Science

What are the symptoms of COVID-19?

How will you know if you have the novel coronavirus that causes the COVID-19 disease? 

COVID-19 symptoms range from mild to severe, and some infected people show no symptoms (they’re asymptomatic). Though there are a wide spectrum of symptoms, the Centers for Disease Control and Prevention (CDC) has listed the 11 most common COVID-19 symptoms that appear two to 14 days after exposure to the virus:

  • Fever or chills
  • Cough
  • Shortness of breath or difficulty breathing
  • Fatigue
  • Muscle or body aches
  • Headache
  • New loss of taste or smell
  • Sore throat
  • Congestion or runny nose
  • Nausea or vomiting 
  • Diarrhea

Emergency COVID-19 symptoms

The following symptoms, the CDC says, are emergency warning signs that you should seek immediate medical attention: 

  • Trouble breathing
  • Persistent pain or pressure in the chest
  • New confusion
  • Inability to wake or stay awake
  • Bluish lips or face
  • Other severe symptoms that concern you

Less common COVID-19 symptoms

There are other, less common symptoms that have been reported in COVID-19 patients.

For example, various skin rashes have been linked to COVID-19. “The rashes can take many forms — some appear as tiny red spots, while others appear as larger flat or raised lesions. Some have a hive-like appearance, while others look like frostbitten toes,” Live Science reported. It’s not clear whether these rashes are caused by the novel coronavirus or related to other factors, such as a charged-up immune system in those infected with the virus, or lifestyle factors associated with stay-at-home orders. Several studies found that “COVID toes” occurred even in cases where patients tested negative for SARS-CoV-2, raising questions about the underlying cause of the condition, which dermatologists call perniosis. [See The American Academy of Dermatology Association for more information on skin conditions that could be caused by COVID-19].

COVID-19 can also cause neurological symptoms. In addition to the loss of smell and taste, the virus can cause muscle weakness, tingling or numbness in the hands and feet, dizziness, confusion, delirium, seizures and stroke, according to Harvard Medical School.

How COVID-19 symptoms progress

A person with COVID-19 may have mild symptoms for about a week before rapidly worsening, according to Harvard Medical School. “Let your doctor know if your symptoms quickly worsen over a short period of time,” according to Harvard.

In more serious cases of COVID-19, patients experience pneumonia, which means their lungs begin to fill with pockets of pus or fluid. This leads to intense shortness of breath and painful coughing. In some people, the virus can also cause severe disease indirectly by triggering a “cytokine storm” or an overreaction of the immune system that can cause severe damage in the body, according to Harvard.

The CDC recommends that people with COVID-19 or any respiratory illness monitor their symptoms carefully. Worsening shortness of breath is reason to seek medical care, particularly for older individuals or people with underlying health conditions. The CDC information page has more on what to do if you are sick. 

COVID-19 symptoms in children

The risk of severe disease “increases steadily” with age, but younger people can also become severely ill, according to Harvard Medical School.

Most children with COVID-19 have either mild symptoms or no symptoms, but some can become seriously ill, according to the CDC. Babies under the age of 1 year old and children with certain underlying conditions such as asthma or chronic lung diseases, diabetes, heart disease and obesity may be at an increased risk of severe illness, according to the CDC. In children, the most common symptoms of COVID-19 are fever and cough but they may also develop chills, nasal congestion or runny nose, loss of taste or smell, sore throat, shortness of breath or difficulty breathing, diarrhea, nausea or vomiting, stomach, tiredness, headache, muscle or body aches, poor appetite or poor feeding, especially in infants, according to the CDC.

Parents should “pay particular attention” to markers that can indicate COVID-19 in the child such as a fever of 100.4 degrees Fahrenheit (38 degrees Celsius) or higher, sore throat, a new uncontrolled cough that causes difficulty breathing, diarrhea, vomiting or stomach ache and a new onset of severe headache especially if it’s along with a fever, according to the CDC. If the child is showing any emergency signs (same as the ones listed for adults), the CDC recommends seeking emergency medical care immediately.

What is MISC in kids?

A multisystem inflammatory syndrome in children (MIS-C) has also been associated with the novel coronavirus, according to the CDC. This syndrome is a condition in which parts of the body such as the heart, lungs, kidneys, brain, skin, eyes or gastrointestinal organs become inflamed. It’s not yet clear what causes MIS-C, but children diagnosed with the condition often had COVID-19 or had been around someone who had COVID-19, according to the CDC.  Several cases of MIS have also been reported in adults, Live Science previously reported.

The inflammatory syndrome was first described at the end of April 2021 in the United Kingdom, when doctors began to notice an increasing number of kids coming in with severe symptoms that seemed to resemble Kawasaki disease, a rare childhood disease that causes inflammation of blood vessels and can lead to heart damage. Some of the symptoms also overlapped with those of toxic shock syndrome, a life-threatening illness caused by toxins released by certain bacteria.

Parents should mainly watch out for:

—A persistent fever that lasts for more than 24 hours and is typically present for a couple of days

—Signs the child is fatigued and ill

—Signs the child has a loss of appetite or is not drinking enough fluids, according to Boston Children’s Hospital

 —Other symptoms include rash, inflamed mucous membranes (such as in the mouth and eyes), gastrointestinal symptoms like abdominal pain, vomiting and diarrhea.

These are not mild symptoms, so parents will likely notice them, The New York Times reported. For instance, the abdominal pain is not just a little bellyache but “severe enough for the parent to be worried,” Dr. George Ofori-Amanfo, division chief of pediatric critical care medicine at Mount Sinai Kravis Children’s Hospital in New York, told the Times. And the rashes, the Times reported, tend to be red, cover a large area, and usually appear on the hands, forearms and chest, turning white when you press on them, according to the Times. 

If your child has a persistent fever above 101 degrees Fahrenheit (38.3 degrees Celsius), call your pediatrician. 

Treatment includes supportive care to reduce symptoms, including steroids for inflammation, fever reducers and other medications, the Times reported. Children may also be treated with intravenous immunoglobulin (IVIG), a cocktail of various antibodies that serves as an anti-inflammatory treatment, Live Science reported

As of June 28, 2021, there have been 4,196 reported cases of MIS-C across the U.S. and 37 associated deaths, according to the CDC.

Symptoms of delta variant

The delta variant has rapidly overtaken other variants of the coronavirus and causes the same symptoms as the original strain, according to UC Davis. However, because the virus seems to replicate faster in the nose and upper airways, the symptoms may occur more quickly after exposure, and people may become infectious sooner, Live Science previously reported. This rapid replication could be part of the reason why delta is 50% more transmissible than the alpha variant first discovered in the United Kingdom, and roughly twice as infectious as the earliest versions of SARS-CoV-2. 

The ZOE COVID Study in the U.K. is an opt-in, self-reported symptom tracker. With the emergence of the delta variant, the five most common symptoms reported by unvaccinated people in the U.K. have been: headache, sore throat, runny nose, fever and a persistent cough. Loss of smell and shortness of breath seem not as common as those top 5. 

However, it’s unclear if these changes reflect any actual difference in symptoms from different viral variants. They might also be an artifact of younger, less-vaccinated populations making up more of the infected population, as younger people are more likely to experience mild disease. In general, the public health advice has not changed: COVID-19 can present as a mild head cold all the way up to a serious respiratory infection, and any respiratory symptom signals the need for a test. 

Breakthrough COVID-19 symptoms

Though there are varying estimates of how common symptomatic breakthrough infections after vaccination are, COVID-19 vaccines remain more than 90% effective against hospitalization. Most people who experience a post-vaccination breakthrough infection will feel mildly ill with symptoms reminiscent of a head cold. The ZOE COVID Study finds that headache, runny nose, sore throat, sneezing and loss of smell are the top five symptoms reported to the tracker for breakthrough infections in the U.K., where delta predominates. 

Originally published on Live Science.

Editor’s note: This article was updated on Aug. 5, 2021, to include updated information on common COVID-19 symptoms as well as those related to different types of infections.

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