Symptoms of COVID-19

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Coronavirus disease 2019 (COVID-19) is a contagious disease caused by the coronavirus wikipedia SARS-CoV-2. In January 2020, the disease spread worldwide, resulting in the COVID-19 pandemic.

The symptoms of COVID‑19 can vary but often include fever,[7] fatigue, cough, breathing difficulties, loss of smell, and loss of taste.[8][9][10] Symptoms may begin one to fourteen days after exposure to the virus. At least a third of people who are infected do not develop noticeable symptoms.[11][12] Of those who develop symptoms noticeable enough to be classified as patients, most (81%) develop mild to moderate symptoms (up to mild pneumonia), while 14% develop severe symptoms (dyspnea, hypoxia, or more than 50% lung involvement on imaging), and 5% develop critical symptoms (respiratory failure, shock, or multiorgan dysfunction).[13] Older people have a higher risk of developing severe symptoms. Some complications result in death. Some people continue to experience a range of effects (long COVID) for months or years after infection, and damage to organs has been observed.[14] Multi-year studies on the long-term effects are ongoing.[15]

COVID‑19 transmission occurs when infectious particles are breathed in or come into contact with the eyes, nose, or mouth. The risk is highest when people are in close proximity, but small airborne particles containing the virus can remain suspended in the air and travel over longer distances, particularly indoors. Transmission can also occur when people touch their eyes, nose, or mouth after touching surfaces or objects that have been contaminated by the virus. People remain contagious for up to 20 days and can spread the virus even if they do not develop symptoms.[16]

Testing methods for COVID-19 to detect the virus’s nucleic acid include real-time reverse transcription polymerase chain reaction (RT‑PCR),[17][18] transcription-mediated amplification,[17][18][19] and reverse transcription loop-mediated isothermal amplification (RT‑LAMP)[17][18] from a nasopharyngeal swab.[20]

Several COVID-19 vaccines have been approved and distributed in various countries, many of which have initiated mass vaccination campaigns. Other preventive measures include physical or social distancing, quarantining, ventilation of indoor spaces, use of face masks or coverings in public, covering coughs and sneezes, hand washing, and keeping unwashed hands away from the face. While drugs have been developed to inhibit the virus, the primary treatment is still symptomatic, managing the disease through supportive care, isolation, and experimental measures.

The first known case was identified in Wuhan, China, in December 2019.[21] Most scientists believe that the SARS-CoV-2 virus entered into human populations through natural zoonosis, similar to the SARS-CoV-1 and MERS-CoV outbreaks, and consistent with other pandemics in human history.[22][23] Social and environmental factors including climate change, natural ecosystem destruction and wildlife trade increased the likelihood of such zoonotic spillover.[24][25][26][27]

During the initial outbreak in Wuhan, the virus and disease were commonly referred to as “coronavirus” and “Wuhan coronavirus”,[28][29][30] with the disease sometimes called “Wuhan pneumonia”.[31][32] In the past, many diseases have been named after geographical locations, such as the Spanish flu,[33] Middle East respiratory syndrome, and Zika virus.[34] In January 2020, the World Health Organization (WHO) recommended 2019-nCoV[35] and 2019-nCoV acute respiratory disease[36] as interim names for the virus and disease per 2015 guidance and international guidelines against using geographical locations or groups of people in disease and virus names to prevent social stigma.[37][38][39] The official names COVID‑19 and SARS-CoV-2 were issued by the WHO on 11 February 2020 with COVID-19 being shorthand for “coronavirus disease 2019”.[40][41] The WHO additionally uses “the COVID‑19 virus” and “the virus responsible for COVID‑19” in public communications.[40][42]

The symptoms of COVID-19 are variable depending on the type of variant contracted, ranging from mild symptoms to a potentially fatal illness.[43][44] Common symptoms include coughing, fever, loss of smell (anosmia) and taste (ageusia), with less common ones including headaches, nasal congestion and runny nose, muscle pain, sore throat, diarrhea, eye irritation,[45] and toes swelling or turning purple,[46] and in moderate to severe cases, breathing difficulties.[47] People with the COVID-19 infection may have different symptoms, and their symptoms may change over time.

Three common clusters of symptoms have been identified: a respiratory symptom cluster with cough, sputum, shortness of breath, and fever; a musculoskeletal symptom cluster with muscle and joint pain, headache, and fatigue; and a cluster of digestive symptoms with abdominal pain, vomiting, and diarrhea.[47] In people without prior ear, nose, or throat disorders, loss of taste combined with loss of smell is associated with COVID-19 and is reported in as many as 88% of symptomatic cases.[48][49][50]

Published data on the neuropathological changes related with COVID-19 have been limited and contentious, with neuropathological descriptions ranging from moderate to severe hemorrhagic and hypoxia phenotypes, thrombotic consequences, changes in acute disseminated encephalomyelitis (ADEM-type), encephalitis and meningitis. Many COVID-19 patients with co-morbidities have hypoxia and have been in intensive care for varying lengths of time, confounding interpretation of the data.[51]

Of people who show symptoms, 81% develop only mild to moderate symptoms (up to mild pneumonia), while 14% develop severe symptoms (dyspnea, hypoxia, or more than 50% lung involvement on imaging) that require hospitalization, and 5% of patients develop critical symptoms (respiratory failure, septic shock, or multiorgan dysfunction) requiring ICU admission.[52][needs update]

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