The SARS-CoV-2 virus, which causes COVID-19, primarily targets the respiratory system and is known for symptoms like fever, cough, and fatigue. Many people experience uncomfortable symptoms in the upper respiratory tract, where the throat and voice box are located. A frequently reported, though less recognized, issue is a noticeable change in voice quality, which can range from mild hoarseness to a complete loss of the ability to speak. This voice alteration is a direct consequence of the infection impacting the delicate structures involved in voice production.
Is Loss of Voice a Common Symptom
Loss of voice, or hoarseness, is a recognized manifestation of COVID-19 infection, often medically termed acute laryngitis. This symptom, which involves a raspy or weak voice quality, is a result of inflammation in the larynx, or voice box. While not as universal as fever or cough, studies indicate that a significant number of patients experience this vocal impairment. One systematic review found that voice impairment occurred in about 25% of individuals who contracted COVID-19. Later strains, such as Omicron, showed a greater propensity to affect the upper airways, leading to more cases of laryngitis than earlier variants.
Mechanisms Behind Voice Changes
The main reason for a compromised voice during a COVID-19 infection is the direct inflammatory response the body mounts against the virus. The SARS-CoV-2 virus can cause swelling and stiffness in the vocal folds, the two bands of tissue within the larynx that vibrate to produce sound. When these folds are swollen, they cannot vibrate normally, which results in the characteristic raspy or deep sound of hoarseness.
A second significant factor is the mechanical trauma caused by a persistent or severe cough. Forceful and repeated coughing slams the inflamed vocal folds together, causing further irritation and swelling in the delicate laryngeal tissue. Even secondary symptoms, like post-nasal drip, can contribute, as the excess mucus draining onto the larynx further irritates the sensitive voice box.
In more complex cases, the voice issue can stem from the virus’s effect on the nervous system, known as neurotropism. The virus has been shown to potentially irritate or damage the vagus nerve, which controls the movement and sensation of the vocal cords. Furthermore, in the rare instance of severe illness requiring a ventilator, the breathing tube inserted through the vocal cords can cause direct mechanical injury.
Home Management Strategies
Managing acute voice changes involves actively reducing irritation and strain on the vocal folds to allow the inflammation to subside. Maintaining high levels of hydration is beneficial, as the vocal cords require lubrication to function smoothly. Drinking at least two liters of fluid daily, while avoiding dehydrating beverages like caffeine and alcohol, is recommended.
Voice rest is another important intervention, meaning one should minimize speaking and avoid common straining behaviors. It is particularly important to avoid whispering, which places more tension on the vocal cords than a quiet, normal voice.
- Using a humidifier or inhaling steam from a hot shower helps keep the upper airway moist, which soothes the irritated tissues of the larynx.
- Over-the-counter options, such as lozenges or gargling with warm salt water, can provide temporary relief from throat discomfort.
When Persistent Symptoms Require Medical Attention
For the majority of people, COVID-related hoarseness is temporary and resolves as the infection clears, typically within one to two weeks. If the voice changes persist for an extended period, generally longer than three to four weeks, seek evaluation from a healthcare provider. This longer duration suggests the possibility of persistent vocal fold trauma or other underlying issues that require a formal diagnosis.
Warning Signs
Certain symptoms alongside voice changes necessitate immediate medical attention. These include difficulty breathing, severe pain when swallowing, or coughing up blood. Consulting a specialist is also advisable if the voice suddenly worsens or declines again after an initial recovery period.