Getty What are the early symptoms of coronavirus? (COVID-19)
We’ve been there. You feel like you’re coming down with something, and now you’re worried: Could it be coronavirus (COVID-19)? What are the early symptoms of coronavirus? What are the signs that you might have it?
Symptoms can vary by person, but people who’ve had it often describe feeling like a mild cold is coming on before being hit with a fever, a dry cough, and shortness of breath. However, others are asymptomatic or experience other symptoms, such as diarrhea, fatigue, a sore throat, a runny nose, and a headache. The problem is that coronavirus symptoms are really very similar to those for a cold or flu. You can also read some real-life accounts of people who have had coronavirus later in this story as they describe how it unfolded for them.
According to NBC News, coronavirus is a virus with a “slow burn,” and experts say that, “very often,” the earliest symptoms are “minor physical complaints — slight cough, headache, low-grade fever,” that gradually get worse. Loss of taste and smell and red rimmed eyes have also emerged as possible symptoms of COVID-19. It often takes about a week after symptoms start to know whether the virus will worsen or the person will just get better, experts say. About half of the people who have COVID-19 never get symptoms at all, according to Fox News. That detail is based on research studies in Iceland, Vo, Italy, and the Diamond Princess cruise ship.
The Centers for Disease Control and Prevention has now expanded its symptom list to include a headache. Previously, the CDC listed only shortness of breath, a fever, and a dry cough as the key symptoms of coronavirus. Now the CDC lists the following:
People with COVID-19 have had a wide range of symptoms reported – ranging from mild symptoms to severe illness. These symptoms may appear 2-14 days after exposure to the virus:
Fever
Cough
Shortness of breath or difficulty breathing
Chills
Repeated shaking with chills
Muscle pain
Headache
Sore throat
New loss of taste or smell
“Patients tend to have symptoms for about a week before either getting better, or getting really sick,” Dr. Joshua Denson, who works at Tulane Medical Center in New Orleans, told NBC. Sometimes, the network reported, coronavirus patients think they’re getting better until they take a sharp turn for the worse. Of course, most people do recover (in the world of celebrity, for example, Tom Hanks, Rita Wilson, Pink, and Prince Charles seem to be among those recovering fine.)
Diarrhea – and other digestive issues like vomiting, nausea, abdominal pain, and lack of appetite – have all been documented as symptoms seen in coronavirus patients. Diarrhea, vomiting and abdominal pain may be early symptoms of coronavirus in some cases.
“Coronavirus disease 2019 (COVID-19) most commonly presents with respiratory symptoms, including cough, shortness of breath, and sore throat. However, digestive symptoms also occur in patients with COVID-19 and are often described in outpatients with less severe disease,” researchers in a study in The American Journal of Gastroenterology found.
That study found that the early symptoms of coronavirus can be gastrointestinal, with respiratory symptoms coming later: “In some cases, the digestive symptoms, particularly diarrhea, can be the initial presentation of COVID-19, and may only later or never present with respiratory symptoms or fever.”
However, the three most prevalent symptoms are a fever, a dry cough, and shortness of breath.
Absence of those things doesn’t mean you don’t have it, though. The scientific community is just starting to understand COVID-19. However, some research studies have sketched out the prevalence of different symptoms in patients with it. You can see those breakdowns later in this article.
Compounding the anxiety: Some people aren’t sure whether their symptoms are caused by anxiety or it’s a symptom of coronavirus (or something else.) We live in uncertain times, and we’re dealing with an unknown illness. It’s important to be vigilant about symptoms but to also remember that most people with coronavirus recover from it.
“The most common symptoms of COVID-19, the disease caused by the new coronavirus, are fever, cough and shortness of breath,” according to John Hopkins Medicine. “Some patients also have body aches, runny nose, sore throat or diarrhea. If you have a sore throat and think you have been exposed to the new coronavirus, contact a health care provider by phone and discuss your risk.”
Here’s what you need to know:
What Do People Who Have Had COVID-19 Say About Early Symptoms?
People who had suffered from COVID-19 have described their symptoms on social media. Danielle Nelson is a Wisconsin woman recovering from coronavirus. You can read her full post above. Here’s what she says about the early symptoms: “I am a generally healthy person. I have no underlying health conditions. Before March, I had never spent a night in a hospital bed. About 3 weeks ago, I started having chest pain. I self-quarantined but I wrote it off as anxiety. About 2.5 weeks ago, I got a fever. Despite regular Tylenol and ice packs, it could not be controlled. After a week of this and sleeping 20 hours a day, I went to the ER. They tested me and sent me home. A few days later I barely had the energy to get to the bathroom. I was so tired and winded. I went back to the ER and was admitted.”
David Lat is a lawyer, writer, and founder of the site Above the Law. He’s described his struggles with COVID-19 on Twitter. Here’s what he says about the early symptoms.
“On the evening of Saturday, 3/7, Z. and I went out to dinner with friends. After dinner, we were going to have a round of drinks – but I suddenly felt unwell, so I excused myself and went home. On Sunday, 3/8, I was still feeling tired, but I didn’t put much stock in it – I even went to a gym class that afternoon (and struggled, but again just chalked it up to it being one of those days). That evening, we went out to dinner with Z..’s parents. In the middle of dinner, I again felt unwell, excusing myself early.”
He continued: “On Monday, 3/9, I felt decently. I even went into the office for a few hours. But upon returning home that night, I knew something was off. My fever and chills began that night going into Tuesday, 3/10. I didn’t go into work that day (and basically didn’t leave my apartment since then, except when I finally went to the hospital). Other symptoms included joint aches and extreme fatigue. But it didn’t (yet) feel that different from the ‘regular’ flu. During this period, I managed the fever and pain with a rotating cast of OTC pain meds. On Tuesday and Wednesday (3/10-3/11), my fever ranged from 101-104, with the 101-102 range most common. On Thursday, 3/12, I woke up fever-free without having taken fever-reducing meds, which struck me as great. In fact, by that afternoon I was thinking that maybe I was over whatever little three-day bug I had.”
But then things got worse. “Boy was I wrong. On Thursday afternoon/evening, I developed a nasty cough, replete with heavy chest congestion. This continued into Friday, which is when my fever returned (101.6). I called my internist on Friday, 3/13. The physician’s assistant I spoke with said it sounded like a flu that turned into bronchitis. She prescribed cough syrup and a Z-Pak and said I could feel better as early as the next day. Unfortunately, I got worse over the weekend, my coughing having progressed to the point where it was making it hard for me to breathe. On Sunday, 3/15, I made my way to the emergency room at NYU Langone Medical Center, my nearest ER.”
He went back home but was soon back. “By Monday 3/16, I couldn’t breathe again. I rushed back to the ER – and this time they were on their game. They admitted me, gave me oxygen, put me in an isolation room – and FINALLY gave me the #coronavirus test.” He tested positive, and ended up very sick in the hospital, but is now recovering:
This is so true (and part of what makes #Covid19/#coronavirus so scary). My husband, who’s in what I’d describe as similar health, suffered what he describes as an above-average flu.
You can follow Lat on Twitter here.
Chris Gough is a doctor who recovered from COVID-19. He also described his symptoms on Twitter.
Now that I am recovering from Covid-19, I want to share my symptoms, and my experience, in case it is of help to anyone else. I’ve felt pretty rotten the last few days, but am finally improving.
I am only talking about my own experiences – as a patient, not a doctor. (1/n)
“D1: The day of fevers and exhaustion. Shivers and sweats were the story of the day. That and being utterly exhausted, with whole-body ache. Random temp: 38.5. One flight of stairs then stop for a rest. No appetite at all. he cough started in the afternoon. Not a bad cough, and not productive. But just there every now and again to remind me that my lungs were also not happy. I found out my brother (who I spent the proceeding week with) is unwell with similar symptoms. D2: No energy. Horizontal is the position to be in. Sweats/shivers ongoing, but not as bad as yesterday. Cough more noticeable but not a big issue. Intermittent headache started. Whole body still aches, and feeling weak. Zero appetite. Felt a bit brighter in the eve. D3: Feeling worse. Headache and fatigue worse. Cough less frequent. Appetite improving but far from normal. Another day of frequent naps & predominantly horizontal state. Had to help with childcare in the evening – either baby has doubled in weight or I’m half as strong.” He recovered by day 10. You can read Gough’s full account at the tweet thread above.
Yale Tung Chen is a doctor in Spain who also is recovering from COVID-19. He, too, has been sharing his symptoms (and lung scans) on Twitter. You can see his full account here. Here’s what he wrote about the earliest symptoms:
Day 1 after #COVID diagnosis. Sore throat, headache (strong!), Dry cough but not shortness of breath. No lung US abnormalities. Will keep a #POCUS track of my lungs. #coronavirus @TomasVillen @ButterflyNetInc
“Day 1 after #COVID diagnosis. Sore throat, headache (strong!), Dry cough but not shortness of breath. No lung US abnormalities. Will keep a #POCUS track of my lungs. Day 2 after #COVID diagnosis. Less sore throat, cough & headache (thank God!), still no shortness of breath or pleuritic chest pain. #POCUS update: small bilateral pleural effusion, thickened pleural line & basal b-lines (plaps). Day 3 after #COVID diagnosis. No sore throat/headache. Yesterday was cough day, still no shortness of breath/chest pain. Diarrhea started, lucky cough got better. #POCUS update: similar effusion, seems less thickened pleural line + no b-lines (PLAPS). Day 4 after #COVID diagnosis. More cough & tiredness (very badly), still no dyspnea/chest pain. #POCUS update: Right side on resolution, Left side a more thickened pleural line + 2 subpleural consolidations.”
Most Patients Reported Fever & Respiratory Symptoms in One Study But Gastrointestinal Issues Also Cropped Up
First of all, just because you have these symptoms doesn’t mean you have coronavirus. You might have the flu, a common cold, or something else. There might be something non-viral going on of concern. Or maybe it’s anxiety. Your doctor is better equipped to tell you that (don’t take medical advice over the Internet!) But credible research studies and governmental sites have outlined the common symptoms for coronavirus. Also be aware that the virus has an incubation stage (symptoms appear between 2-14 days).
A new study from the Wuhan Medical Treatment Expert Group for COVID-19 appeared in The American Journal of Gastroenterology. It studied 204 people who received medical care for COVID-19. You can find the study here. The researchers found that digestive problems were far more common in coronavirus patients than other studies indicated, writing that “half of patients in our cohort reported a digestive symptom.” However, that statistic was inflated by including people reporting a loss of appetite.
This study found that 34 percent of people reported suffering from diarrhea.
They concluded: “Although most patients presented to the hospital with fever or respiratory symptoms, we found that 103 patients (50.5%) reported a digestive symptom, including lack of appetite (81 [78.6%] cases), diarrhea (35 [34%] cases), vomiting (4 [3.9%] cases), and abdominal pain (2 [1.9%] cases).”
The researchers noted:
If lack of appetite is excluded from the analysis (since it is less specific for the gastrointestinal tract), there were 38 total cases (18.6%) where patients presented with a gastrointestinal-specific symptom, including diarrhea, vomiting, or abdominal pain. Patients with digestive symptoms had a significantly longer time from onset to admission than patients without digestive symptoms (9.0 days vs. 7.3 days). In 6 cases there were digestive symptoms but no respiratory symptoms. As the severity of the disease increased, digestive symptoms became more pronounced. Patients with digestive symptoms had higher mean liver enzyme levels, lower monocyte count, longer prothrombin time, and received more antimicrobial treatment than those without digestive symptoms.
The study also found: “Curiously, our data indicate that patients with digestive symptoms in our case series rarely had underlying digestive diseases.”
Another Study Found That Fever Is Not Always Present in COVID-19 Patients
The article Clinical Characteristics of Coronavirus Disease 2019 in China was published in the New England Journal of Medicine. That article noted, “During the first 2 months of the current outbreak, Covid-19 spread rapidly throughout China and caused varying degrees of illness. Patients often presented without fever, and many did not have abnormal radiologic findings.” Thus, although fever is often cited as a leading indicator of coronavirus, an absence of a fever does not mean that you don’t have it, either.
What were the early symptoms in this study? “The most common symptoms at onset of illness were fever (136 [98.6%]), fatigue (96 [69.6%]), dry cough (82 [59.4%]), myalgia (48 [34.8%]), and dyspnea (43 [31.2%]). Less common symptoms were headache, dizziness, abdominal pain, diarrhea, nausea, and vomiting. A total of 14 patients (10.1%) initially presented with diarrhea and nausea 1 to 2 days prior to development of fever and dyspnea.”
This study found that, while gastrointestinal symptoms could occur in coronavirus patients, they were “uncommon” (nausea or vomiting was experienced by just 5 percent of patients studied, and diarrhea was suffered by only 3.8 percent).
“The median incubation period was 4 days (interquartile range, 2 to 7). The median age of the patients was 47 years (interquartile range, 35 to 58); 0.9% of the patients were younger than 15 years of age. A total of 41.9% were female. Fever was present in 43.8% of the patients on admission but developed in 88.7% during hospitalization,” the researchers reported. “The second most common symptom was cough (67.8%); nausea or vomiting (5.0%) and diarrhea (3.8%) were uncommon. Among the overall population, 23.7% had at least one coexisting illness (e.g., hypertension and chronic obstructive pulmonary disease).”
A Third Study Found That a Fever & Cough Were the Most Common Symptoms
Emerging 2019 Novel Coronavirus (2019-nCoV) Pneumonia is another research study that broke down the percentages of symptoms in Chinese patients with the virus.
That study of coronavirus patients found that 10 percent had diarrhea and 6 percent had nausea or vomiting. The most common symptom was fever, which was reported by 96 percent of patients, following by a cough (47 percent), a little phlegm (20 percent), myalgia or fatigue (31 percent), mild headache and dizziness (16 percent), loss of appetite (18 percent), and stuffy or runny nose (4 percent).
According to Harvard Medical School, “some people infected with the virus have no symptoms. When the virus does cause symptoms, common ones include low-grade fever, body aches, coughing, nasal congestion, and sore throat. However, COVID-19 can occasionally cause more severe symptoms like high fever, severe cough, and shortness of breath, which often indicates pneumonia.”
Government Sites Still Indicate That a Fever, Cough & Shortness of Breath Are the Most Common Signs of Coronavirus
According to the Centers for Disease Control and Prevention, coronavirus symptoms “may appear 2-14 days after exposure (based on the incubation period of MERS-CoV viruses).” The site lists the most common symptoms as:
Fever
Cough
Shortness of breath
The Australian government explains, “If you develop symptoms (fever, a cough, sore throat, tiredness or shortness of breath) within 14 days of leaving country or region that is at higher risk for COVID-19, or within 14 days of last contact of a confirmed case, you should arrange to see your doctor for urgent assessment.”
In general, according to the National Foundation for Infectious Diseases, coronaviruses (of which there are many), can cause these symptoms:
runny nose
headache
cough
sore throat
fever
Sometimes the virus leads to pneumonia, which is when the virus gets more serious and can require hospitalization.
What is the incubation period? “Because this coronavirus has just been discovered, the time from exposure to symptom onset (known as the incubation period) for most people has yet to be determined. Based on current information, symptoms could appear as soon as three days after exposure to as long as 13 days later. Recently published research found that on average, the incubation period is about five days,” says Harvard.
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