‘Covid tongue’ is symptom for 1 in 4 patients – while 40% get red, burning hands and feet, study finds

A QUARTER of Covid patients suffer with a bumpy, inflamed tongue while 40 per cent get red, burning hands and feet, research suggests.

Experts have urged the NHS to add so-called "Covid tongue" and skin rashes to the official coronavirus symptoms list after a rise in cases.

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They fear that until its formally recognised as a Covid sign, as many as one in five cases could be missed and allowed to spread.

Scientists in Spain have been monitoring the unusual side effect and found that 26 per cent of Covid positive patients had a rash inside their mouth.

Changes to the hands and feet were also a sign in 46 per cent of people who had the disease.

Their findings were first published in the British Journal of Dermatology as a 'research letter' in September, but were formally presented on Tuesday.

The team, from Hospital Universitario La Paz, Madrid, Spain, analysed 666 coronavirus patients with mild to moderate pneumonia.

VIRAL PEAK

Their study was conducted at the peak of the first Covid wave, between April 10 and 25, 2020.

It showed that overall, 45.7 per cent had noticed some form of skin rash inside their mouth, or on their hands or feet.

Changes to the tongue, which has since been dubbed "Covid tongue", affected 25.7 per cent of patients – or one in four.

Some of the types of changes included transient lingual papillitis – or small bumps on the surface of the tongue.

For 6.9 per cent, the most notable sign was benign and non-contagious mouth ulcers.

Tongue inflammation, known medically as glossitis, was a factor for 6.6 per cent of patients, who reported theirs had swollen and changed colour.

While almost four per cent reported having a whitish coating appear on the surface of their tongue.

When it came to changes to the hands and feet, the most common sign was peeling skin, known medically as diffuse desquamation.

In 15 per cent, a reddish-to-brown mark appeared on on the palms of the hands and soles of the feet which caused an urge to scratch.

Just over seven per cent reported a burning sensation known as erythrodysesthesia when they first started feeling unwell.

While 6.9 per cent reported an outbreak of hives and 2.9 per cent had a skin rash.

Dr Almudena Nuno‐Gonzalez, who led the study, wrote: "In summary, almost half of patients with mild‐to‐moderate Covid‐19 admitted in a field‐hospital during a two‐week period showed mucocutaneous findings.

"The oral cavity was frequently involved and deserves specific examination under appropriate circumstances to avoid contagion risk. 

"Redness and swelling of the hands and feet, fine palmoplantar desquamation and reddish‐to‐brown macules can help us to diagnose Covid‐19 infection and should be routinely checked."

MAKE IT OFFICIAL

It comes after experts said skin rashes – including "Covid tongue" should be considered as the fourth official coronavirus symptom.

The NHS currently lists a new persistent cough, a lost of taste and smell or a high temperature as the key symptoms.

But researchers from King's College London said they identified eight different types of skin rash which could be a potential sign of Covid-19.

The experts from King's College London, who run the Covid Symptom Tracker app, noticed a rise in users reporting the unusual reaction.

They found that nine per cent of people who had tested positive for coronavirus also had either a body rash or a rash on their fingers or toes.

Researchers said rashes were twice as common in children as in adults and may be a better predictor of needing a swab test than a fever or cough.

According to the data, rashes may appear before, during or after the presence of other Covid symptoms and sometimes many weeks later.

Rashes were also the only sign of infection for 21 per cent of people with a positive nasal swab.

EARLY WARNING

Doctors have also previously warned that a rash in the mouth could be a sign of the virus.

Gabriel Scally, a public health physician and president of epidemiology and public health at Royal Society of Medicine, told The Sun: "Symptoms in the mouth have been described for some time in association with Covid-19.

"It is such a problematic virus to treat as it produces effects in such a wide range of body systems."

Professor Tim Spector, who runs the ZOE Covid Symptom Study app, warned he is seeing a rise in the number of people with the side effect.

What are some unusual signs of Covid?

Here are some of the more unusual signs of Covid-19:

1. Hearing loss: Experts at the University of Manchester said people who had the virus have reported a deterioration in their hearing as well as conditions such as tinnitus.
2. Headache: Research by Imperial College London previously found that headaches are a common symptom of the virus. Experts say 62 per cent of people who experienced any Covid-19 symptoms reported having a sore head.
3. Blood clots: Blood clots are a common cause of Covid-19 death. While scientists are clear the blood clots aren’t the main cause of death in each case, the findings support previous research that suggests the virus causes vascular issues.
4. Skin rashes: According to King's College London, rashes were the only sign of infection for 21 per cent of people with a positive nasal swab.
5. Conjunctivitis: Scientists have previously warned that the coronavirus can enter the body through your eyes and that tears could spread the infection.

Prof Spector, an epidemiologist at King's College London (KCL), said on Twitter: "One in five people with Covid still present with less common symptoms that don't get on the official PHE [Public Health England] list – such as skin rashes.

"Seeing increasing numbers of Covid tongues and strange mouth ulcers."

It means that up to 20 per cent of Covid positive cases could be unaccounted for and continuing to spread the deadly disease.

He tweeted last week urging people to continue sending him pictures of their "Covid tongues" – when the mouth rash is coincided with fever and fatigue.

"[It's] important to draw attention to these, skin rashes, Covid toes and the 20 plus other symptoms of Covid that go ignored," he said.

"Thirty-five per cent of people have non-classic symptoms in the first three days when most infective."

Prof Spector has previously called for the NHS to expand its list to ensure Covid cases are spotted in the early stages.

His team were among the first to spot that a loss of taste and smell could be an indicator of the virus and successfully had it added to the official list.

When someone experiences one of the NHS-identified signs they must order a test and self-isolate.

These steps are designed to help prevent the spread of the virus.

Prof Spector said: "We're still missing 35 per cent of cases that have symptoms that aren't in the NHS 111 list which is the briefest list in the world."

Anyone with the ZOE Covid Symptom app can get a free test if they have any of symptoms – not just the NHS approved ones, Prof Spector added.

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