COVID-19 Symptom: Tongue Sores and Changes

• “COVID tongue” is an uncommon, but known symptom of COVID
• The duration of “COVID tongue” can vary widely, from a few days to several months or longer
• Treatment options may be available to help alleviate symptoms and speed up recovery
• Medical researchers are unsure of how COVID causes symptoms of the tongue and mouth

A “COVID-19 tongue” is a symptom that some people with Omicron and other variants of COVID-19 experience. Small studies have mentioned oral symptoms, such as lesions on the tongue. However, the symptom has not been mentioned by larger medical organizations such as The National Health Service (NHS), the US Centers for Disease Control and Prevention (CDC) or the World Health Organization (WHO). 

"COVID-19 tongue" can look different from person to person and seem similar to other tongue and mouth conditions.

Studies suggest that a “COVID tongue” is one of the possible symptoms of an infection with the coronavirus. A study in Spain found people reporting tongue ulcers, swelling, and other oral problems. 1 These symptoms of the tongue and the mouth usually go together with other, more frequent symptoms of the coronavirus and can look different in each person. 

The most common “COVID tongue” symptoms are: 2 3 4 5

• Swollen or sore tongue 
• Inflammation of the tongue with indentations on the sides of the tongue
• Painful ulcers that can develop on the mouth's soft tissues or at the base of your gums and may look like bumps on the back of the tongue
• White patches on the tongue
• Burning sensation of the tongue
• Taste disturbances
• A “furry coating” on the tongue

A “COVID tongue” can be painful for the patient experiencing it. 6

“COVID tongue” is a relatively new and unusual symptom of COVID-19. Though the exact causes of this symptom remain unclear, researchers have proposed a few possible explanations.

One theory is that the cells of the tongue and the inner lining of the mouth have a high number of so-called “ACE2 receptors,” a certain type of protein, in their cell wall. The coronavirus can connect to this protein and enter the cells this way. Your immune system’s reaction to the virus causes inflammation. 

Another possible explanation is that the COVID virus weakens the body’s immune response. The immune system plays a critical role in fighting off viral infections. It’s possible that in this weakened state, new viruses, bacteria or fungi that impact the tongue may be given an opportunity to infect the body, leading to the development of these oral symptoms. 7

Further research is still necessary to know more about the symptoms of the tongue that occur with a COVID infection, but usually the symptoms go away once your infection has cleared. In some cases, a “COVID tongue” can persist and treatment may be necessary. 

Symptoms of “COVID tongue” may not develop until days or weeks after the onset of the disease. In rare cases, the symptom can resolve itself and then flare up again over several months. 8

Several viruses can affect the tongue and may cause blisters and ulcers. These lesions may be mistaken for the aphthous lesions caused by COVID-19. General illness, an impairment of the immune system, or treatment with certain medications or chemotherapy can cause you to be more susceptible to these viruses. 3 9

COVID patients frequently present tongue indentations. However, it’s essential to know that many people have an anatomical tongue variation that can cause the same type of indentations. Besides that, teeth grinding can also cause indentations on the sides of the tongue.

A “COVID tongue” usually doesn’t need any specific treatment apart from the treatment for COVID which you may need. The signs of COVID usually go away on their own, although in some cases the symptoms can persist. 

In some reported cases, mouthwash fortified with antivirals, antifungals, antibiotics, anesthetics, or steroids has been used to treat “COVID tongue”. Laser therapy is another treatment option. 

Home remedies used to treat COVID-19 include: 10

• Multivitamins
• Multiminerals
• Improved diet and lifestyle

“Covid tongue” is an uncommon symptom of COVID-19, and it’s still not fully understood by the larger medical community. A “COVID tongue” can come in many forms, such as indentations, swelling of the tongue, mouth ulcers or a patchy pattern on the tongue. More research is needed to fully understand the underlying causes of this symptom and the best treatments for it. In the meantime, you need to be aware of this symptom and seek medical attention if needed. 

Q: Does “COVID tongue” go away? 

A: A “COVID tongue” usually goes away on its own, although it can also persist after COVID. If this is the case, then treatment is possible to get rid of these symptoms. 

Q: Is a tingling tongue a symptom of COVID?

A: A “COVID tongue” can present itself with a range of possible symptoms, including a tingling sensation or a numb tongue. 

Q: Can I have a white tongue with COVID? 

A: White plaques on the tongue are a possible symptom of a “COVID tongue”. It’s usually a sign of an overgrowth of one of the normal bacteria of the mouth. This overgrowth can emerge due to the reaction of the immune system to the coronavirus.

Q: Can “COVID tongue” symptoms come and go?

A: There are patients with “COVID tongue” who have flares over a period of months. That means the symptoms will repeat a cycle of seeming to clear, only to return again.

Q: Is “COVID tongue” thrush?

“COVID tongue” and thrush have a key difference in that thrush is caused by a fungal infection, and “COVID tongue” is a response to a virus.