Israeli Scientists Warn That COVID-19 Variant Triggers Dangerous Throat Ulcers as Seen in Unusual Cases of Supraglottitis
Nikhil Prasad Fact checked by:Thailand Medical News Team May 18, 2025 9 hours, 46 minutes ago
Medical News: Omicron Variant Now Linked to Painful Throat Ulcers in the Voice Box
Researchers from the Department of Otolaryngology, Head and Neck Surgery at Shamir (Assaf Harofeh) Medical Center in Israel, along with the Faculty of Medicine at Tel-Aviv University, have discovered a strange and painful new presentation of COVID-19 that affects the voice box. The condition, known as ulcerative supraglottitis, has now been confirmed in a number of hospitalized patients who tested positive for SARS-CoV-2. This condition was previously rarely seen in adults and even more rarely linked to viruses.
Israeli Scientists Warn That COVID-19 Variant Triggers Dangerous Throat Ulcers as Seen
in Unusual Cases of Supraglottitis
Their study revealed that this form of supraglottitis—an inflammation of the upper part of the larynx above the vocal cords—can now be caused by the Omicron variant and all the latest strains of the COVID-19 virus. It results in painful ulcers, fever, hoarseness, and even a choking sensation. This
Medical News report uncovers how COVID-19 has shifted from a primarily lower respiratory tract illness to one that can now inflame critical areas higher up in the airway.
Understanding Supraglottitis and Why This Is So Unusual
Supraglottitis, sometimes mistaken for bacterial epiglottitis, is a serious inflammation that can rapidly block the airway. What sets this study apart is that all the patients had deep ulcers in their epiglottis—the flap that keeps food from entering the windpipe—a feature not typically seen in bacterial forms of the disease. All the patients were confirmed COVID-19 positive through PCR tests, and most had no other pathogens detected.
Interestingly, most of these cases occurred during the Omicron wave, a variant thought to be milder. Yet the new findings suggest that even supposedly less dangerous COVID strains may have surprising and severe symptoms in certain individuals. Patients ranged in age from 21 to 78, with an average age of 61. Some were vaccinated up to five times, but still developed this unusual and painful throat condition.
What the Patients Experienced
Every single one of the ten patients suffered from severe throat pain and odynophagia (pain when swallowing). Seven had fevers, six had hoarseness, and half described a frightening choking sensation. The laryngoscopic examination showed ulcers in the epiglottis of all patients, with some also having swelling in nearby areas, pus, and redness. One patient even developed long-term laryngeal candidiasis, a fungal infection in the throat.
Laboratory results showed raised inflammation markers: C-reactive protein (CRP) levels were high, and many had elevated white blood cell counts. These indicators matched the severity of the patients' symptoms and helped doctors assess how serious the condition was. Despite the alarming symptoms, none of the patients needed intubation or intensive care.
Treatment
Approaches and Outcomes
Although the ulcers were linked to a viral infection, all patients were given antibiotics to prevent possible secondary bacterial infections. Most received amoxicillin combined with sulbactam, along with steroids such as dexamethasone or hydrocortisone. In two cases, antivirals such as remdesivir or paxlovid were also used.
Hospital stays were relatively short—averaging 3.4 days—and no immediate life-threatening complications were recorded. This was surprising, given how serious supraglottitis can be when caused by bacteria. Still, one case did lead to a lingering fungal infection, which required longer-term monitoring and care.
Distinct Patterns in Severity
To better understand the condition, the research team divided the patients into three groups based on how severe their throat findings were. Those with more swelling and choking sensations tended to have higher CRP and white blood cell counts, and they stayed in the hospital longer. Curiously, patients with more vaccinations actually showed a trend toward more severe cases, though the sample size was too small to make any firm conclusions.
Vaccination status, presence of comorbidities, and smoking history were all noted. While many had underlying health conditions like diabetes or hypertension, four were completely healthy. This suggests that ulcerative supraglottitis could affect anyone infected with COVID-19, even those previously thought to be at low risk.
Could COVID Be Causing More Than We Think
This discovery is especially important because it shows that COVID-19 is continuing to evolve and affect the body in unexpected ways. Previously, sore throats and laryngitis linked to the virus were considered minor symptoms. Now, doctors are urged to look deeper—especially when patients complain of intense throat pain, voice changes, and choking.
The ulcers found in these patients could easily be mistaken for signs of autoimmune disorders like Crohn’s disease or Behçet’s disease, or even injury from chemicals or hot smoke. But because the symptoms were sudden, non-repeating, and resolved with proper treatment, researchers ruled out these other causes. Instead, they believe the ulcers represent a new and distinct COVID-related manifestation.
What Doctors and Patients Should Know?
The research team recommends that any patient who reports severe throat pain and voice changes should be examined with a flexible scope to check for laryngeal ulcers, especially if they also test positive for COVID-19. Fast treatment with steroids and antibiotics can prevent complications and speed recovery. Otolaryngologists, in particular, should now consider COVID-19 as a potential cause of ulcerative supraglottitis and respond quickly to these alarming symptoms.
The study also raises broader questions: How many people might have been misdiagnosed with bacterial infections or inflammatory diseases, when in fact their symptoms were caused by a virus? How many patients with “mild” COVID-19 are actually experiencing this painful condition without proper diagnosis?
This discovery reminds us that COVID-19 is still full of surprises and continues to challenge our understanding of respiratory illnesses. With the virus still circulating globally and new variants emerging regularly, staying alert to its evolving symptoms is more critical than ever.
The study findings were published in the peer reviewed journal: European Archives of Oto-Rhino-Laryngology
https://link.springer.com/article/10.1007/s00405-025-09458-x
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Read Also:
https://www.thailandmedical.news/news/covid-19-infections-are-destroying-human-voices-and-causing-long-term-damage-to-vocal-cords
https://www.thailandmedical.news/news/brazilian-study-uncovers-impact-of-covid-19-on-voice-and-speech
https://www.thailandmedical.news/news/covid-19-news-sars-cov-2-causes-damage-to-vocal-cords-along-with-long-term-health-complications
https://www.thailandmedical.news/articles/coronavirus
https://www.thailandmedical.news/pages/thailand_doctors_listings
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