Severely Swollen Tongues Are Affecting Some COVID Patients

A handful of COVID-19 patients in U.S. hospitals have developed severely swollen tongues—and doctors are trying to understand why the condition, known as macroglossia, is occurring.

Dr. James Melville, from the University of Texas Health Science Center at Houston School of Dentistry (UTHealth), told KHOU 11 in a report published on Thursday that he knew of nine documented cases of macroglossia in COVID-19 patients in the United States. This is a tiny proportion of the 33 million COVID cases recorded in the U.S. since the start of the pandemic.

All nine patients had been intubated in hospital and eight of the individuals are Black. Two had suffered strokes while the other seven were hospitalized with COVID before developing a swollen tongue.

Melville said the condition made it impossible for people to eat normally and talk. He has conducted a number of operations to treat macroglossia patients and help them regain the use of their tongues.

Although it is not yet clear what the link is between the virus and the condition, Melville said inflammatory cells had been detected in the patients' tongues.

"I think it has a lot to do with where the virus is attaching itself and the body's immune response to it," Melville told KHOU 11.

One of the patients treated by Melville was Anthony Jones, from Lake City, Florida.

Jones had survived COVID-19 after spending more than a month in hospital. But his tongue remained massively swollen.

"The doctor was shaking his head and said he could do surgery, but he couldn't guarantee that Anthony would ever eat or talk again," his mother, Mary Ann Jones, told UTHealth News.

"Anthony started crying like he was giving up and I said, 'Don't worry baby, we will find someone to help you.' The look on his face after the doctor left hurt my heart so bad."

A specialist told the family the condition was called macroglossia and Mary Ann Jones began searching online for more information. She stumbled across a study published by Melville and contacted him in the hope that he could help.

Melville told UTHealth News that Jones's macroglossia was classified as massive.

"It is psychologically depressing because they are looked at as an oddity. They have to be on a feeding tube, a permanent tracheostomy for an airway, and there is an infection risk. The tongue completely dries out, so you have to wrap it to keep it moist so it doesn't crack and bleed," he said.

Melville performed a procedure on Jones, which was successful. Within a week, the patient was able to speak and slowly begin to swallow fluids and soft solids again.

The 45-minute surgery, known as a partial glossectomy, "allows for full feeling, full functional speech and close to 100 percent taste back. The tongue is 95 percent muscle so it heals quickly," added Melville.

The doctor said he was now trying to find out whether the COVID-19 patients with macroglossia shared certain genetic characteristics that could shine a light on the condition—and potentially how to prevent it.

The U.S. Centers for Disease Control and Prevention says COVID-19 has a wide range of symptoms, while some people experience no symptoms at all.

Some of the most common symptoms are fever or chills, cough, shortness of breath or difficulty breathing, fatigue, muscle or body aches, headache, loss of taste or smell, sore throat, congestion or runny nose, nausea or vomiting, and diarrhea.

Initial research into COVID-19 indicated that the disease primarily affected the respiratory system. But studies are increasingly demonstrating that it is a multi-system disorder, with some patients experiencing unusual symptoms such as skin lesions, swollen eyelids and confusion.

More than 160 million Americans have now received at least one dose of the COVID vaccine, according to the CDC.

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A man sticking out his tongue
Stock image showing a man sticking out his tongue. A handful of hospitalized COVID-19 patients in the United States have developed massively swollen tongues. iStock