COVID-19 is a highly contagious respiratory infection caused by SARS-CoV-2. Symptoms vary between people but most commonly include a fever, cough, and fatigue. Some people, especially those over the age of 65 with preexisting health conditions, can develop potentially life-threatening illnesses.

As researchers gather more data on the virus, they’re discovering more potential symptoms. It’s thought that people with COVID-19 may be more likely to get nosebleeds, but more research is needed to confirm the link.

Let’s take a look at what the latest research has found about the association between nosebleeds and COVID-19. We also take a look at other more common symptoms of the virus.

Nosebleeds are common and have a wide range of potential causes. Anything that dries out the tissues in your nose or causes injury can potentially lead to a nosebleed. A few possible causes include:

Researchers have established that the virus that causes COVID-19 can enter cells through a receptor called angiotensin-converting enzyme-2 (ACE-2). ACE-2 is found in many parts of your body, including the cells that line your:

  • respiratory tract
  • heart
  • blood vessels
  • kidneys
  • gastrointestinal tract

The tissues that line your nose have the highest concentration of ACE-2 of any part of your respiratory tract. It’s been proposed that SARS-CoV-2 may cause inflammation in your nose that could increase your chances of developing a nosebleed.

A few small studies have found evidence that people with COVID-19 experience nosebleeds more frequently than people without COVID-19, but more research is needed to fully understand the link.

Results of studies

In an August 2020 study, researchers sought to evaluate the frequency of coronavirus infection among people visiting a hospital with nosebleeds. Each person who arrived at the hospital was tested with a COVID-19 nasal swab.

Of the 40 people who were tested, 15 percent tested positive for the coronavirus. In a control group of 40 people without nosebleeds, only 2.5 percent tested positive. The difference between the two groups was found to be statistically significant.

The researchers concluded that nosebleeds might be a symptom of coronavirus infection, but larger studies are needed to confirm this.

Several other small studies have also found that nosebleeds are more common in people with COVID-19.

  • An August 2020 study found 11 percent of a group of 114 people with COVID-19 had nosebleeds.
  • A July 2020 study found that in a group of 20 people with COVID-19 who needed to see an ear, nose, throat specialist, 30 percent (6 people) had nosebleeds.

Nosebleeds after receiving oxygen

People with COVID-19 who receive oxygen may be at an increased risk of developing nosebleeds due to increased nose dryness and tissue injury from the cannula.

In one case study, researchers examined the frequency of nosebleed in a group of 104 people admitted to a hospital with confirmed COVID-19.

The researchers found 30 of them developed nosebleeds and attributed the high prevalence to the use of oxygen. They concluded that people on oxygen and blood-thinning drugs are at higher risk of developing nosebleeds.

Nosebleeds after nasal swabs

Although fairly rare, some people may develop a nosebleed after undergoing a nasal swab to test for COVID-19. Most of the time, nosebleeds caused by COVID-19 are minor. In rare cases, medical attention may be necessary.

In a study that examined nasal symptoms in a group of 417 people with mild or moderate COVID-19, researchers found 357 people, or 85.6 percent, reported changes in their ability to smell. Among these 357 people:

  • 79.6 percent reported a loss of smell
  • 20.4 percent reported a reduced ability to smell
  • 12.6 percent experienced a condition called phantosmia, which is when you smell things that aren’t there
  • 32.4 percent experienced distortion of smells

Another review of studies found nasal congestion in 4.1 percent of people in a group of 1,773 people with COVID-19. A runny nose was reported in 2.1 percent of people.

According to the World Health Organization, the most common symptoms of COVID-19 are:

Less common but still frequently reported symptoms include:

If you think you have COVID-19, you should isolate yourself from other people for 10 days. If your symptoms are mild, you can treat yourself at home. You should avoid public transportation and other crowded areas, and If possible, you should try to use a separate bathroom from other people in your home.

It’s best not to visit a doctor in person if you have mild symptoms because it may put others at risk of getting the virus. If you need to see a doctor, it’s best to phone ahead. Many clinics are taking appointments by phone or online.

Medical emergency

Call 911 and tell the dispatcher you believe you may have COVID-19, or go to the nearest emergency room if you have the following symptoms, which may be a sign of a medical emergency:

  • trouble breathing
  • persistent chest pain
  • new confusion
  • an inability to stay awake or wake up
  • pale gray or blue skin, lips, or nail beds
  • any other concerning symptoms

People with COVID-19 may be more likely to develop a nosebleeds. Some studies have found a potential link, but larger studies are needed to understand the association. Some people with COVID-19 develop nosebleeds after receiving oxygen due to increased nasal dryness and scratching from the cannula.

The most common symptoms of COVID-19 include fever, cough, and tiredness. If you have emergency symptoms like trouble breathing or persistent chest pain, you should seek immediate medical attention.