Tongue sores, or oral lesions, have been reported as a symptom in individuals with COVID-19. This article explores the relationship between COVID-19 and tongue sores, along with other common causes of oral discomfort.
COVID-19 and Oral Manifestations
Research indicates that tongue sores, often called “COVID tongue,” can be a symptom in some COVID-19 patients. These oral issues may appear as swollen or sore tongues, inflammation (glossitis), or painful ulcers resembling canker sores (aphthous ulcers). Other reported oral symptoms include dry mouth (xerostomia) and changes in taste (dysgeusia). Dry mouth is frequently an early indicator, sometimes appearing before other symptoms, and can weaken the oral cavity’s defenses.
Oral manifestations vary; some studies suggest oral symptoms, including lesions, were present in a significant percentage of hospitalized COVID-19 patients. For instance, one study found oral symptoms in approximately 25.7% of patients, while another review reported dry mouth in over 40% of cases. Aphthous ulcers linked to COVID-19 tend to occur in younger patients with mild symptoms, sometimes appearing concurrently with or slightly preceding systemic manifestations. The duration of “COVID tongue” can range from a few days to several months or longer.
Understanding the Connection
Oral symptoms in COVID-19 patients stem from several biological mechanisms. The SARS-CoV-2 virus interacts with ACE2 receptors found in oral tissues, including the tongue and salivary glands. This interaction can decrease saliva production, contributing to dry mouth and making the oral environment more susceptible to irritation and lesions.
Systemic inflammation, a hallmark of COVID-19, also plays a role. The body’s immune response to the virus can trigger an inflammatory cascade affecting various tissues, including those in the mouth. This heightened inflammatory state can contribute to the development of ulcers and other oral lesions. Viral damage, an overactive immune response, or effects on blood vessels may also contribute to these oral changes. Secondary factors, such as stress or medication side effects used to treat COVID-19, might also influence oral manifestations.
Common Causes of Tongue Sores
Many factors beyond COVID-19 can cause tongue sores. One frequent cause is aphthous ulcers, commonly known as canker sores, which are shallow, round lesions with a red border. These can result from minor trauma, such as accidentally biting the tongue, or from irritation caused by dental appliances.
Oral thrush, a fungal infection caused by Candida albicans, can also present as white patches and sores on the tongue. Nutritional deficiencies, particularly those involving B vitamins like B12, folate, or iron, are known to cause tongue inflammation and soreness. Allergic reactions to certain foods, dental products, or medications can also trigger oral lesions. Other infections, including herpes simplex virus, can lead to painful sores on the tongue and other parts of the mouth.
When to Seek Medical Attention
If you experience persistent tongue sores, especially with other symptoms, consult a healthcare professional. Medical attention is warranted if sores are severely painful, interfere with eating or drinking, or do not heal within one to two weeks. Recurring sores, or those accompanied by fever or other concerning systemic symptoms, also necessitate medical evaluation. Consultation is important if an underlying condition is suspected or if oral discomfort impacts quality of life.