Data from millions of ZOE COVID Symptom Study app contributors has shown that a hoarse voice can be a symptom of COVID-19. Here’s how to spot it and what it feels like.

What is a hoarse voice like in COVID-19?

People using the app have reported changes to their voice which affected the sound of their speech. 

A hoarse voice isn’t a very common symptom of COVID-19; however, during the beginning of the pandemic lots of clinical staff reported experiencing a hoarse voice during their illness.  

A hoarse voice can sound, and feel, different from person to person. For example, your voice might become more croaky, raspy, or rough, quieter or even change in pitch. If you have a hoarse voice, you might feel like it requires more effort to speak.  

We know that the COVID-19 virus affects the tissues in our respiratory system of which the voice box (larynx) is a part of. This explains why some people get a hoarse voice during their infection. 

While it’s not a particularly strong predictor of COVID-19, if you have an unexplained hoarse voice we believe you should get a test just to be sure.  

When does a hoarse voice happen in COVID-19?

A hoarse voice can be an early symptom of COVID-19, but its pattern of presentation can vary. Usually, it appears in the first week of illness and builds gradually. For other people, a hoarse voice comes and goes. 

On average, a hoarse voice will last two to three days but can last longer in adults (up to six or seven days compared to four days for children). 

How common is a hoarse voice in COVID-19?

A hoarse voice isn’t a very common symptom of COVID-19 but the likelihood of having it increases with age. 13% of children, 29% of adults aged 16-35 and 32% of adults aged over 35 experience a hoarse voice during their illness.

Only 2% of people who were ill with COVID-19 reported a hoarse voice as their only symptom.

What other symptoms of COVID-19 are common alongside a hoarse voice?

A hoarse voice is most likely to occur alongside many other symptoms of COVID-19. People reported a hoarse voice throat with varying combinations of symptoms, some of which are associated with a higher risk of needing hospital support.

In adults, a hoarse voice usually occurs with fatigue or headache. In adults aged under 65, it also tends to happen alongside a sore throat and a loss of sense of smell. 

A hoarse voice is reasonably common alongside other symptoms such as a persistent cough, fever, a loss of appetite and unusual muscle pains. In children, a hoarse voice is most commonly associated with a sore throat, fatigue and headache and sometimes with fever, cough and loss of smell. 

Depending on your age and sex, you should contact your doctor if you have multiple different symptoms of COVID-19 in the first week of being ill.

What should I do if I have a hoarse voice and think it might be COVID-19?

If you have an unexplained hoarse voice it could be COVID-19. You should:

• Follow the NHS guidelines and self-isolate at home to help protect the people around you and the wider community.
• Download the ZOE COVID Symptom Study app and log your symptoms to be offered a test through the app.
• Also log your health daily in the app, if you’re not already, to help us understand more about how COVID-19 affects people and contribute to life-saving scientific research.
• Check out our tips on looking after yourself if you are sick with COVID-19, monitoring your health at home and staying hydrated.
  

If you’re straining to speak you should try to rest your voice as much as possible. Drinking plenty of liquids, particularly water, and taking simple painkillers like paracetamol or soluble aspirin can help alleviate discomfort. 

Stay safe and keep logging.