Some COVID-19 patients are developing a condition that causes their tongue to permanently expand so much they can not speak or eat.
Macroglossia is a condition where someone’s tongue is inflamed and begins to swell.
Dr James Melville, one of the top researchers of the condition, is aware of nine cases where a COVID-19 patient developed the condition.
‘It’s actually a relatively common condition, but not to the degree of those patients. Those are what we consider massive or giant macroglossia and those are extremely rare,’ he said.
One of the patients he treated, Anthony Jones, woke up after surviving a critical case of COVID-19 that left him on a ventilator with his tongue swollen to several times its normal size.
He has finally recovered, but Dr Melville and other doctors remain mystified over what might cause the rare complication.
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Anthony Jones developed massive macroglossia after being hospitalized with COVID-19. The exact causes of it are unknown. He tongue became so swollen that he could not eat or speak
Dr. James Melville treated Jones’ condition, and he is expected to make a full recovery. Dr. Melville is leading research into the condition, and how it may be associated with COVID-19
Dr Melville treated the first two cases of COVID-related macroglossia early in the pandemic last year.
There have been seven new cases of the condition related to COVID-19 since then, with each being the rare, massive version of the condition.
One case was that of Anthony Jones, a Houston man who developed the condition after being hospitalized with the virus.
Jones had to use a ventilator in order to handle the virus, and when he woke up after treatment, his tongue was so swollen that he could not speak or eat.
As became common practice, Jones’s doctors rolled him onto his stomach to alleviate some of the strain on his lungs – but that only made his tongue worse.
Dr Melville had to perform surgery to reduce the massive size of Jones’s tongue and alleviate the inflammation.
The operation was a success, but how Jones became inflicted with massive macroglossia is still unknown.
Dr Melville has a few guesses as to how it happens, though.
He thinks the inflammation is caused for the same reasons that other organs in someone’s body may become inflamed and swell after contracting the virus.
There are reports that some have had their hearts, or other organs, enlarge after contracting the virus.
Patients who develop massive macroglossia require medical treatment, as the condition does not heal on its own. Eight of nine COVID-related cases in the United States have occurred among Black Americans
‘We were noticing similar histological features with our COVID positive patients with other organs they were doing autopsies on, so say kidneys or lungs or heart,’ he said.
‘I think the [cases] we’re finding, and histology is proving that COVID may be causing, are a more exaggerated inflammatory reaction in the tongue, which might be causing the tongue to get bigger, but that’s all the research work that I’m doing trying to prove that.’
Dr. Melville is working to find what other factors combine with COVID-19 to cause the tongue swelling.
Typical causes of macroglossia include strokes, and laying in a prone position for a long time, as Jones was when he was in the hospital.
He believed that it was possible that patients who needed a ventilator to breathe when in the hospital with COVID-19 were sometimes turned over to their stomach to help them breathe easier.
Spending so long in that position could have cause tongue swelling.
Not all the patients Dr Melville looked at were incubated in a prone position, though.
Eight of the nine patients to develop the condition were Black, leading him to believe race may be involved, specifically angioedema.
Angioedema is a condition where parts of someone’s body may begin to swell due to either an allergic reaction or hereditary causes.
Black people are more likely to develop the condition than white people.
Answers for what causes the condition at this level of severity in COVID patients are few and far between, though.
Macroglossia caused by COVID-19 will not naturally go away on its own, and requires treatment from a specialist.
Some patients have needed a stomach tube in order to eat since they could not eat food with the condition.
Jones is expected to make a full recovery, and will slowly be able to regain his ability to talk over time.