Swollen Glands Might Be a COVID-19 Symptom—But Not in the Way You Think

It’s pretty common to get swollen glands when you have an infection—so it's understandable to wonder if COVID-19—a SARS-CoV-2 infection—might cause swollen glands like other infections, including colds, the flu, and even ear infections do.

For what it’s worth, swollen glands aren’t on the official list of COVID-19 symptoms shared online by the Centers for Disease Control and Prevention (CDC)—those include:

Fever or chills
Cough
Shortness of breath or difficulty breathing
Fatigue
Muscle or body aches
Headache
New loss of taste or smell
Sore throat
Congestion or runny nose
Nausea or vomiting
Diarrhea

But here’s the thing: The CDC also says that the list “does not include all possible symptoms." So, if you’re dealing with swollen glands, you might start to wonder if there could be a COVID-19 link. The answer, according to experts: Maybe. Here’s what you need to know.

What exactly are swollen glands?

When people talk about swollen glands, they’re usually referring to their lymph nodes—the small, bean-shaped structures that are part of your body’s immune system, per the National Cancer Institute (NCI). You have hundreds of lymph nodes, and they’re found all over your body, including clusters that are found in your neck, armpits, chest, abdomen, and groin.

Your lymph nodes, which are connected to each other, filter out substances that travel through your lymphatic fluid, the NCI explains. They contain lymphocytes (aka white blood cells) that help your body fight off infections and diseases.

When your body is fighting off an infection, you may get swollen lymph nodes—technically called lymphadenopathy—in that part of your body, Thomas Russo, MD, professor and chief of infectious disease at the University at Buffalo, tells Health. “If you have a respiratory tract infection, for example, you could get some swollen glands in your head and neck,” Dr. Russo says.

So, can COVID-19 cause swollen glands?

Here’s where it gets a little tricky: There is a small amount of research to suggest that COVID-19 can cause swollen lymph nodes in some patients with the virus—but it wasn't in those with mild illness, or in the lymph nodes in the neck, so commonly associated with other respiratory illnesses.

Two 2020 studies—both published in the journal The Lancet: Infectious Diseases—not only discovered that swollen lymph nodes were found more often in seriously ill patients, but that the main lymph nodes affected by COVID-19 were those in the mediastinum (aka, the mediastinal lymph nodes), located in the area between your lungs that includes your heart, esophagus, and trachea.

Enlargement of those mediastinal lymph nodes is not something you or your doctor would be able to feel during a physical exam, Raymond Casciari, MD, a pulmonologist at St. Joseph Hospital in Orange, Calif., tells Health. Instead, any abnormalities there are usually detected in a CT scan.

So, technically, the research says that COVID-19 can cause swollen glands, but probably not in the way you’re thinking—and that goes for what doctors have seen in their own COVID-19 patients too. "I have not seen swollen glands in COVID patients," Dr. Casciari says. Neither has Dr. Russo, or Richard Watkins, MD, an infectious disease physician in Akron, Ohio, and a professor of internal medicine at the Northeast Ohio Medical University.

What should you do if you think you have swollen glands?

Though doctors haven't seen the typical presentation of swollen glands in those with mild cases of COVID-19—and have only seen swollen glands detectable by CT scan in seriously ill COVID patients—it's still wise to get yourself checked out if you think your lymph nodes are enlarged.

“It’s like many things with COVID: If someone notices swollen glands—regardless—it would be critical to have them assessed to make sure it’s not of concern,” Dr. Russo says.

It's also important to note that swollen glands could be caused by a number of things—all of which deserve a thorough check-up by a doctor. That's not limited to cold and flu infections, but also mononucleosis, sexually transmitted illnesses, skin infections, rheumatoid arthritis, and even certain types of cancer. Overall, when it comes to swollen lymph nodes—especially those that have stayed around for a while—"it needs to be assessed to see what's going on," Dr. Russo says.

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