COVID-19 Symptoms Tend to Appear in Order

If you are someone who often worries about getting sick, it’s easy to see any symptom as a sign of a more significant illness. With the long list of symptoms associated with COVID-19, it’s possible to suffer from some of them and have something completely different.

COVID-19 is a severe illness and impacts older people and people with underlying health conditions worse than many other folks. We completely empathize with people’s concerns. There are good reasons for us to socially distance, wear masks, wash our hands and protect ourselves. But, we don’t want to jump to the wrong conclusions at the first sign of illness.

A study of more than 55,000 COVID-19 patients has shown that the illness tends to reveal its symptoms in a specific order. Although it’s not true for 100 percent of cases, knowing the typical order may ease your mind before you get your test results if you believe you may be ill. Usually, COVID-19 starts with a fever, grows to a cough, progresses to nausea and finally may cause diarrhea. There are many other symptoms. But that is the essential roadmap.

Many illnesses share the same symptoms, but not in that order. “The order of the symptoms matters,” said Joseph Larsen, who researches computational biology and bioinformatics at the Univ. of Southern California. “Knowing that each illness progresses differently means that doctors can identify sooner whether someone likely has COVID-19, or another illness, which can help them make better treatment decisions.”

Headaches, fatigue headaches and more are peppered in. But, usually, COVID-19 starts in that order before other symptoms start adding themselves to the list. While the checklist cannot stand in for a diagnostic test, it does help your doctor narrow it down.

The list may be especially important as we head into the fall and cold and flu season. Having a way to help distinguish them from each other quickly could let doctors treat patients better while waiting for confirmation from tests. For instance, the seasonal flu usually starts with a cough before the fever.

Doctors who have been fighting COVID-19 on the front line have said that the list isn’t perfect because of how odd some symptoms are. The list is, after all, a general guide.

Some patients may present only with loss of taste or smell and otherwise feel well,” said Dr. Robert Glatter, emergency physician, Lenox Hill Hospital. “I have also seen patients present with ‘COVID-toes,’ or chilblains; a livedo-type [reddish-blue discoloration] of skin reaction in response to acute inflammation, in the absence of fever, cough or other respiratory symptoms.”

However, Dr. Glatter doesn’t disregard the meaningfulness of the research. “It’s critically important to understand the progression of symptoms of COVID-19-infected persons so you stop the spread of the disease — in effect, isolate and then initiate effective contact tracing. This is quite relevant for a virus that is two to three times more transmissible than influenza, leading to outbreaks in clusters.”

Knowing the order may ease your mind if you have been exposed and are waiting on results, if you think you might be ill or if you need to go to the doctor. It can also help your doctor determine the best course of treatment as they diagnose your problem, which is an excellent tool as we head into the flu season.
August 21, 2020
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