Should you be examining your tongue? Here’s how to tell if it’s COVID tongue and how to treat it.

By  Korin Miller September 22, 2023; Medically reviewed by  Michael Menna, DO HEALTH

You may have heard of COVID-19 causing loss of taste and smell, COVID toes, and unusual skin rashes, but did you know COVID can affect your tongue, too? In fact, people have been reporting tongue symptoms like bumps, inflammation, and swelling since the pandemic started in 2020.¹

This article contains sensitive medical imagery.

The tongue can become red and swollen, lesions can appear, and a white coating can develop. Sometimes COVID can also cause loss of papillae, making your tongue look smooth.² Papillae are projections on the surface of your tongue that house your tastebuds.

While COVID tongue isn’t extremely common, it can happen. Here’s what to know about why it happens and how to treat it.

Prevalence of COVID Tongue

Although the Centers for Disease Control and Prevention (CDC) and other health organizations do not list COVID tongue among COVID symptoms, tongue manifestations are not uncommon. Scientific research has reported multiple instances of people getting COVID tongue and other mouth symptoms.

COVID tongue and other mouth symptoms have been known since early on in the pandemic. For example, a 2020 study from Spain found more than 25% of COVID patients had oral symptoms, including inflammation of the papillae and overall redness and swelling of the tongue. It was common for those patients also to say they felt a burning sensation in their mouth and a loss of taste.¹

 Sore Throat Can Be a Symptom of COVID-19

Research from 2022, however, found COVID manifestations on the tongue and in the mouth to be slightly less common. Estimates of how common oral manifestations are range from 15.4% to 20.5% of people with COVID. Oral manifestations include tongue swelling as well as other lesions, ulcers, and swelling in the mouth.³⁴

COVID tongue isn’t extremely common, but it can happen, and the chances of you getting it may be related to how severe the disease is. People who have a severe case of COVID are more likely to get oral manifestations, like COVID tongue.³

Causes of COVID Tongue

The mouth is one of the main entryways into the body for SARS-CoV-2—the virus that causes COVID.⁵

Once inside the mouth and airway, the virus encounters the body’s receptors for angiotensin-converting enzyme (ACE). This enzyme has been implicated in high blood pressure and other cardiovascular disorders.²

Your tongue has a lot of these receptors, and SARS-CoV-2 causes them to become inflamed. This can lead to tongue swelling and other symptoms. Your salivary glands and the lining of your mouth also have a lot of these receptors and can show signs of COVID as well.²

You may not necessarily have COVID just because your tongue is bumpy or swollen, however. Other viruses can also cause tongue swelling (known as glossitis).⁶

Glossitis can present the same way as COVID tongue: A person might have a sore or swollen tongue, or their tongue could appear pale or bright red. The condition could also appear due to conditions such as allergic reactions (e.g., to oral care products or food), mouth-related skin conditions, mouth injuries, hormones, or some vitamin deficiencies.⁶

You’ll want to pay attention if you have any additional COVID symptoms to determine if COVID is the true culprit of your tongue inflammation.

Treatments

There aren’t any treatments to alleviate COVID tongue specifically. However, because COVID tongue symptoms include swelling and inflammation, it’s possible that any remedies that help with tongue swelling can help with an instance of COVID tongue.

Remedies for reducing tongue swelling include:⁶

• Avoiding foods or other substances (e.g., tobacco) that could cause tongue irritation
• Maintaining good oral hygiene (e.g., brushing at least twice per day and flossing at least once per day)
• Making any diet changes or utilizing supplements for nutritional issues
• Taking antibiotics or other medications for infections

If your tongue is very swollen, that could indicate a severe allergic reaction, which would require an immediate visit to the hospital.⁶

Additionally, tongue swelling and inflammation related to having COVID would also likely go away with treatment of COVID itself. Therefore, following the CDC’s guidelines for what to do when you get sick from COVID—such as getting rest, staying hydrated, and taking over-the-counter (OTC) medications—may be helpful.⁷

When To See a Healthcare Provider

If you get it, COVID tongue is unlikely going to be your only symptom of COVID. You’ll most likely have other symptoms along with it.

Also, if your tongue feels or looks unusual, it could be a sign that you have another type of virus—or that you just ate something that irritated you, Thomas Russo, MD, professor and chief of infectious disease at the University at Buffalo in New York, told Health.

“All of these oral and mucocutaneous manifestations tend to be nonspecific,” said Dr. Russo. They don’t point specifically to what’s causing them.

While Dr. Russo noted that tongue symptoms “could increase your suspicion for coronavirus infection, it’s likely that other symptoms would trigger that diagnostic pathway.”

COVID symptoms you may want to look out for that could accompany a swollen tongue include:⁸

• Cough
• Diarrhea
• Fatigue
• Fever or chills
• Headache
• Loss of taste or smell
• Muscle or body aches
• Nasal congestion or runny nose
• Nausea or vomiting
• Shortness of breath
• Sore throat

The bottom line is that you don’t want to ignore bumps or inflammation of your tongue—but don’t panic if you develop one of these symptoms, either. Get checked out by a healthcare provider or tested for COVID to find out what’s causing your symptoms.

A Quick Review

COVID tongue isn’t the most common symptom of COVID, but it can happen. As a result of the virus infecting certain receptors found in plenty on the tongue, this organ can develop bumps and become swollen.

A swollen tongue and other mouth symptoms are more common in people with severe cases of COVID. However, tongue swelling can have a number of other causes including viruses and allergic reactions. Unless you have other accompanying symptoms of COVID, your swollen tongue could be caused by something else.

Try remedies like avoiding irritating substances to reduce general tongue swelling. Treating any underlying disease can also make symptoms go away. Contact a healthcare provider to find out the exact cause of bumps on your tongue or swelling.