By this point in the long run of the pandemic, many people are familiar with the telltale symptoms of a Covid-19 infection: excruciating sore throat, terrible cough, congestion, fever, and whole-body exhaustion. But a small subgroup of people also experience less common symptoms, which can seem like curses from a children’s story: hairy tongue, purple toes, hives on the face.
“All infectious diseases have common and uncommon manifestations,” said Mark Mulligan, an infectious disease specialist at NYU Langone Health. And as we learn more about the coronavirus, he added, we’ll be able to better understand the underlying causes of these rare symptoms, but until then we will only have conjectures.
Confusing symptoms have been a component of Covid since the beginning of the pandemic; loss of taste and smell has become a disturbing indication of the disease. the covid it can also alter the menstrual cyclea side effect that some women also reported after vaccination.
A study of more than 60,000 people who tested positive for Covid and reported their symptoms revealed that a small percentage experienced ringing in the ears, eye pain, rashes, red bumps on the face or lips, hair loss, and aches and pains. unusual joints.
A broader analysis of more than 600,000 people in Great Britain showed that a proportion of those affected by COVID also had purple sores and blisters on the feet and numbness throughout the bodyamong other disorders.
Doctors don’t know for sure why only some people have these unusual symptoms. According to Mulligan, genetics could have a role; Vaccination status could also play a role, as an unvaccinated person could have a more severe infection, which could lead to a different set of symptoms.
Scientists have also discovered that the coronavirus can enter the bloodstream in a minority of people, he said, meaning the virus could enter various organs in the body and cause symptoms outside of the respiratory system.
Antiviral treatments such as Paxlovid can alleviate symptoms like Covid-related rashes, perhaps because they can reduce the amount of virus in the blood, said Kelly Gebo, an infectious disease specialist at Johns Hopkins Medicine. But it’s not clear if those symptoms are caused directly by the virus or by the body’s response to it.
Inflammation could also be one cause, according to Peter Chin-Hong, an infectious disease specialist at the University of California, San Francisco. If the virus enters the bloodstream and affects various parts of the body, immune cells target those areas, Chin-Hong said. That means that the ear, for example, which would not normally be affected by the virus, can become inflamed, not function as well, and potentially hurt.
Covid also leaves patients in a weakened state, he said, meaning pathogens that linger in their bodies from previous infections — such as herpes or the virus that causes shingles — can reactivate, causing rashes or cold sores. after covid.
A third theory is that stress that a Covid infection can bring – quarantine anxiety, loss of income, fear of long-term health implications – can also trigger symptoms such as hair loss and hivesChin Hong said.
All these symptoms, when associated with Covid, usually disappear in a matter of weeks, often without treatment, he added. And there are no set rules for how doctors should treat them, Gebo said. “We have clear guidelines on how to treat shortness of breath,” he said, “but we don’t have clear guidelines on these.”
Here’s what we know about the causes and possible treatments for some of these symptoms.
Healthy tongue cells renew rapidly, Chin-Hong said, but if old cells persist and build up on top of one another, a dark, thick, fuzzy overgrowth forms, often called a hairy tongue. Even before there was Covid, doctors were seeing patients with hairy tongues due to viral infections, smoking, antibiotic use, and poor hygiene. “It’s more common than people realize,” Chin-Hong said.
“I know people are very scared,” he added, but the condition is usually temporary. Some people can also feel burning mouth. Those with this symptom should not “frighten,” Chin-Hong said. People with hairy tongues can use a tongue scraper or toothbrush to remove those cells from their tongues and make sure they practice good oral hygiene to prevent further buildup.
In rare cases, people with Covid can also develop thrush, also known as oral candidiasis, which occurs when a fungus infects the mouth. They have been linked to suppression of the immune system or the use of antibiotics, according to Chin-Hong. Doctors usually diagnose oral thrush by examining the white lesions that can appear on the cheeks, tongue, or mouth; treatment is usually 10 to 14 days of an antifungal medication.
If a person’s skin suddenly tingles, it may be because their nerves are inflamed by immune cells that fight infection, Chin-Hong said. It’s also possible that the virus itself damages peripheral nerves, such as those to the hands and feet, Gebo said; this also happens with the herpes infection.
“What we don’t know is what is a direct impact of the virus itself or what is inflammation,” he said. “Those are things we’re trying to figure out.”
Researchers at Washington University in St. Louis found that people who tested positive for Covid were about three times more likely to report pain, tingling and numbness in their hands and feet than those who tested negative.
In many cases, the tingling sensation disappears in a matter of daysGebo said. If patients are in pain, she added, they should see their doctor, who may recommend taking acetaminophen or ibuprofen.
People with persistent nerve pain, even after recovering from the virus, should see their doctor, said Marc Sala, co-director of Northwestern Medicine’s Comprehensive COVID-19 Center.
Viruses are known to cause rashes, Sala said, noting that he has seen a wide variety of skin conditions in Covid patients. The Association of the American Academy of Dermatology cites hives, chickenpox-like blisters, rashes that form lacy patterns on the skin, and hives as possible Covid-related skin conditions. If a person develops a rash that persists after recovering from Covid, Sala recommends that they see a dermatologist.
Any kind of physical or emotional distress can cause our hair to fall out, said Shilpi Khetarpal, a dermatologist at the Cleveland Clinic. It’s not entirely clear whether the Covid infection itself or the stress related to it causes some people to experience hair loss, he said. If you are among those who lose some hair during or after a Covid infection, don’t panic, he said: “It’s not permanent; the hair comes back. It just takes time.”
Scientists remain uncertain about the cause of “Covid finger,” the frostbite-like rash and blisters that form on the feet and toes of some people after becoming infected and cause the toes and tips of the fingers of the hand to swell and turn purple. One theory is that people with Covid may have microvascular clotswhich are produced in the smallest blood vessels in the body and block the blood supply, causing the discoloration, Sala said.
Patients who develop Covid toes usually do so during the acute phase of the infection, he added, with symptoms tending to disappear soon after. The Association of the American Academy of Dermatology recommends using a hydrocortisone cream to treat them. Like most of the weird symptoms of Covid, the swelling, as disconcerting as it is, usually goes away on its own…for reasons doctors don’t fully understand.
“We’re still learning about Covid,” Mulligan said. “We don’t understand everything.”
The New York Times. Especial
Translation: Elisa Carnelli