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“Hairy tongue,” pins and needles and Covid toe are just a few unnerving yet real manifestations of the coronavirus.
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By Dani Blum
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By this point in the long slog of the pandemic, many people know the telltale symptoms of a Covid-19 infection: a ragged ache in your throat, a pernicious cough, congestion, fever and full-body exhaustion. But a tiny subset of people also develop less common symptoms, ones that can sound like hexes from a children’s story: hairy tongues, purple toes, welts that sprout on their faces.
“Every infectious disease has common and uncommon manifestations,” said Dr. Mark Mulligan, an infectious disease specialist at NYU Langone Health. And as we learn more about the coronavirus, he said, we may better understand the underlying causes behind these infrequent symptoms — but until then, it’s largely guesswork.
Confounding symptoms have been a component of Covid since the start of the pandemic — the loss of taste and smell has become a disturbing sign of the disease. Covid also has the potential to disrupt menstrual cycles, a side effect some women also reported after vaccination.
A study of over 60,000 people who tested positive for Covid and reported their symptoms found that a small percentage experienced ringing in their ears, sore eyes, rashes, red welts on their faces or lips, hair loss and unusual joint pains. A larger analysis of more than 600,000 people in Britain showed that a fraction of those with Covid also developed purple sores and blisters on their feet and numbness across their bodies, among other maladies.
Doctors aren’t sure why only some people develop these unusual symptoms. Genetics might play a role, Dr. Mulligan said; vaccination status could also have something to do with it, as an unvaccinated person might have a more severe infection, which could generate a different course of symptoms. Scientists have also found that the coronavirus can enter the bloodstream in a minority of people, he said, which means that it’s possible that the virus could enter various organs across the body and cause symptoms beyond the respiratory system.
Antiviral treatments like Paxlovid may potentially alleviate symptoms like a Covid-related rash, perhaps because they can reduce the amount of virus in your blood, said Dr. Kelly Gebo, an infectious disease specialist at Johns Hopkins Medicine. But it’s unclear whether these symptoms are directly caused by the virus, or by the body’s response to it.
Inflammation could also be a culprit, said Dr. Peter Chin-Hong, an infectious disease specialist at the University of California, San Francisco. If the virus gets into the bloodstream and impacts multiple parts of the body, immune cells flock to those areas, Dr. Chin-Hong said. That means an ear, for example, which the virus would typically not impact, may become inflamed, not function as well and potentially ache.
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Covid also leaves patients in a weakened state, he said, which means pathogens lingering around their bodies from previous infections — like herpes or the virus that causes shingles — can reactivate, causing rashes or cold sores in the wake of Covid.
A third theory is that the stress that can come with a Covid infection — the anxiety of quarantine, the loss of income, the fear of long-term health implications — can also trigger symptoms like hair loss and hives, Dr. Chin-Hong said.
Each of these symptoms, when associated with Covid, typically resolves in a matter of weeks, often without treatment, he added. And there aren’t set rules for how doctors treat them, said Dr. Gebo. “We have definitive guidelines on how to treat shortness of breath,” she said, “but we don’t have definitive guidelines on these.”
Here’s what else we know about the causes of — and potential treatments for — some of these symptoms.
Hairy tongue
Healthy tongue cells rapidly replace themselves, Dr. Chin-Hong said, but if older cells linger and build on top of one another, it forms a dark, thick, fuzzy overgrowth, often called hairy tongue. Even before Covid, doctors saw patients with hairy tongue related to viral infections, smoking, antibiotic use and poor hygiene, he said, adding, “It’s more common than people think.”
“I know it looks really scary to people,” he said, but the affliction is generally temporary. Some people may also feel a burning sensation inside their mouths. Those with this symptom shouldn’t be “freaked out,” Dr. Chin-Hong said. People with hairy tongue can use a tongue scraper or toothbrush to scratch away those tongue cells, and they can make sure to practice good oral hygiene to prevent additional buildup.
In rare cases, people with Covid may also develop thrush, otherwise known as oral candidiasis, which occurs when a fungus infects your mouth. It has been linked to a suppressed immune system or the use of antibiotics, Dr. Chin-Hong said. Doctors typically diagnose thrush by examining the white lesions that can sprout on your cheek, tongue or mouth; the treatment is usually 10 to 14 days of an antifungal medication.
Tingling nerves
When people develop the sensation of pins and needles on their skin, it may be because their nerves are inflamed by immune cells as they fight off infection, Dr. Chin-Hong said. It’s also possible that the virus itself could damage peripheral nerves, like those that go to your hands and feet, Dr. Gebo said; this also occurs with the shingles infection.
“What we don’t know is what’s a direct impact of the virus itself, or what’s inflammation,” she said. “These are things we’re trying to figure out.”
Researchers at Washington University in St. Louis found that people who tested positive for Covid were roughly three times as likely to report pain, tingling and numbness in their hands and feet than those with negative tests.
For many people, that tingling sensation goes away in a matter of days, Dr. Gebo said. If patients are in pain, she added, they should consult their doctors, who may recommend taking Tylenol or Motrin.
People with persistent nerve pain, even after they recover from the virus, should consult their doctors, said Dr. Marc Sala, co-director of the Northwestern Medicine Comprehensive Covid-19 Center.
Rashes
It’s well-established that viruses can induce rashes, Dr. Sala said, and he noted that he has seen a wide variety of skin afflictions in patients with Covid. The American Academy of Dermatology Association cites itchy bumps, chickenpox-like blisters, rashes that form lacy patterns on the skin and raised bumps as potential skin conditions linked to Covid. If you develop a rash that lingers after you recover from Covid, Dr. Sala recommends consulting a dermatologist.
Hair loss
Any type of physical or emotional distress can cause your hair to fall out, said Dr. Shilpi Khetarpal, a dermatologist at Cleveland Clinic. It’s not totally clear whether an infection with Covid itself, or the stress related to it, leads some people to experience hair loss, she said. If you find yourself among those who lose some hair during or after a Covid infection, don’t panic, she said, adding: “It’s not scarring — it comes back. It just needs time.”
Covid toe
Scientists are still conflicted about what causes “Covid toe,” the frostbite-like rash and blisters that form on some people’s feet and fingers after they become infected, causing toes and the tips of fingers to become swollen and purple. One theory is that people with Covid may experience microvascular clots, which occur in the smallest blood vessels in your body and block the blood supply, causing that discoloration, Dr. Sala said.
Patients who develop Covid toe usually do so during the acute phase of an infection, he added, and the symptoms tend to resolve soon after. The American Academy of Dermatology Association recommends using a hydrocortisone cream to treat it. Like most rare Covid symptoms, as unnerving as it might be, the swelling typically resolves on its own — for reasons doctors aren’t entirely sure of.
“We’re still learning about Covid,” Dr. Mulligan said. “We don’t understand everything.”
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FAQs
What do I do if my COVID symptoms are bad? ›
- you're feeling gradually more unwell or more breathless.
- you have difficulty breathing when you stand up or move around.
- you feel very weak, achy or tired.
- you're shaking or shivering.
- you've lost your appetite.
- Trouble breathing.
- Persistent pain or pressure in the chest.
- New confusion.
- Inability to wake or stay awake.
- Pale, gray, or blue-colored skin, lips, or nail beds, depending on skin tone.
You can treat symptoms with over-the-counter medicines, such as acetaminophen (Tylenol) or ibuprofen (Motrin, Advil), to help you feel better.
What is the first symptom of Omicron? ›All of the variants, including omicron BA.5, cause similar COVID-19 symptoms: runny nose. cough. sore throat.
What are the current symptoms of Omicron? ›BMJ: “Covid-19: Runny nose, headache, and fatigue are commonest symptoms of omicron, early data show.”
What to avoid if you have COVID? ›Avoid foods (e.g. snacks) that are high in salt and sugar. Limit your intake of soft drinks or sodas and other drinks that are high in sugar (e.g. fruit juices, fruit juice concentrates and syrups, flavoured milks and yogurt drinks).
What is the best medicine for COVID cough? ›Use medications containing guaifenesin, such as Robitussin, Mucinex, and Vicks 44E. keeping you from getting rest. Coughing is useful because it brings up mucus from the lungs and helps prevent bacterial infections. People with asthma and other lung diseases need to cough.
Is mucinex good for COVID? ›Managing Cough and Shortness of Breath
Over-the-counter medications used for upper respiratory infections may help alleviate symptoms. Those medications include guaifenesin (Mucinex), pseudoephedrine (Sudafed), and dextromethorphan (Robitussin, Delsym).
If you have a fever, muscle aches, cough, or other symptoms, you might have COVID-19. Most people with COVID-19 have only mild symptoms and can recover at home. If you have severe symptoms of COVID-19, including difficulty breathing, call 911 or visit your local emergency room immediately.
What is a COVID cough like? ›A dry cough is one of the most common coronavirus symptoms, but some people may have a cough with phlegm (thick mucus). It can be difficult to control your cough but there are a few ways to help.
What does COVID sore throat feel like? ›
Some people describe COVID sore throat as the most painful sore throat they've ever experienced. Others report a sore throat that isn't too different from one caused by a regular cold. Other COVID sore throat symptoms people notice include: Pain when swallowing or talking.
Should I take a decongestant if I have COVID-19? ›You may take an expectorant/cough suppressant combination as needed for cough and congestion. Take an antihistamine/decongestant combination for your allergy symptoms and congestion. If you have uncontrolled blood pressure, then you should avoid the decongestant component.
How long are you contagious after testing positive for Covid? ›You are most infectious (or contagious) in the first 5 days after your symptoms start. You can also spread COVID-19 in the 48 hours before your symptoms start. If you never have symptoms, consider yourself most infectious in the 5 days after you test positive.
When is COVID not contagious? ›Isolation should continue for at least 10 days after symptom onset (day 0 is the day symptoms appeared, and day 1 is the next full day thereafter). Some people with severe illness (e.g., requiring hospitalization, intensive care, or ventilation support) may remain infectious beyond 10 days.
What day of COVID is worst? ›Days 4–6: These are important days to be more aware of your symptoms. This is when lung (respiratory) symptoms may start to get worse, especially for older people and people who have other conditions like high blood pressure, obesity, asthma or diabetes. toes or fingers.
What medicine to take for omicron at home? ›For those without any underlying health issues, treating omicron is primarily supportive, similar to previous variants. Both Campbell and Johnson recommended using acetaminophen (Tylenol) when needed for symptoms that include headache, muscle aches or fever.
What are the symptoms of the new variant? ›Symptoms such as the temporary loss of taste and smell can still happen in some instances, but it has become less common with the Omicron variant and subvariants. Other symptoms may include fever, chills, fatigue, muscle or body aches, sore throat, nausea or vomiting and diarrhea.
What are the symptoms of Delta variant in adults? ›Delta variant symptoms are the same
Typically, vaccinated people are either asymptomatic or have very mild symptoms if they contract the delta variant. Their symptoms are more like those of a common cold, such as cough, fever or headache, with the addition of significant loss of smell.
Generally speaking, a healthy person infected with the delta variant can expect to need at least two weeks to recover from a mild illness to six weeks or more to recover from a more severe infection.
How do you test for omicron? ›“A PCR or laboratory-based molecular test is still the gold standard,” Hayden says. PCR tests are typically sent to a lab, which means it takes longer to get the results compared with off-the-shelf, rapid antigen tests that give you results in minutes.
What fruits are best for COVID? ›
Eat fruits and veggies
Fruits and vegetables, particularly citrus fruits and leafy greens, provide a steady stream of vitamins A and C, while nuts, seeds, and vegetable oils are rich in vitamin E, dairy products, eggs, and seafood are good sources for vitamin D.
- Grapes.
- Gooseberries (amla even dried or pickle)
- Oranges.
- Red bell pepper (Vit C + Antioxidants)
- Tangerines (Keenoo)
- Lemon.
- Limes (Mausambi)
- Broccoli.
Try to eat 75-100 grams of protein per day which is 10-14 ounces of a protein source. Good protein sources are: peanut or nut butters, milk, eggs, yogurt, cheese, meat/fish/poultry, protein shakes. Due to decreased appetite, now is not the time to restrict calories. Eat nutrient-dense foods.
Is Nyquil good for COVID? ›Many over-the-counter (OTC) medications can help relieve symptoms of the common cold, the flu, and COVID-19. However, these medications are not treatments for the viruses themselves. They don't work to kill the viruses that cause these infections.
What color is COVID phlegm? ›Green and cloudy: viral or bacterial infection
A lot of the symptoms of viral infections – fever, cough, headache, loss of smell – overlap for COVID-19 and other viral infections like the flu, respiratory syncytial virus and the common cold.
You may be able to get Paxlovid at your local pharmacy without needing to see a healthcare provider. You'll need to give recent health records, certain blood tests, and a medication list to your pharmacist to receive the medication this way. Paxlovid interacts with many common medications.
What home remedies can I use to treat COVID-19? ›- Keep a daily routine, such as taking a shower and getting dressed.
- Take breaks from COVID-19 news and social media.
- Eat healthy meals and drink plenty of fluids.
- Stay physically active.
- Get plenty of sleep.
- Avoid use of drugs, tobacco and alcohol.
For a runny nose: Take a Benadryl or another medication containing diphenhydramine which is a specific type of antihistamine. These medications block a chemical reaction in your body that can make the tissues in your nose swell and itch.
How to sleep with COVID? ›- Exercise and/or stay active. ...
- Reduce or cut out alcohol consumption. ...
- Turn off the screens. ...
- Do relaxing, soothing things just before bedtime. ...
- Get out of the bedroom. ...
- Avoid daytime naps. ...
- Try breathing exercises. ...
- Optimize your sleep environment.
Days 1 to 4: A high temperature and fever. You do not need to have a thermometer to know if you have a temperature – you feel hot, sweaty, tired. The temperature will come and go – sometimes it goes and you feel better, then it comes back.
What is the danger zone for COVID? ›
The risk of developing dangerous symptoms increases with age, with those who are age 85 and older are at the highest risk of serious symptoms. In the U.S., about 81% of deaths from the disease have been in people age 65 and older. Risks are even higher for older people when they have other health conditions.
Can COVID turn into bronchitis? ›Acute Bronchitis
But it can also be a symptom of COVID-19. Coronaviruses and other viruses that affect your respiratory system can cause bronchitis. This can sometimes lead to pneumonia, an infection of the tiny air sacs in your lungs.
In some people, COVID-19 causes more severe symptoms like high fever, severe cough, and shortness of breath, which often indicates pneumonia. A person may have mild symptoms for about one week, then worsen rapidly.
Can you get COVID twice? ›Reinfection with the virus that causes COVID-19 means a person was infected, recovered, and then later became infected again. After recovering from COVID-19, most individuals will have some protection from repeat infections. However, reinfections do occur after COVID-19.
How do you feel in early stages of COVID? ›a high temperature or shivering (chills) – a high temperature means you feel hot to touch on your chest or back (you do not need to measure your temperature) a new, continuous cough – this means coughing a lot for more than an hour, or 3 or more coughing episodes in 24 hours.
What is earliest symptom of COVID? ›Common Symptoms
The most common things people who become ill with COVID-19 have include: Fever or chills. A dry cough and shortness of breath.
They only work on bacterial infections. COVID-19 is caused by a virus, so antibiotics do not work. Antibiotics should not be used as a means of prevention or treatment of COVID-19. They should only be used as directed by a physician to treat a bacterial infection.
What can I do if my Covid symptoms are worse? ›If your symptoms get worse, call your healthcare provider immediately. stay hydrated. ahead of time and tell them that you have or may have COVID-19. that you have or may have COVID-19.
What is a good natural decongestant? ›Try rubbing diluted eucalyptus oil on the chest as a decongestant, or inhale eucalyptus or peppermint oil to clear stuffiness. Adding lavender, cedar, or lemon to steam may also soothe nasal passages. Inhaling menthol not only provides relief from nasal congestion, but might help inhibit infection as well.
Is runny nose sneezing a symptom of Covid? ›Common symptoms of COVID-19 include fever and/or chills, headache, muscle pain or body aches, feeling tired or weak, sore throat, runny or stuffy nose, sneezing, cough, shortness of breath or difficulty breathing, vomiting and diarrhea, and change in or loss of taste or smell.
What medications can I take to relieve the symptoms of COVID-19? ›
You can treat symptoms with over-the-counter medicines, such as acetaminophen (Tylenol) or ibuprofen (Motrin, Advil), to help you feel better.
Can you test negative for Covid and still be contagious? ›A negative result means it's likely you are not infectious. But a negative test is not a guarantee you do not have COVID-19 and there's still a chance you may be infectious. You should follow advice on how to avoid catching and spreading the virus.
How long do you have to quarantine with Covid? ›If you test positive or symptoms develop, isolate. If you test negative and have no symptoms, end quarantine or work exclusion after Day 5. If you don't test and have no symptoms, end quarantine or work exclusion after Day 10.
What is the best medicine for Covid cough? ›Use medications containing guaifenesin, such as Robitussin, Mucinex, and Vicks 44E. keeping you from getting rest. Coughing is useful because it brings up mucus from the lungs and helps prevent bacterial infections. People with asthma and other lung diseases need to cough.
When is Omicron most contagious? ›Your infectiousness is highest 1 day before the start of your symptoms and begins to wane about a week later for most people. The Omicron variant has a shorter incubation period, compared to other variants. For the Omicron variant, the incubation period is 1 to 4 days.
How long do Omicron symptoms last? ›How long do omicron symptoms last? Most people who test positive with any variant of COVID-19 typically experience some symptoms for a couple weeks. People who have long COVID-19 symptoms can experience health problems for four or more weeks after first being infected, according to the CDC.
What does COVID brain fog feel like? ›Brain fog—one of long COVID's most misunderstood symptoms—is a name that has gained more traction to refer to a range of neurological symptoms such as feeling slow, difficulty thinking or concentrating, confusion and forgetfulness.
What are the advanced symptoms of Covid-19? ›- Trouble breathing.
- Persistent chest pain or pressure.
- Inability to stay awake.
- New confusion.
- Pale, gray or blue-colored skin, lips or nail beds — depending on skin tone.
Chest pain is one of the most common symptoms you can get after having COVID. Lots of people get chest pain after COVID. Chest pain can be worrying but it is not normally a risk to your life. You could get chest pains after COVID due to other causes that might not be related to your COVID infection.
What are latest Covid-19 symptoms? ›Strain says that we now see mostly upper respiratory symptoms, fever, myalgia, fatigue, sneezing, sore throat, and cough.
When am I no longer contagious with COVID? ›
Everyone's immune response is different, and we can spread the virus for different amounts of time. Masking on days 6-10 helps reduce the risk that we will get others sick after recovering from COVID-19. Most people are no longer infectious after day 10.
When are you most contagious with COVID? ›When Is the Coronavirus the Most Contagious? Researchers estimate that people who get infected with the coronavirus can spread it to others 2 to 3 days before symptoms start and are most contagious 1 to 2 days before they feel sick.
How long do you test positive after COVID? ›After a positive test result, you may continue to test positive for some time after. You may continue to test positive on antigen tests for a few weeks after your initial positive. You may continue to test positive on NAATs for up to 90 days.
What is COVID diarrhea like? ›Diarrhea caused by COVID-19 tends to be more watery, yellow or green in color. It may be accompanied by cramping and bloating. If you have COVID-19, you will likely develop other symptoms within a day or two, such as fever, cough, congestion and/or loss of taste and smell.
Should you exercise with COVID? ›It's normal to feel tired, weak or short of breath when you are recovering from COVID-19. But being active can help your recovery if you take your time and set small goals. Do not worry if you feel more tired and have less energy than usual.
Does COVID affect your fingernails? ›A January 2022 review of studies about COVID-19 impacts on hair and nails published in the Journal of Cosmetic Dermatology found three documented cases of Beau's lines after COVID-19. In those three cases, the nails were affected after one month, two months, or a little over three months after COVID-19.
What are some symptoms of the new Delta variants of COVID? ›Typically, vaccinated people are either asymptomatic or have very mild symptoms if they contract the delta variant. Their symptoms are more like those of a common cold, such as cough, fever or headache, with the addition of significant loss of smell.
What variant of COVID do i have? ›When you receive a COVID-19 test, you won't find out which variant caused your infection. That's because COVID-19 tests only detect the presence of the virus – they don't determine the variant. Genomic sequencing looks at the genetic code of the virus to determine which variant caused the infection.