COVID Tongue: Be Considered as a Symptom After All?
Dentists have been known to diagnose plethora of diseases through oral cavity which is supposed to be a mirror to overall health. One of the latest symptoms that is being noticed in association with coronavirus infection is COVID tongue where dentists may play a major role.
The term “COVID tongue” was coined recently after Mr Tim Spector, a professor of genetic epidemiology at King’s College London tweeted about patients reporting with COVID tongue and tongue ulcers. Mr Spector heads the ZOE COVID-19 Symptom Study app, where participants submit symptom reports on a daily basis. He found in his research that almost 1-2 patients out of every 500 got some strange symptoms in their mouths with may include swelling in the tongue, strange patches on the tongues and ulcers. According to the ZOE website, however, there is an increased user submissions of abnormal looking tongue, in particular white and patchy appearance.
According to The British Journal of Dermatology, which published a report on 666 patients, 25.7% patients had oral cavity symptoms and 3.9% were reported having tongue swelling with patchy depapillation. As per Oral Diseases report, COVID‐19 patients frequently develop oral lesions symptoms related to a certain state of immunosuppression where stress may also play a crucial role in the appearance of these oral conditions.
The British Dental Journal, published by Springer Nature, has suggested that the COVID Tongue has a resemblance of Geographic Tongue, an inflammatory condition affecting the surface of tongue. While there may be a possible association of Geographic Tongue with SARS-CoV-2 infection, there are only two communications in the literature reporting it as part of COVID-19 illness till date. The symptoms may be linked to the elevated levels of the inflammatory Cytokine Interleukin-6 (IL-6) in both Geographic Tongue and SARS-CoV-2 infection, as well as higher angiotensin-converting enzyme 2 (ACE2) receptor expression in the tongue where ACE2 receptors are also the entry point of the SARS-CoV-2 virus.
The diagnostic value of COVID Tongue is still unknown and it should be treated with caution. According to the ZOE website, these changes to the mouth or tongue may not be the only symptom of COVID-19, or whether they tend to come earlier or later in the illness. Whilst a report by NDTV also claims that COVID Tongue could be one of the “non-classic symptoms” that tends to get overlooked since not every ulcer or patch in the mouth is associated with COVID. This may be very early sign in a very recent finding.
Contributed by: Lt Gen Dr Vimal Arora & Dr Rahul Kumar Raman
How to Talk to Your Child About Coronavirus Disease 2019
It’s easy to feel overwhelmed by everything you’re hearing about coronavirus disease 2019 (COVID-19) right now. It’s also understandable if your children are feeling anxious, too. Children might find it difficult to understand what they are seeing online or on TV – or hearing from other people – so they can be particularly vulnerable to feelings of anxiety, stress and sadness. But having an open, supportive discussion with your children can help them understand, cope and even make a positive contribution for others.
1. Ask open questions and listen
Start by inviting your child to talk about the issue. Find out how much they already know and follow their lead. If they are particularly young and haven’t already heard about the outbreak, you may not need to raise the issue – just take the chance to remind them about good hygiene practices without introducing new fears.
Make sure you are in a safe environment and allow your child to talk freely. Drawing, stories and other activities may help to open up a discussion.
Most importantly, don’t minimize or avoid their concerns. Be sure to acknowledge their feelings and assure them that it’s natural to feel scared about these things. Demonstrate that you’re listening by giving them your full attention, and make sure they understand that they can talk to you and their teachers whenever they like.
2. Be honest: explain the truth in a child-friendly way
Children have a right to truthful information about what’s going on in the world, but adults also have a responsibility to keep them safe from distress. Use age-appropriate language, watch their reactions, and be sensitive to their level of anxiety.
If you can’t answer their questions, don’t guess. Use it as an opportunity to explore the answers together. Websites of international organizations like UNICEF and the World Health Organization are great sources of information. Explain that some information online isn’t accurate, and that it’s best to trust the experts.
3. Show them how to protect themselves and their friends
One of the best ways to keep children safe from coronavirus and other diseases is to simply encourage regular handwashing. It doesn’t need to be a scary conversation. Sing along with The Wiggles or follow this dance to make learning fun.
You can also show children how to cover a cough or a sneeze with their elbow, explain that it’s best not to get too close to people who have those symptoms, and ask them to tell you if they start to feel like they have a fever, cough or are having difficulty breathing.
4. Offer reassurance
When we’re seeing lots of troubling images on TV or online, it can sometimes feel like the crisis is all around us. Children may not distinguish between images on screen and their own personal reality, and they may believe they’re in imminent danger. You can help your children cope with the stress by making opportunities for them to play and relax, when possible. Keep regular routines and schedules as much as possible, especially before they go to sleep, or help create new ones in a new environment.
If you are experiencing an outbreak in your area, remind your children that they are not likely to catch the disease, that most people who do have coronavirus don’t get very sick, and that lots of adults are working hard to keep your family safe.
If your child does feel unwell, explain that they have to stay at home/at the hospital because it is safer for them and their friends. Reassure them that you know it is hard (maybe scary or even boring) at times, but that following the rules will help keep everyone safe.
5. Check if they are experiencing or spreading stigma
The outbreak of coronavirus has brought with it numerous reports of racial discrimination around the world, so it’s important to check that your children are neither experiencing nor contributing to bullying.
Explain that coronavirus has nothing to do with what someone looks like, where they are from or what language they speak. If they have been called names or bullied at school, they should feel comfortable telling an adult whom they trust.
Remind your children that everyone deserves to be safe at school. Bullying is always wrong and we should each do our part to spread kindness and support each other.
6. Look for the helpers
It’s important for children to know that people are helping each other with acts of kindness and generosity.
Share stories of health workers, scientists and young people, among others, who are working to stop the outbreak and keep the community safe. It can be a big comfort to know that compassionate people are taking action.
7. Take care of yourself
You’ll be able to help your kids better if you’re coping, too. Children will pick up on your own response to the news, so it helps them to know you’re calm and in control.
If you’re feeling anxious or upset, take time for yourself and reach out to other family, friends and trusted people in your community. Make some time to do things that help you relax and recuperate.
8. Close conversations with care
It’s important to know that we’re not leaving children in a state of distress. As your conversation wraps up, try to gauge their level of anxiety by watching their body language, considering whether they’re using their usual tone of voice and watching their breathing.
Remind your children that they can have other difficult conversations with you at any time. Remind them that you care, you’re listening and that you’re available whenever they’re feeling worried.
So, You Have Completed Your COVID Vaccination.
As COVID vaccinations emerge, there are a few things to consider once your vaccinations are complete. As many of us are excited to jump into socializing and some much-needed time with loved ones, it is important to take precautions post-vaccination to keep everyone’s safety in mind. Activities like dinning at a restaurant instead of take-out, or spending time indoors with a friend outside of your household are not out of reach. However, there are a few things to keep in mind once you have been fully vaccinated.
When are you considered fully vaccinated?
According to the Centers for Disease Control and Prevention, or CDC, you are considered fully vaccinated two weeks after your second dose of either Pfizer-BioNTech or Moderna, or two weeks after a single-dose of the Johnson & Johnson’s Janssen COVID-19 vaccines.
What activities are you able to participate in?
Once you have been fully vaccinated, there are activities you can finally participate in to feel a sense of normalcy. Although it is recommended to still take precautions like social distancing and mask wearing, it is nice to finally feel that there is a light at the end of this COVID tunnel. Here are a few activities we can happily engage in with COVID safety in mind2:
- Gathering indoors without masks or staying 6 feet apart with other vaccinated individuals.
- Gather outdoors without wearing a mask. However, you should not gather without a mask if you are at a large venue or in a crowd of people.
- You do not have to get tested or quarantine before or after traveling within the United States.
- For international travel, destination requirements vary so be sure to check before travel. You will need to show a negative COVID-19 test result before boarding an international flight to the United States. It is still recommended to get tested 3-5 days after travel.
- You do not need to get tested if you have been exposed to someone COVID-19 positive unless you experience symptoms. However, you should get tested and stay away from others if you live in a group setting or home and you are exposed to someone who has COVID.
What precautions to still take
A few precautions you should still take include
- Wear a mask in indoor public settings and avoid large gatherings.
- Wear a mask while traveling.
- Avoid gatherings with multiple households of unvaccinated people.
- Avoid gathering indoors with a high-risk unvaccinated person.
- Continue to follow guidelines in the workplace.
The CDC also recommends anyone taking medications that weaken the immune system or with any serious condition to consult their healthcare provider to discuss what activities are safe after getting vaccinated1.
Antibody testing
For some people, anti-body testing might be an option. According to the CDC, antibodies, or proteins made in response to infection, are detected through testing to see if they are in the blood of people post-infection. Antibodies are used to analyze the body’s efforts to fight off infection3. The CDC states, “In general, a positive antibody test is presumed to mean a person has been infected with SARS-CoV-2, the virus that causes COVID-19, at some point in the past. It does not mean they are currently infected.”
In terms of cost, the SARS-CoV-2 antibody test is currently estimated to cost between $30 and $50, a price that increases to between $120 and $175 when administration costs are included 4. In most cases, please contact your insurer for more accurate rates and coverage estimates.
There are some precautions when it comes to this testing3
- This testing should not be used to determine if someone can return to work.
- False negative or positive results are possible to occur.
- If you receive a positive result but do not have symptoms or haven’t been around any COVID positive individuals, you are not likely to be currently infected.
- It is recommended to continue taking precautions like mask wearing, frequent hand washing, and social distancing even if the antibody test results are positive.
- Although testing positive for antibodies may aid in protecting you from getting infected with COVID, it is still unknown how much and how long the extent of the protection will be.
