What are swollen glands?
Lymph nodes, commonly known as glands, are components of the immune system. They are tiny bean-shaped structures that filter out foreign material such as bacteria and viruses. Lymph nodes may be found all throughout your body. Normally, lymph nodes have the texture of firm peas. However, during an infection, lymph nodes create an increased number of white blood cells to fight the pathogens. They may become bloated, big, and mushy to the touch as a result. A swollen lymph node appears as a huge round or oval lump under the skin. COVID-19 may induce enlarged lymph nodes in the neck or beneath the jaw, although it is not very common.
Causes
Swollen glands are frequently caused by a mild viral or bacterial illness, such as:
- cold tonsillitis glandular fever
- throat infection
- ear infection
- dental abscess
- cellulitis is a kind of infection (eg., skin infection)
- lupus rheumatoid arthritis
- tonsillitis, mononucleosis, herpes infection
- infection with HIV
- hyperthyroidism
- thyroiditis
- Hodgkin's lymphoma
- Non-Hodgkin lymphoma
- a few medicines
- flu or cold
- tuberculosis/strep throat
The glands in the afflicted region will often become sensitive or uncomfortable. Other symptoms like sore throat, cough, or fever may occur too. These infections normally cure up on their own, and the swollen glands subside within 2 weeks of fighting off foreign germs.
Symptoms
Swollen lymph nodes indicate that something is amiss with the human body. Noticing the following symptoms when lymph nodes initially swell:
- tenderness and discomfort in the lymph nodes
- swelling in the lymph nodes that may be the size of a pea or kidney bean, or even greater
Other indications and symptoms may be dependent on the reason for enlarged lymph nodes including:
- upper respiratory infection symptoms (runny nose, sore throat, fever)
- lymph nodes all throughout your body are swollen (when this happens, it might be the result of an infection (eg., HIV or mononucleosis) or an immune system condition (like lupus or rheumatoid arthritis))
- nodes that are hard, fixed, and fast-developing, suggesting probable malignancy or lymphoma
- fever
- sweating at night
Swollen glands and Coronavirus
Swollen lymph nodes are not a common sign of COVID-19, according to Chung et al1 However, quite a few individuals with COVID-19 have been reported to experience this symptom. Haigh et al.’s case report, for example, shows a young man with COVID-19 had enlarged lymph nodes in the neck and behind the jaw.2 A young lady with modest COVID-19 symptoms had a large gland in her neck, according to another case report.3 Additionally, swollen lymph nodes were also reported in three persons who tested positive for COVID-19.4
SARS-CoV-2 may induce throat irritation. This inflammation may trigger an immunological response in adjacent lymph nodes, including those in the neck. According to these studies, COVID-19 may produce swollen glands, which is unusual. It is also worth mentioning that symptoms might vary greatly amongst people. Researchers are currently still learning about the effects of COVID-19 on various individuals.
Neck swelling in patients with coronavirus infection
The lymphatic system is a network of organs, veins, and lymph nodes located all throughout the body. The lymph nodes in the head and neck are many. This region, as well as armpits and groin, has lymph nodes that commonly enlarge.
Sudden neck swelling with rash is most likely caused by COVID-19 and late SARS-CoV-2. For 7 days, a patient was given lopinavir/ritonavir, hydroxychloroquine, and piperacillin/tazobactam. The swelling in the neck subsided in less than 24 hours, although the erythema persisted for up to two days.5
Neck and throat symptoms of COVID-19
Coughing, sore throat, and muscular pains, which may impact the neck region are some of the more typical symptoms concerning the neck and throat.
Other symptoms of COVID-19
People exhibiting these symptoms may have COVID-19:
- being unwell or feeling sick
- chills or fever
- cough (coughing for more than an hour, 3 or more coughing episodes in 24 hours, loss or change in sense of smell or taste, breath shortness)
- appetite loss
- breathing difficulties or shortness of breath (painful throat, runny or clogged nose)
- fatigue (tiredness or exhaustion)
- muscle or body aches
- headache
- new aversion to taste or scent
- throat discomfort
- runny nose or congestion
- vomiting or nausea
- diarrhoea
Diagnosis
Medical background checks will be needed to know when and how enlarged lymph nodes appeared, as well as whether there are any other symptoms.
A physical examination is performed to examine lymph nodes near the skin's surface for size, sensitivity, warmth, and texture. The location of enlarged lymph nodes, as well as other indications and symptoms, will provide information about the underlying reason.
Blood tests are performed. Certain blood tests may assist in confirming or ruling out any underlying illnesses that are suspected. The particular tests may vary depending on the probable reason, but will almost certainly involve a full blood count (CBC). This test assesses your general health and detects a variety of illnesses, like infections and leukaemia.
Imaging research, namely a chest X-ray or computed tomography (CT) scan of the afflicted region may aid in the identification of probable sources of infection or the detection of malignancies.
Biopsy of lymph nodes to confirm the diagnosis. The doctor will take a sample, or possibly an entire lymph node, for microscopic inspection.
Treatment
After a viral infection ends, swollen lymph nodes normally return to normal. Treatment for enlarged lymph nodes caused by different sources varies depending on the cause:
- Infection: antibiotics are the most often used therapy for enlarged lymph nodes caused by a bacterial infection and if enlarged lymph nodes are caused by an HIV infection, patients will be treated accordingly
- Immune dysfunction: if swollen lymph nodes are caused by a disorder like lupus or rheumatoid arthritis, therapy is focused on the underlying cause
- Cancer: cancer-related swollen nodes need cancer therapy; treatment may include surgery, radiation, or chemotherapy, depending on the cancer
Recovery
There has been little information on the occurrence of enlarged lymph nodes in persons who have had COVID-19. Swollen lymph nodes may linger after a person recovers from COVID-19, based on a 2021 case report. It is also conceivable that they will emerge after recovery. According to the study, a young lady recovered from COVID-19 with swollen glands. The enlarged lymph nodes, on the other hand, were in the hilum and mediastinum. The hilum is the structure that connects your lungs to your supporting structures. The region between the lungs is known as the mediastinum. More study is required to determine the relationship between long COVID-19 and enlarged lymph nodes.
Swollen glands after COVID-19 vaccine
After receiving a COVID-19 vaccination, it is possible to acquire enlarged lymph nodes. It usually happens in the neck or armpit area. It might also appear around the arm when getting the immunisation.
Mitchel et al. show four out of eight persons experienced an enlarged lymph node in their neck after taking the first dosage of the vaccination.6 A case report published in 2021 details 20 persons who had enlarged glands on their collarbones after receiving the first or second dosage.7 Furthermore, lymph node enlargement in the armpit was the second most frequent local response, according to an FDA document. Local responses are restricted to a single bodily part. Typically, enlarged lymph nodes emerge 2-4 days after receiving the vaccination.
The response is also usually linked to the Moderna vaccination, although it may occur with the Pfizer vaccine as well. This is a normal adverse effect of immunisation. The vaccine comprises mRNA fragments causing the body to create spike protein, a molecule unique to SARS-CoV-2. The protein is recognized by the body as a foreign substance. This causes an immunological response, which in turn causes an increase in the creation of white blood cells to combat the protein. As a result, lymph nodes may enlarge.
When to see a doctor
Speak with a nurse or doctor if suspecting to have COVID-19. Based on symptoms, specialists may recommend the next measures. If a lymph node swells after receiving the COVID-19 vaccination, keep in mind that this is a typical response. However, if concerned, see a physician immediately.
Consider visiting a doctor if experiencing:
- swollen lymph nodes that continue for more than two weeks red, sensitive, or painful lymph nodes
- nocturnal sweats caused by difficulties breathing or swallowing
- fever that does not go away
- unexpected weight loss
The following symptoms need prompt medical attention:
- fever and chills not going away
- swallowing or breathing problems
Summary
Because of COVID-19, it is possible to develop a large lymph node in the neck or beneath the jaw. However, it is a rare side effect of the condition. More cases of enlarged lymph nodes in the neck and armpit have been reported as a result of the COVID-19 vaccination. This is associated with the immunological response elicited by the vaccination.
References
- Chung M, Bernheim A, Mei X, Zhang N, Huang M, Zeng X et al. CT Imaging Features of 2019 Novel Coronavirus (2019-nCoV). Radiology. 2020;295(1):202-207.
- Haigh K, Syrimi Z, Irvine S, Blanchard T, Pervaiz M, Toth A et al. Hyperinflammation with COVID-19: The key to patient deterioration?. Clinical Infection in Practice. 2020;7-8:100033.
- Roldán-Santiago E, Benito-Berlinches A, Martínez-García L, Quereda C, Rodríguez-Martín E, Pérez-Elías P et al. Severe Acute Respiratory Syndrome Coronavirus 2 Spreads to Lymph Nodes and Strongly Expands CD4+ Effector Memory RA Cells in a Patient With Mild Coronavirus Disease 2019. Clinical Infectious Diseases. 2020;73(11):e3970-e3973.
- Distinguin L, Ammar A, Lechien J, Chetrit A, Idrissi Y, Circiu M et al. MRI of Patients Infected With COVID-19 Revealed Cervical Lymphadenopathy. Ear, Nose & Throat Journal. 2020;100(1):26-28.
- Giannitto C, Bonifacio C, Esposito S, Ammirabile A, Mercante G, De Virgilio A et al. Sudden neck swelling with rash as late manifestation of COVID-19: a case report. BMC Infectious Diseases. 2021;21(1).
- Mitchell O, Couzins M, Dave R, Bekker J, Brennan P. COVID-19 vaccination and low cervical lymphadenopathy in the two week neck lump clinic - a follow up audit. British Journal of Oral and Maxillofacial Surgery. 2021;.
- Fernández-Prada M, Rivero-Calle I, Calvache-González A, Martinón-Torres F. Acute onset supraclavicular lymphadenopathy coinciding with intramuscular mRNA vaccination against COVID-19 may be related to vaccine injection technique, Spain, January and February 2021. Eurosurveillance. 2021;26(10).
