We’ve been living through a global pandemic for almost two years. At this point, we all know that fever, cough, and the loss of taste and smell are possible signs of COVID. But as the research presses on and doctors continue to treat COVID patients, more symptoms have started to emerge. Some strange ones include COVID tongue, COVID nails, and even COVID toes.
The problem is, these symptoms are in sort of a “gray zone.” Meaning, not everyone experiences them, and other conditions could cause them. One of those gray zone symptoms is hoarseness, which has also been dubbed “COVID Voice.”
What Is COVID Voice?
According to Health, some COVID patients have reported developing a raspy voice while infected with the virus. Commonly known in medical circles as hoarseness, this raspy voice can sound breathy or strained. And it’s usually a sign that you have problems with your voice box, i.e. the vocal folds of your larynx.
Is There A Link Between COVID-19 And Hoarseness?
One small study published in the Journal of Voice in March 2021 concluded that it’s possible COVID-19 can lead to hoarseness.
In the study, 70 out of 160 COVID patients had dysphonia. Which is kind of a kitchen sink term for a voice disorder because it can cover everything from having trouble saying a word to not being able to talk at all.
69 of the patients had dysphonia that was rated mild to moderate. In 33 patients, the COVID voice symptom lasted for more than two weeks. For 11 study participants, the dysphonia lasted more than a month.
Another COVID study published in the Journal of Voice in June 2020 found that approximately 27% of participants had dysphonia. Researchers analyzed data from 702 mild to moderate COVID cases across 19 hospitals in Europe.
They found that 188 patients had dysphonia. The data also showed that women were more likely than men to develop that specific symptom.
“Dysphonia may be encountered in a quarter of patients with mild-to-moderate COVID-19 and should be considered as a symptom list of the infection,” the researchers wrote.
Hoarseness Is Common
Infectious disease expert Dr. Amesh A. Adalja—senior scholar at the Johns Hopkins Center for Health Security—warns that hoarseness is not unique to COVID. In fact, it’s quite a common symptom for respiratory viruses.
“This is not something specific to COVID-19 but a general complication of many upper respiratory infections,” Dr. Adalja told Health.
He explained that upper respiratory infections often cause a sore throat, which can inflame the vocal cords or cause a post-nasal drip. Both of which “can lead to changes in the voice.”
Dr. William Schaffner—infectious disease specialist and professor at the Vanderbilt University School of Medicine—points out to Health that one of the most common COVID symptoms, coughing, “can certainly also exacerbate the larynx and lead to hoarseness.” This is because coughing can cause inflammation that can make the vocal cords swollen and inflexible.
Yet another expert Dr. Omid Mehdizadeh, otolaryngologist and laryngologist at Providence Saint John’s Health Center, says that when coughing causes inflammation, it can definitely make you sound hoarse.
“Any type of inflammation in the vocal cords can cause hoarseness,” Dr. Mehdizadeh told Health.
What’s more, when severe COVID cases are treated with the steroid dexamethasone, that can cause acid reflux to develop. Dr. Mehdizadeh says that in general, steroids can cause acid reflux, which can irritate the throat and lead to hoarseness.
Because hoarseness can be caused by a number of different factors, it’s not considered an early sign that you have COVID.
“If you develop a hoarse voice, don’t assume it’s due to COVID unless you have other symptoms,” Dr. Schaffner advises.
The core COVID symptoms remain fever, cough, and shortness of breath. But with the Delta variant, the virus often presents more like a bad cold.
What To Do
If you develop hoarseness—but don’t have any pain, swelling, or shortness of breath—Dr. Mehdizadeh says the best course of action is to stay hydrated and rest your voice. Which means speaking softly and talking as little as possible.
“People tend to try to push through the hoarseness and that could potentially injure the vocal cords,” he says.
Dr. Joseph Khabbaza from the Cleveland Health Clinic also recommended to Health using cough drops, especially menthol ones. This is because they “numb the nerves of the cough receptors and make your trigger a little less sensitive.”
If the hoarseness persists more than two weeks—and there’s no obvious reason for it, like an upper respiratory tract infection—then it’s time to see your doctor for an evaluation. Untreated respiratory issues will only promote more coughing. And, it can cause more damage to your vocal cords. Some COVID patients have even developed asthma.
“If you’re feeling any symptoms of shortness of breath or other potential asthma symptoms post-illness, you need to be evaluated,” Dr. Khabbaza says. “If needed, you could be given an inhaler which minimizes coughing and lessens the strain on your vocal cords as they heal.”