12 Coronavirus Symptoms Everyone Should Watch for
Scientists are starting to understand the symptoms of the new coronavirus. Here's what you need to know.
A global concern
As of May 11, the new coronavirus has infected more than 4 million people worldwide and every day it seems, experts are learning more about the symptoms of what is now called Covid-19. According to the Centers for Disease Control and Prevention (CDC), confirmed illnesses of Covid-19 have ranged from very mild to severe with some even fatal. The Centers also recently added more symptoms to the list. (Here’s how to differentiate between coronavirus and flu symptoms.)
Most of the cases—about 80 percent—are mild, says Robert Glatter, MD, an emergency physician with Lenox Hill Hospital in New York City. And many of the symptoms are also very “nonspecific,” adds Nestor Sosa, MD, chief of infectious diseases at the University of New Mexico School of Medicine in Albuquerque. That means they could easily be caused by other respiratory illnesses, like a cold or the flu.
The three most common symptoms seem to be fever, cough, and shortness of breath. Here’s more on each of those—plus other, less common symptoms.
The most common symptom of coronavirus by far seems to be a fever. A CDC report says that 77 percent to 98 percent of people hospitalized with the virus have an elevated temperature. And another analysis reports that the fever is typically 100.4 degrees Fahrenheit or higher, sometimes with chills. One note: A fever may or may not be the first symptom reported. About 44 percent of more than 1,000 patients hospitalized with coronavirus in China had a fever when they first arrived at a healthcare facility, reports a study in the New England Journal of Medicine. That number rose to almost 89 percent after they were hospitalized. Fatigue has also been a common symptom, with the World Health Organization (WHO) estimating this affects 38.1 percent of patients. And night sweats have been described by some patients and are a sign of fever during the night.
Two symptoms the CDC added at the end of April were chills and repeated shaking with chills. According to the University of Pittsburgh, chills often accompany a fever and are caused by your muscles contracting and relaxing, burning energy as a way to generate heat in the form of a fever. High temperatures help kill the infection. It’s a little counterintuitive because even though your core body temperature may be raging, you actually feel cold. You can have chills without a fever as well as a fever without chills. And, of course, having chills doesn’t necessarily mean you have Covid-19, just that you may have some kind of viral or bacterial infection.
A second common symptom is a cough, affecting between 46 percent and 82 percent of patients in the hospital, according to the CDC. Although cough is a fairly widespread symptom, one distinguishing feature of this one is that it’s usually dry, says Dr. Sosa. The CDC believes that Covid-19 mostly spreads through respiratory droplets among people who are in close proximity to one another (within about six feet). That makes it imperative that people with symptoms cough (or sneeze) into a tissue or the crook of their arm, not their hands, advises the American Academy of Family Physicians (AAFP).
Shortness of breath
This is a potentially troubling symptom which the CDC says affects between 3 percent and 31 percent of patients in the hospital. A study in the International Journal of Antimicrobial Agents (IJAA) puts the number at 34.5 percent, making it the third most common symptom. Shortness of breath can be scary. It can also escalate. The IJAA article reports that Covid-19 patients in the intensive care unit were more likely to have dyspnea than people who did not end up in the ICU. Respiratory symptoms are one of the main features of Covid-19, with many patients developing pneumonia and some even requiring oxygen therapy or mechanical ventilation. Fatigue has also been a common symptom, with the World Health Organization (WHO) estimating this affects 38.1 percent of patients.
Aches and pains
Also called myalgia, muscle aches and pains affected 13.9 percent of patients investigated by WHO. According to the Cleveland Clinic, it’s a common symptom of viral infections like colds and the flu. “Whether you have influenza or Covid-19 or any other virus, muscle aches and pains are part of the inflammatory response,” explains William Schaffner, MD, an infectious diseases specialist at Vanderbilt University Medical Center. Symptoms in mild cases of coronavirus infection (which is most cases) should subside on their own, says the AAFP. The association suggests calling your doctor if symptoms feel worse than a cold. Definitely phone first: Officials are asking that people always call their doctor or healthcare facility before showing up. Here’s what else doctors want you to know about coronavirus.
Headaches have been reported in patients with Covid-19 affecting—according to WHO—about the same proportion of people as a sore throat, and both were relatively rare. There are, of course, many different types of headaches all with many possible causes, including stress. That said, if you have a headache along with symptoms like a fever, cough, and shortness of breath and have traveled recently or been in one of the areas of the United States with community transmission, call your doctor. (Don’t fall for these coronavirus myths.)
Although sore throats had been noted before in Covid-19 patients, it wasn’t part of the original CDC list of symptoms. It is now. Again, sore throats are a sign of inflammation which itself is a sign that your body is mounting an immune response to the invader. “The virus is attaching to those mucous membranes in the back of the throat and causing local inflammation because it’s killing some cells back there,” says Dr. Schaffner. A WHO document reported sore throat in about 14 percent of Covid-19 patients. A sore throat is one of the “nonspecific” symptoms of Covid-19. It can also be caused by other viruses (like those that cause the flu or the common cold), bacteria, allergies and smoking or even secondhand smoke, says the CDC.
Not many people with Covid-19 have reported diarrhea (only 3.7 percent by the WHO’s calculations) but it is notable in that it’s one of the few non-respiratory symptoms attached to the current outbreak. Coronaviruses in general can cause diarrhea in cows and pigs (infected chickens more often have respiratory disease), says the National Foundation for Infectious Diseases. The first confirmed case of coronavirus in the United States—in a 35-year-old man who had returned to Washington state from Wuhan, China—had loose bowel movements not long after being hospitalized. Stool samples did test positive for Covid-19, according to an article in the New England Journal of Medicine. Patients with SARS and MERS also reported gastrointestinal symptoms, according to one study.
Or, more accurately, lack of a runny nose and other nasal symptoms. Only 4 percent of patients in one sample reported this symptom but its absence may be notable in itself. “Covid-19 tends to be lower respiratory symptoms more than upper respiratory nasal symptoms,” says Dr. Sosa. Stanford Children’s Health is recommending that children who have congestion along with fever, cough, congestion, and nausea be tested for the flu. Those who have fever, cough, problems breathing and fatigue without a runny nose or nausea may be candidates for Covid-19 testing. Most of the Covid-19 cases in China were in adults, not children, says the CDC. Learn about other reasons your nose might be running.
Loss of smell or taste
This symptom has been widely reported by people infected with Covid-19 but was only recently added to the CDC list. “Other viral infectious can affect smell and taste but this seems to be a heck of a lot more widespread with Covid-19 patients and it seems to be an early symptom,” says Matthew G. Heinz, MD, a hospitalist and internist at Tucson Medical Center in Arizona. “It doesn’t necessarily mean you’re going into the hospital and getting intubated.” In fact, research in the International Forum of Allergy & Rhinology backs this up, finding that people with this symptom were more likely to have a milder illness.
According to a report issued by the World Health Organization (WHO), some cases of Covid-19 have been asymptomatic (patients didn’t have any symptoms, but most of these people did go on to develop symptoms later. A big concern is whether or not people with coronavirus but without symptoms can still spread the disease. The CDC reports that there have been asymptomatic transmissions, although the WHO states that this does not seem to be the main way the infection is spread. Learn more information about the current outbreak of coronavirus.
There are no specific treatments for Covid-19, although scientists are looking at existing drugs to see if they can be useful. Some that have been tested so far include the HIV drugs (ritonavir and ASC09) and the antiviral remdesivir, originally developed to treat Ebola, according to an article in the journal Nature. Other than that, patients are receiving what’s known as “supportive care,” meaning fluids, acetaminophen (Tylenol), if needed, supplemental oxygen and mechanical ventilation. Instead of using anti-inflammatories like ibuprofen for fever and myalgia, doctors are recommending acetaminophen as anti-inflammatories might actually worsen the infection. For people with mild symptoms who are staying at home, the AAFP recommends rest and plenty of fluids, then calling a healthcare professional if you’re having trouble breathing.
- Johns Hopkins Center for Systems Science and Engineering: "Coronavirus Covid-19 Global Cases."
- Centers for Disease Control and Prevention: "Symptoms."
- Robert Glatter, MD, emergency physician, Lenox Hill Hospital, New York City.
- Nestor Sosa, MD, chief of infectious diseases, University of New Mexico School of Medicine, Albuquerque.
- Centers for Disease Control and Prevention: "Interim Clinical Guidance for Management of Patients with Confirmed Coronavirus Disease (Covid-19)."
- European Review of Medical and Pharmacological Sciences: "Novel coronavirus 2019-nCoV: prevalence, biological and clinical characteristics comparison with SARS-CoV and MERS-CoV."
- New England Journal of Medicine: "Clinical Characteristics of Coronavirus Disease 2019 in China
- Centers for Disease Control and Prevention: "How Covid-19 Spreads."
- American Academy of Family Physicians: "Coronavirus Disease 2019 (Covid-19)."
- International Journal of Antimicrobial Agents: "Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and coronavirus disease-2019 (Covid-19): The epidemic and the challenges."
- World Health Organization: "Report of the WHO-China Joint Mission on Coronavirus Disease 2019 (Covid-19)."
- William Schaffner, MD, infectious diseases specialist, Vanderbilt University Medical Center, Nashville, Tennessee.
- Cleveland Clinic: "Muscle Pain: Possible Causes."
- Centers for Disease Control and Prevention: "Sore Throat."
- National Foundation for Infectious Diseases: "Coronaviruses."
- New England Journal of Medicine: "First Case of 2019 Novel Coronavirus in the United States."
- Stanford Children's Health: "Covid-19: What Parents Need to Know." Centers for Disease Control and Prevention: "Frequently Asked Questions and Answers: Coronavirus Disease-2019 (Covid-19) and Children." Matthew G. Heinz, MD, hospitalist and internist, Tucson Medical Center, Tucson, Arizona. International Forum of Allergy & Rhinology: “Self‐reported olfactory loss associates with outpatient clinical course in Covid‐19.”