From COVID tongue to COVID toe, doctors have seen some bizarre cases<\/p>\n\n\n\n
By\u00a0Meghan Rosen<\/a>, 2022 Science News<\/p>\n\n\n\n As we head into our third pandemic winter, most people are all too familiar with the signs of COVID-19<\/a>. The disease wears many different faces and can show up as chills, cough, difficulty breathing or other troublesome jumbles of symptoms. But sometimes, this illness can look positively peculiar. <\/p>\n\n\n\n On rare occasions, SARS-CoV-2 rears its head in body parts not typically touched by respiratory viruses. From head to COVID toe, doctors have seen a bevy of bizarre cases. Patchy tongues, puffy digits, hair loss \u2014 such issues can be worrisome for patients, says Peter Chin-Hong, an infectious diseases physician at the University of California, San Francisco.<\/p>\n\n\n\n But the outlook doesn\u2019t have to be. That\u2019s because such symptoms can end up going away on their own, says Chin-Hong, who has treated hundreds of people with COVID-19.<\/p>\n\n\n\n No one knows exactly how often COVID tongue<\/a>, COVID toe<\/a>, COVID eye<\/a> or other rare conditions occur \u2014 and it\u2019s not always clear that COVID-19 is the actual culprit. Still, the sheer scale of coronavirus infections<\/a> means that SARS-CoV-2 has had many chances to show its stuff (SN: 9\/8\/22<\/em>). The United States is now closing in on 98 million confirmed cases<\/a>. Such a staggering case count means that \u201cstatistically speaking, you\u2019re going to find people with more and more weird things,\u201d Chin-Hong says.<\/p>\n\n\n\n Doctors rely on medical case reports for leads on potential treatments and hints about how long symptoms may last. Even just knowing that someone else has had splotchy mouth sores or tender toes can be helpful, Chin-Hong says. That lets him tell his patients, \u201cYou\u2019re not the only one,\u201d he says. \u201cThat means a lot to a lot of people.\u201d <\/p>\n\n\n\n Internal medicine doctor Saira Chaughtai published one such study in October in the Journal of Medical Case Reports<\/em> after one of her primary care patients came in with a symptom Chaughtai had never seen. Ten days after testing positive for COVID-19, the patient\u2019s tongue began to swell<\/a>, eventually erupting in white-ringed lesions.<\/p>\n\n\n\n Certain spots looked \u201cdenuded,\u201d says Chaughtai, of Hackensack Meridian Health in Neptune, N.J. It was as if some of the tongue\u2019s surface bumps had been sandpapered away. The patient wasn\u2019t someone doctors would typically consider vulnerable, either. She was 30 years old, fit and healthy.<\/p>\n\n\n\n \u201cI was like, \u2018Oh my god, COVID can do anything,\u2019\u201d Chaughtai remembers thinking. <\/p>\n\n\n\n Oral sores can look different among patients. Chin-Hong has seen people with tongues coated white, as if they\u2019d chewed a mouthful of tortilla chips. For Chaughtai\u2019s patient, COVID tongue felt sensitive and irritated, with flare-ups that burned. Chaughtai wasn\u2019t sure how to treat it. <\/p>\n\n\n\n She searched the scientific literature and prescribed an assortment of mouthwashes, which helped. But six months in, the patient\u2019s tongue hadn\u2019t fully healed. So Chaughtai got creative. She teamed up with a sports medicine doctor, who beamed low-level laser light at the patient\u2019s tongue. He had previously used this photobiomodulation therapy to treat muscle injuries.<\/p>\n\n\n\n Laser light therapy makes blood vessels dilate, enhancing blood flow to treated areas, which could promote healing, Chaughtai says. It seemed to work for her patient. The tongue lesions began to heal and flare-ups subsided. The woman still occasionally feels some tongue sensitivity when stressed, but never as bad as her initial outbreak.<\/p>\n\n\n\n About 1,300 kilometers west, a podiatrist in Crown Point, Ind., also dilated a patient\u2019s blood vessels to treat a curious coronavirus condition: COVID toe. After infection with SARS-CoV-2, patients\u2019 fingers and toes can plump up, sometimes painfully, and turn pink or reddish purple.<\/p>\n\n\n\n \u201cWe were seeing cases of these lesions that look like chilblains, which is something you get when you\u2019re exposed to cold weather,\u201d says Michael Nirenberg of Friendly Foot Care. But his patients hadn\u2019t been in the cold \u2014 they\u2019d been exposed to the coronavirus. <\/p>\n\n\n\n Nirenberg has seen as many as 40 people with the symptom, which he\u2019s found tends to clear up in a month or two. But one of his patients, a 59-year-old man, just couldn\u2019t kick COVID toe. It ultimately lingered for nearly 670 days \u2014 the longest documented case Nirenberg has seen. \u201cThe term we used was\u00a0long COVID toe<\/a>,\u201d he says. Nirenberg and colleagues reported the case this spring in the\u00a0Journal of Cutaneous Pathology<\/em>.\u00a0<\/p>\n\n\n\n Nirenberg prescribed daily application of a nitroglycerin ointment to boost blood flow to the toes. That may have helped, Nirenberg says, \u201cbut I don\u2019t know if time also did the trick.\u201d After 22 months, the condition may have finally resolved on its own. <\/p>\n\n\n\n The number of COVID toes Nirenberg encounters these days has gone down, but he\u2019s still seeing people come in with the condition. And though Chaughtai has not treated another case of COVID tongue, a man recently e-mailed her saying that he had suffered from a similar affliction for two years. <\/p>\n\n\n\nThe effects of COVID toe<\/h4>\n\n\n\n