Is Hoarseness a Symptom of COVID? Here's What Infectious Disease Experts Say
After nearly two years of living through a global pandemic, it's only natural to wonder if any new symptom you develop could be a sign of COVID-19. And, while a cough or loss of taste and smell should raise a red flag, there are some symptoms that fall into a gray zone. Hoarseness is one of them.
Dubbed "COVID voice," some people with the virus have reported developing a raspy voice. But…is this a thing? And should you panic that you could have COVID-19 if you suddenly develop hoarseness? Here's what you need to know.
What is hoarseness, exactly?
When you're hoarse, your voice can sound breathy, raspy, or strained, according to the National Institutes of Health (NIH). It will usually be softer in volume or lower in pitch, and your throat might feel scratchy. Hoarseness is usually a symptom of problems in the vocal folds of your larynx, aka your voice box.
What's the link between hoarseness and COVID-19?
There is some data to show that COVID-19 can lead to hoarseness. One small study published in the Journal of Voice in March 2021 found that 70 out of 160 patients with COVID-19 had dysphonia, which is a catch-all term for trouble speaking that includes having hoarseness. This was rated as mild to moderate in 69 of the patients. But it lasted for more than two weeks in 33 of them and for more than a month in 11 study participants.
Another study published in the Journal of Voice in June 2020 analyzed data from 702 patients with mild to moderate COVID across 19 hospitals in Europe. Of those, 188 (or about 27%) had dysphonia, with women being more likely than men to develop the symptom. "Dysphonia may be encountered in a quarter of patients with mild-to-moderate COVID-19 and should be considered as a symptom list of the infection," the researchers wrote.
Why might COVID-19 cause hoarseness?
It's important to point out upfront that hoarseness isn't unique to COVID-19. "It is very common for respiratory viruses to cause hoarseness," infectious disease expert Amesh A. Adalja, MD, senior scholar at the Johns Hopkins Center for Health Security in Maryland, tells Health. "This is not something specific to COVID-19 but a general complication of many upper respiratory infections."
Upper respiratory infections, including COVID-19, can cause a sore throat, Dr. Adalja says. That could be the result of inflammation of the vocal cords themselves or post-nasal drip "which can lead to changes in the voice," he explains.
Coughing—a major symptom of COVID-19—"can certainly also exacerbate the larynx and lead to hoarseness," William Schaffner, MD, an infectious-disease specialist and professor at the Vanderbilt University School of Medicine, tells Health.
Coughing can specifically lead to inflammation that makes your vocal cords swollen and less flexible, Omid Mehdizadeh, MD, an otolaryngologist and laryngologist at Providence Saint John's Health Center in Santa Monica, California, tells Health. When that happens, it can affect the pitch of your voice and make it sound hoarse, he says. "Any type of inflammation in the vocal chords can cause hoarseness," he points out.
If you happen to have a more severe case of COVID-19 and are treated with the steroid dexamethasone, you could develop acid reflux, which can irritate your throat and lead to hoarseness, Dr. Mehdizadeh. "Steroids in general can cause acid reflux," he points out.
Ultimately though, most of these factors that can cause hoarseness are likely to develop after you've developed other signs of COVID-19. In other words, suddenly developing hoarseness is unlikely to be an early sign that you have the virus.
What to do if your voice becomes hoarse
If you happen to develop hoarseness and you don't have any pain, shortness of breath, or obvious swelling, Dr. Mehdizadeh recommends doing your best to stay hydrated, speak as little as possible, and rest your voice. "People tend to try to push through the hoarseness and that could potentially injure the vocal cords," he says.
On the other hand, if you have hoarseness that lasts for more than two weeks and there isn't an obvious reason (like COVID-19 or another upper respiratory tract infection), he recommends seeing your doctor to get evaluated.
The information in this story is accurate as of press time. However, as the situation surrounding COVID-19 continues to evolve, it's possible that some data have changed since publication. While Health is trying to keep our stories as up-to-date as possible, we also encourage readers to stay informed on news and recommendations for their own communities by using the CDC, WHO, and their local public health department as resources.
To get more inspiring stories delivered to your inbox, sign up for the Healthy Living newsletter