We are now in our third winter of pandemics. Most people are familiar with this.Signs of COVID-19. This disease can present in many forms, including difficulty breathing, chills, and cough. This illness can sometimes look quite bizarre.
Rarely, SARS-CoV-2 can rear its ugly head in parts of the body not normally affected by respiratory viruses. Doctors have seen many bizarre cases, from head to COVID foot. Patchy tongues, puffy digits, hair loss — such issues can be worrisome for patients, says Peter Chin-Hong, an infectious diseases physician at the University of California, San Francisco.
But the outlook doesn’t have to be. That’s because such symptoms can end up going away on their own, says Chin-Hong, who has treated hundreds of people with COVID-19.
Nobody knows how often. COVID tongue, COVID toe, COVID eye or other rare conditions occur — and it’s not always clear that COVID-19 is the actual culprit. However, there are still some good reasons to believe that COVID-19 is the culprit. Coronavirus infections are staggering in scaleSARS-CoV-2 was given many chances to showcase its talents (SN: 9/8/22). The United States is closing in now 98 million confirmed cases. Such a staggering case count means that “statistically speaking, you’re going to find people with more and more weird things,” Chin-Hong says.
For information about possible treatments and how long symptoms might last, doctors rely on medical cases. Chin-Hong states that even knowing someone has experienced tender toes or splotchy lips can help. That lets him tell his patients, “You’re not the only one,” he says. “That means a lot to a lot of people.”
Saira Chaughtai, an internal medicine doctor, published a study in October in The Journal of Medical Case ReportsAfter a patient in her primary care came in with a new symptom, Chaughtai was able to diagnose the patient. Ten days after testing positive for COVID-19, the patient’s The tongue started to swellEventually, it will erupt as white-ringed lesions.
Certain spots looked “denuded,” says Chaughtai, of Hackensack Meridian Health in Neptune, N.J. It was as if some of the tongue’s surface bumps had been sandpapered away. The patient wasn’t someone doctors would typically consider vulnerable, either. She was healthy and fit at 30 years of age.
“I was like, ‘Oh my god, COVID can do anything,’” Chaughtai remembers thinking.
Oral sores can look different among patients. Chin-Hong has seen people with tongues coated white, as if they’d chewed a mouthful of tortilla chips. For Chaughtai’s patient, COVID tongue felt sensitive and irritated, with flare-ups that burned. Chaughtai wasn’t sure how to treat it.
She reviewed the scientific literature to find a variety of mouthwashes that worked. But six months in, the patient’s tongue hadn’t fully healed. Chaughtai came up with a solution. She teamed up with a sports medicine doctor, who beamed low-level laser light at the patient’s tongue. He was familiar with photobiomodulation therapy for muscle injuries.
Chaughtai states that laser light therapy dilates blood vessels, increasing blood flow to the areas being treated. This could encourage healing. It seemed to work well for her patient. Flare-ups stopped and the tongue lesions started to heal. Although the woman may still feel some tongue sensitiveness when she is stressed, it is not as severe as her first outbreak.
COVID’s effects on the skin
About 1,300 kilometers west, a podiatrist in Crown Point, Ind., also dilated a patient’s blood vessels to treat a curious coronavirus condition: COVID toe. After infection with SARS-CoV-2, patients’ fingers and toes can plump up, sometimes painfully, and turn pink or reddish purple.
“We were seeing cases of these lesions that look like chilblains, which is something you get when you’re exposed to cold weather,” says Michael Nirenberg of Friendly Foot Care. But his patients hadn’t been in the cold — they’d been exposed to the coronavirus.
Nirenberg has seen as many as 40 people with the symptom, which he’s found tends to clear up in a month or two. But one of his patients, a 59-year-old man, just couldn’t kick COVID toe. It ultimately lingered for nearly 670 days — the longest documented case Nirenberg has seen. “The term we used was long COVID toe,” he says. Nirenberg, along with colleagues, reported the case this spring to the Journal of Cutaneous Pathology.
Nirenberg recommended daily application of a Nitroglycerin ointment for blood flow. That may have helped, Nirenberg says, “but I don’t know if time also did the trick.” After 22 months, the condition may have finally resolved on its own.
The number of COVID toes Nirenberg encounters these days has gone down, but he’s still seeing people come in with the condition. Chaughtai has never treated another COVID tongue case, but a man emailed her recently to say that he’d suffered from the same condition for two years.
UCSF’s Chin-Hong says he thinks it’s important for people to know that COVID-19 can cause such There are many symptoms (SN: 11/11/22). “We can’t really predict who’s going to get what,” he says. But in his experience, strange symptoms have tended to crop up more often in people who haven’t been vaccinated.
These symptoms might not be as severe as COVID-affected hearts and lungs, but they can look very scary, Chin Hong states. “If this is a reason why some people might get vaccinated,” he says, “I think that would be great.”
