COVID-19 Symptoms Typically Show Up in This Order
A new study by The University of Southern California (USC) has shed light on how COVID-19 symptoms present. This new research may help individuals differentiate a cough from something worse.
Study results show that while influenza typically begins with a cough, the first symptom of COVID-19 is fever. The following is the order of COVID-19 symptoms according to research findings:
- Fever
- Cough and muscle pain
- Nausea or vomiting
- Diarrhea
Data Used in Research
“The order of the symptoms matter,” said Joseph Larsen, lead study author, and USC Dornsife doctoral candidate. “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.”
Researchers analyzed rates of symptom incidence collected by the World Health Organization (WHO) for over 55,000 confirmed COVID-19 cases in China. They also examined a data set of almost 1,100 cases collected between December and January by the China Medical Treatment Expert Group for COVID-19 and provided by the National Health Commission of China.
To compare the order of COVID-19 symptoms to influenza, the researchers analyzed data from over 2,000 COVID-19 cases in North America, Europe, and the Southern Hemisphere reported to health authorities between 1994 and 1998.
Broad Range of Symptoms
“I have also seen patients present only with chest pain, devoid of any respiratory symptoms,” stated Dr. Robert Glatter, an emergency physician at Lenox Hill Hospital in New York. “The onset of nausea, vomiting, and diarrhea after onset of respiratory symptoms such as fever and cough may also suggest that a person may have COVID-19.”
Glatter also finds that sudden loss of smell and taste and inflammatory skin reactions like chilblains “may be important clinical clues that may distinguish COVID-19 from seasonal influenza.”
Knowledge of Symptom Progression is Key
“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,” said Glatter. “This is quite relevant for a virus that is two to three times more transmissible than influenza, leading to outbreaks in clusters.”
Flu season may complicate COVID-19 with ‘twindemic’
Medical providers on the front lines are anticipating that the flu season could be exponentially worse as these two viruses collide this fall,” said Glatter. “We need to continue to wear masks and practice social distancing and hand hygiene as we approach the fall. It’s a matter of life and death.”
He also warned there’s the possibility of a “twindemic,” a convergence of influenza and COVID-19, which could be devastating.
The Bottom Line
According to Dr.Glatter, the bottom line is that healthcare 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 must cast a wide net when thinking about who may or may not have COVID-19,” he said.
Experts with frontline experience emphasize that this progression is not always how the disease progresses, but it’s still a useful guide for healthcare providers. They also caution that the upcoming flu season may bring a “twindemic” of flu and COVID-19, with potentially devastating consequences.
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