing the area.
When Professional Medical Care is Needed
While many oral sores associated with COVID-19 resolve with home care, certain signs warrant professional medical attention. Individuals should seek medical advice if the sores are severely painful and interfere with eating, drinking, or speaking. Persistent sores that do not improve after several days, or those spreading or worsening in size or number, also require evaluation.
If the oral sores are accompanied by a high fever, chills, or other systemic symptoms that are worsening, it is important to consult a healthcare provider. Any indication of a secondary infection, such as increased redness, swelling, pus, or a foul odor from the sores, necessitates prompt medical assessment. A healthcare professional can accurately diagnose the cause of the sores and recommend appropriate treatment, which may include prescription medications for severe cases or secondary infections.