- A study by the University of Southern California was able to determine that the symptoms of COVID-19 usually start in a certain order.
- According to the study, while the flu usually starts with a cough, the first symptom of COVID-19 is fever.
- However, doctors who work with patients with COVID-19 said that, in their experience, the symptoms are not as predictable.
The symptoms of COVID-19, including fever and cough, are similar to the symptoms of a number of other common illnesses, including seasonal flu.
With the flu season in full swing, how do you know if your fever is a symptom of the flu or COVID-19? A new study has shed light on how the symptoms of COVID-19 appear, which may help people who are trying to find out if the cough is just a cough or worse.
The University of Southern California (USC) research was able to determine that the symptoms of COVID-19 usually begin in a certain order.
This finding may help people with COVID-19 to isolate themselves and get treatment earlier, which can significantly improve patient outcomes.
“This order is especially important to know when we have overlapping cycles of illnesses like the flu that coincide with COVID-19 infections,” said Peter Kuhn, PhD, one of the study’s authors and professor of medicine, biomedical and aerospace engineering and mechanical engineering at USC. “Doctors can determine what steps to take to care for the patient and can prevent the patient’s condition from getting worse.”
To predict the order of symptoms, the researchers analyzed the symptom incidence rates collected by the World Health Organization (WHO) for more than 55,000 confirmed cases of COVID-19 in China.
They also analyzed a data set of nearly 1,100 cases collected between December 2019 and January 2020 by the China Medical Treatment Experts Group for COVID-19 and provided by the National Health Commission of China.
To compare the order of symptoms of COVID-19 with influenza, the researchers analyzed data from more than 2,000 cases of influenza in North America, Europe and the Southern Hemisphere reported to health authorities between 1994 and 1998.
“The order of symptoms is important,” said Joseph Larsen, lead author of the study and a doctoral candidate at USC Dornsife. “Knowing that each disease progresses differently means that doctors can identify earlier if someone is likely to have COVID-19 or another disease, which can help them make better treatment decisions.”
According to the results of the study, this is the order of symptoms that people with COVID-19 may experience:
- fever
- cough and muscle pain
- nausea or vomiting
- diarrhea
“The study found that patients with seasonal flu most commonly develop a cough before the onset of fever,” Dr. Robert Glatter, an emergency physician at Lenox Hill Hospital in New York, told Healthline. “In reality, this can be difficult to discern, as the flu usually starts abruptly with a triad of symptoms, including back pain, chills and a dry cough.”
Glatter said the findings are potentially useful “when evaluating multiple patients in a busy clinical environment”.
According to the study, while the flu usually starts with a cough, the first symptom of COVID-19 is fever.
“Our results support the notion that fever should be used to track entry to the facility as regions begin to reopen after the spring of 2020,” wrote the study authors.
Glatter shared his experience in treating patients with COVID-19 in New York City.
“In general, although fever is generally the most commonly described initial symptom of COVID-19 infection, the reality of what I see on the front lines is more variable,” he said.
“In fact, some patients may experience only loss of taste or smell and feel good,” said Glatter. “I have also seen patients with ‘COVID toes’ or chilblains; a kind of livedo [reddish-blue discoloration] skin reaction in response to acute inflammation, in the absence of fever, cough or other respiratory symptoms ”.
Glatter said other patients also “experienced malaise, headache and dizziness”, which in some ways resemble the symptoms of a stroke, but without fever, cough or any evidence of upper respiratory symptoms.
“I also saw patients experiencing only chest pain, without any respiratory symptoms,” he said. “The onset of nausea, vomiting and diarrhea after the onset of respiratory symptoms, such as fever and cough, may also suggest that a person may have COVID-19.”
According to Glatter, the main point is that health professionals need to be vigilant and keep an open mind when evaluating patients who may have symptoms associated with the disease. “They don’t always present ‘according to the book’, so you should launch a wide network when thinking about who may or may not have COVID-19,” he said.
“It is extremely important to understand the progression of symptoms in people infected with COVID-19 so that you stop the spread of the disease – in fact, isolate and then start effective contact screening,” said Glatter. “This is quite relevant for a virus that is two to three times more transmissible than the flu, leading to group outbreaks.”
He also said that understanding the first symptoms not only helps patients to seek the test more quickly, but also to start to distance themselves physically or socially after the onset of the first symptoms.
“This also underscores the importance of wearing masks and hand hygiene when learning about symptoms,” said Glatter.
He also found that the sudden loss of smell and taste and inflammatory skin reactions like chilblains “can be important clinical clues that can distinguish COVID-19 from seasonal influenza.”
According to
These are three highly monitored variants:
- Variant B.1.1.7. It was first identified in the UK in the fall. It spreads faster (and more easily) than other variants. It may be associated with an increased risk of death compared to other variants, but more research is needed to confirm this. It was detected in the United States in December.
- Variant B.1.351. It was first identified in October in South Africa and subsequently detected in the United States in December.
- Variant P.1. It was first identified in travelers from Brazil who were tested at a Japanese airport in early January.
Recent research claims that variant B.1.1.7 does not affect the respiratory tract or results in more severe lung disease than SARS-CoV-2. The study authors emphasized that “complete and clearer data on this topic will be ready in the near future”.
Another study found that while the new variants of the coronavirus may be more infectious, there is still no evidence that they cause more serious illnesses.
“Scientists have now studied this and found that these variants tend to spread faster, are more transmissible or more infectious,” said Vismita Gupta-Smith, WHO public information and defense officer, in a statement. “However, so far, they do not appear to cause more serious illness or a higher mortality rate or any different type of clinical manifestation.”
She added that the variants behave very similarly to SARS-CoV-2 and cause similar illnesses.
The researchers analyzed data from more than 50,000 patients with COVID-19 and compared their symptoms with previous records of people who had the flu to find that the symptoms of COVID-19 occur in a specific order.
This information can help distinguish people with COVID-19 from those who have the flu, helping people with COVID-19 to seek care and isolate themselves earlier.
Experts with experience on the frontline emphasize that this progression is not always how the disease manifests itself, but it is still a useful guide for healthcare professionals.
Experts are also monitoring how the new variants affect the body and whether there are any changes in symptoms.