The Centers for Disease Control and Prevention (CDC) has made the symptoms of COVID-19 crystal clear: fever, cough, and shortness of breath. But as more and more people develop the respiratory illness caused by the novel coronavirus, experts are seeing a wide range of symptoms in patients—and they tend to overlap with the common cold, flu, and even allergies.
The CDC maintains those big three are the symptoms of novel coronavirus, but the World Health Organization (WHO) has a more extensive list that includes 14 different symptoms detected in people with mild cases of COVID-19. That’s a big deal, since “most people infected with the COVID-19 virus have mild disease and recover,” per a February report of a joint World Health Organization-China mission. In fact, that report found that 80% of confirmed patients had mild to moderate disease.
So, which coronavirus symptoms should you be paying closer attention to—and what should you do if you think you may be infected? Here’s what doctors want you to know.
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Back up: Why does the CDC only list three novel coronavirus symptoms?
“It’s because these are the most common symptoms in the U.S.,” says Richard Watkins, M.D., infectious disease physician and professor of internal medicine at Northeast Ohio Medical University.
Fever: This is by far the most common sign of COVID-19, and is defined by having a temperature of 100.4° F or higher.
Cough: Experts say patients typically develop a dry cough, meaning you’re coughing but nothing is coming up, like phlegm or mucus.
Shortness of breath: This symptom often presents in more advanced cases and can range in severity. Some people simply feel winded by otherwise normal activities, while others end up having trouble breathing on their own. “It feels like you’re not getting enough air,” says David Cutler, M.D., a family medicine physician at Providence Saint John’s Health Center in Santa Monica, Calif.
What are the mild symptoms of novel coronavirus?
In the WHO report, the organization analyzes nearly 56,000 cases of COVID-19 in China and breaks down a wide range of “typical” symptoms, as well as how often people with the virus experienced them:
Dry cough (67.7%)
Sputum production (33.4%)
Shortness of breath (18.6%)
Sore throat (13.9%)
Muscle aches and pains (14.8%)
Nausea or vomiting (5.0%)
Nasal congestion (4.8%)
Coughing up blood (0.9%)
Red eyes (0.8%)
A lost sense of smell wasn’t on the WHO’s list, but several organizations—including the British Rhinological Society, British Association of Otorhinolaryngology, and American Academy of Otolaryngology-Head and Neck Surgery (AAO-HNS), say it’s a possible symptom, too.
Below, what you need to know about the mild symptoms that didn’t make the CDC’s list:
1. Lost sense of smell
This “has been seen in patients ultimately testing positive for the coronavirus with no other symptoms,” the AAO-HNS said in a statement. “It could potentially be used as a screening tool to help identify otherwise asymptomatic patients, who could then be better instructed on self-isolation.” According to a joint statement from the British Rhinological Society and British Association of Otorhinolaryngology, two out of every three people with confirmed cases of COVID-19 in Germany had a lost sense of smell, and 30% of patients in South Korea who tested positive experienced the same thing.
“Viruses are a common cause of changes to the sense of smell or taste that can occur with an upper respiratory infection,” says Rachel Kaye, M.D., assistant professor of laryngology-voice, airway, and swallowing disorders at Rutgers University. “Viral infection can result in both inflammation and swelling of the nasal cavity lining, leading to nasal congestion, which in turn causes a change in smell. Furthermore, there is also some evidence that viral infection can lead to neurologic damage in the smell receptors.”
It’s not shocking that a viral infection would cause people to feel completely wiped out, says Susan Besser, M.D., a primary care physician at Mercy Medical Center in Baltimore. “Your body is working hard to fight the virus, and that requires a lot of energy,” she says. “It doesn’t leave much energy left over for you.”
3. Sputum production
Sputum production, a.k.a. excess mucus that you may cough up, isn’t super common with COVID-19, but it’s common enough that more than a third of patients have experienced it. Dr. Cutler points out that sputum production is common with plenty of other respiratory conditions, like the common cold and allergies, so you shouldn’t rush to assume you have coronavirus if you’re experiencing this.
4. Sore throat
Because COVID-19 is a respiratory virus, you may have postnasal drip (where excess mucus drips down the back of your nose and throat) and that can cause irritation in your throat, Dr. Besser says. Also, constantly coughing can be tough on your throat in general.
5. Aches, pains, and headaches
These are common symptoms with viruses, Dr. Cutler says. “When you get a viral infection, often you get a fever and that fever response can cause the body to feel achy all over,” he explains. “We see that with the flu and other infections as well.”
6. Diarrhea, nausea, and vomiting
There’s no clear reason to explain why this is happening in some people, Dr. Besser says, but she has some theories. “It’s possibly due to increased drainage from postnasal drip into the stomach—that can cause issues,” she says. It could also just be the way the virus itself behaves in some people, she says.
New research in the American Journal of Gastroenterology, which has not yet been peer-reviewed, found that a “unique sub-group” of COVID-19 patients develop digestive symptoms. “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,” the researchers wrote.
They believe these symptoms may occur because the virus enters your system through “a receptor found in both the upper and lower gastrointestinal tract where it is expressed at nearly 100-fold higher levels than in respiratory organs.”
What should you do if you think you have novel coronavirus symptoms?
If you’re experiencing multiple symptoms of COVID-19, get your doctor on the phone. You should not go to the hospital, because you could potentially spread the virus if you do have it or pick it up if you actually don’t. Once you discuss your symptoms, your doctor will be able to determine if you qualify for a COVID-19 test and go from there.
However, there is no specific cure for novel coronavirus and most people are being advised to treat mild symptoms with over-the-counter remedies while isolating at home for at least 14 days, Dr. Watkins says. “Many people have symptoms for two weeks—some longer and others a shorter duration,” he adds.
For a fever, aches, and pains, have acetaminophen (Tylenol) on hand and follow the label’s dosage instructions. Turn to cough medicine or tea with honey to relieve your cough or sore throat. Plenty of rest and fluids are also recommended. If you notice your symptoms getting worse, though, call your doctor again about next steps. And if the following occur, the CDC says it’s your cue to head to the hospital:
Persistent pain or pressure in the chest
New confusion or inability to arouse
Bluish lips or face
Other severe or concerning symptoms (like a fever that won’t die down)
When can you leave your home after experiencing novel coronavirus symptoms?
The CDC has guidelines that depend on whether you have access to a COVID-19 test.
If you will not have a test, the CDC says you can leave home after these three things happen:
You don’t have a fever for at least 72 hours without the use of fever-reducing medication.
Your symptoms have improved.
At least seven days have passed since you first had symptoms.
If you will have a test, you can leave home after the following:
You no longer have a fever without the use of fever-reducing medication.
Your symptoms have improved.
You received two negative tests in a row, 24 hours apart.
When in doubt, call your doctor to be on the safe side.
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