Voice changes, including hoarseness and even temporary loss of voice, are recognized symptoms that can occur with a COVID-19 infection. This article explores how COVID-19 can affect the voice, the range of vocal symptoms, why these changes vary among individuals, and guidance on recovery and when to seek medical advice.
How COVID-19 Affects the Voice
COVID-19 can lead to voice changes primarily through inflammation of the respiratory tract. The SARS-CoV-2 virus directly infects cells lining the upper airways, including the larynx, which houses the vocal cords. This infection causes the vocal cords to swell and stiffen.
When vocal cords become swollen, their flexibility is reduced, making it difficult for them to vibrate freely. This impaired vibration alters the sound of the voice, often resulting in hoarseness or a raspy quality. Frequent and forceful coughing common with COVID-19 further irritates the vocal cords, contributing to inflammation and potential trauma.
Post-nasal drip, another common symptom of respiratory infections like COVID-19, can also irritate the larynx and vocal cords. Mucus dripping down the back of the throat can cause additional inflammation and the need for frequent throat clearing, which further strains the voice. In some severe cases, patients who require mechanical ventilation with a breathing tube may experience direct trauma to the vocal cords and larynx, leading to voice problems. The virus may also affect the vagus nerve, which plays a role in vocal production, potentially leading to long-lasting vocal issues.
Related Vocal Symptoms
Beyond a complete loss of voice, COVID-19 can manifest in various other vocal symptoms. Hoarseness is a common presentation where the voice sounds rough, strained, or breathy. This occurs because inflamed vocal cords cannot come together or vibrate as effectively.
Speaking may also require more effort than usual. Vocal fatigue is another frequently reported symptom, causing the voice to tire quickly during conversation. This fatigue can lead to a reduced vocal range or difficulty projecting the voice. Throat pain, especially during vocal use, can accompany these changes due to the underlying inflammation of the larynx and surrounding tissues.
Why Voice Changes Vary
The extent and nature of voice changes with COVID-19 can differ significantly among individuals. One factor influencing this variability is the specific variant of the virus, as some variants, like Omicron, have been noted to more commonly affect the upper airways, leading to symptoms like laryngitis. Individual immune responses also play a role, with some people experiencing a more pronounced inflammatory reaction that impacts the vocal cords.
Pre-existing respiratory conditions, such as asthma or allergies, can make individuals more susceptible to vocal symptoms or worsen their severity. These conditions may already involve some degree of airway inflammation, which is then exacerbated by the viral infection. Smoking status can also increase the likelihood of developing laryngitis and voice problems, as smoking irritates the vocal cords. The overall severity of the COVID-19 infection itself can influence vocal changes, with more severe cases and those requiring hospitalization potentially leading to more pronounced or persistent voice issues.
Recovery and When to Seek Help
Voice changes associated with COVID-19 improve as other infection symptoms resolve. For many, hoarseness and other vocal issues begin to clear within a few days to two weeks. Resting the voice, avoiding shouting or whispering, and staying well-hydrated by drinking water can help in the recovery process. Using steam inhalations can also help soothe and moisturize the vocal cords.
If voice changes persist for more than two to three weeks after other COVID-19 symptoms have subsided, it is advisable to seek medical attention. Persistent hoarseness beyond this timeframe could indicate underlying issues that require professional evaluation. Red flags that warrant immediate medical consultation include severe throat pain, difficulty breathing, or problems swallowing. These symptoms might suggest a more serious condition or vocal cord damage that needs specialized care.