Laryngitis is the inflammation of the larynx, or voice box, which primarily results in hoarseness or a temporary loss of voice. A SARS-CoV-2 infection can cause laryngitis, as any respiratory virus can trigger inflammation in the upper airway. This inflammation causes the vocal cords to swell, leading to a change in voice quality.
How Frequently Does COVID-19 Cause Laryngitis
The frequency of laryngitis as a COVID-19 symptom has changed significantly as the virus has mutated. Early variants, such as Alpha and Delta, mainly caused lower respiratory tract issues, like severe cough and fever. Hoarseness was less common then. However, the emergence of the Omicron variant and its sublineages shifted the virus’s focus to the upper airways, leading to a notable rise in throat-related symptoms. This made laryngitis a much more prominent feature of the infection in later waves.
The mechanism behind this symptom is multi-faceted, starting with the direct inflammatory response to the virus in the upper respiratory tract. The SARS-CoV-2 virus attaches to specific receptors, called ACE2, which are present in the vocal folds and surrounding tissues. This attachment and subsequent viral replication can cause the vocal cords to become irritated and swollen, preventing them from vibrating normally to produce a clear sound.
A severe, persistent cough often accompanies a respiratory infection and further aggravates the delicate vocal cords. This forceful movement causes significant strain and inflammation, contributing to hoarseness. Some studies suggest that up to a quarter of people with a mild-to-moderate COVID-19 infection experience voice impairment. This prevalence is much higher than what was observed with the original strains of the virus.
Other Common Causes of Hoarseness and Voice Loss
While COVID-19 is a known cause, laryngitis is a non-specific symptom triggered by many different conditions and irritants. The most frequent cause of acute hoarseness is a common viral upper respiratory tract infection, such as the common cold or influenza. These viruses cause inflammation, leading to temporary vocal cord swelling.
Hoarseness may also be linked to non-infectious causes that irritate the larynx over time. Gastroesophageal reflux disease (GERD) can allow stomach acid to travel up the esophagus and irritate the vocal cords, sometimes called laryngopharyngeal reflux. Allergies can also cause postnasal drip, which constantly irritates the throat and voice box.
Excessive or improper use of the voice is another common reason for temporary voice loss. Activities like yelling, prolonged singing, or speaking at an unusual pitch can physically strain the vocal cords. Environmental factors, such as inhaling smoke, dust, or other chemical irritants, can also cause inflammation. If hoarseness persists for more than two weeks, it may indicate a more chronic issue unrelated to a temporary infection.
Relief Measures and When to Consult a Doctor
The primary goal of home care for laryngitis is to reduce inflammation and prevent further irritation of the vocal cords. The most important relief measure is complete vocal rest, which means speaking as little as possible, and avoiding whispering, which actually strains the vocal cords more than speaking softly. Staying well-hydrated by drinking plenty of fluids helps to keep the throat moist and thin any mucus.
Using a humidifier or inhaling steam from a hot shower introduces moisture into the air, soothing the irritated throat and vocal cords. Sucking on lozenges or gargling with warm salt water provides temporary relief from a sore or scratchy throat. Avoid decongestants, as they can dry out the throat. Also, refrain from drinking alcohol and caffeine, which can lead to dehydration.
Most cases of laryngitis resolve on their own within one to two weeks, but specific signs warrant medical attention. If hoarseness lasts longer than two weeks, consult a healthcare provider to rule out more serious underlying conditions. Seek immediate medical care if hoarseness is accompanied by:
- Severe difficulty breathing.
- Pain when swallowing.
- A persistent high fever.
- If a child begins to drool or makes a high-pitched, noisy sound when breathing.
If you suspect your laryngitis is part of a COVID-19 infection, take a home test to guide isolation and treatment decisions.