Symptoms of COVID-19: Most and Least Common

At this point in the COVID-19 pandemic, it is a well-known fact that not every person who is infected is also symptomatic. Plenty of people are asymptomatic, which experts believe is one of the driving forces behind the high number of cases of the novel Coronavirus worldwide. And just as many are suspected to be sub-clinically symptomatic which essentially means they exhibit such mild symptoms that they likely do not raise concerns of a potential COVID-19 infection. Despite the relatively large number of asymptomatic and sub-clinically symptomatic COVID-19 infections, which social distancing measures and rigorous hygiene practices can help cut down on, it’s the symptoms that do occur that should draw our attention since a wider range of symptoms of an intensity that impacts routine life, leading to hospitalization, may speak of higher risks of complications.

  • What is COVID-19?

COVID-19 is the source of the current health crisis worldwide. COVID-19 stands for Corona Virus Disease 2019 – Corona (CO) Virus (VI) Disease (D) 2019 (19). As you can clearly tell from the abbreviations, the name is a friendly identifier of the type of infectious agent that is causing this disease (a Coronavirus), as well as the year of emergence of the disease (2019). The source of the COVID-19 infection or disease is SARS-CoV-2 which means severe acute respiratory syndrome coronavirus 2, indicating the fact that it’s related to SARS-CoV-1, or simply SARS-CoV, the source of the 2002-2003 and 2004 SARS outbreaks, also a Coronavirus. Being primarily a respiratory infection, the COVID-19 disease produces primarily respiratory system-related symptoms, when it does, that is.

COVID-19 symptoms list

  • How long till COVID-19 symptoms show?

Bear in mind that the novel Coronavirus disease, dubbed COVID-19, is produced by a new pathogen and very little is known about it, or its modus operandi, hence the present state of the world. Even so, data gathered up to the present day suggests it takes on average 5-6 days from infection till symptoms show. However, there have been reports of cases where symptoms debut occurred as early as 2-3 days following exposure and infection, as well as cases with symptoms debut as late as 14-20-something days. The variation in symptoms onset since infection is attributed to differences in viral load and immune system particularities that account for virus-host interactions and subsequent infection development, among other factors.

  • Complete list of COVID-19 symptoms

  • Fever – both low and high-grade fevers are possible (most common symptom of COVID-19, occurring in over 80% of symptomatic cases)
  • Coughing, usually a dry cough, but which can progress to productive in severe forms where a secondary infection may also appear (second most common symptom)
  • Shortness of breath or dyspnea (fairly common symptom of COVID-19, occurring in an estimated 30-40% of cases, with prevalence increasing with disease severity)
  • Malaise, tiredness, fatigue (presumed to be determined by the severity of the infection)
  • Body aches: muscle aches, joint aches, bone pain and other aches (estimated to occur in up to 1/3 of infection cases)
  • Phlegm, thick and sticky which can prove difficult to expectorate, source of an ensuing productive cough, coupled with the inability to expectorate properly as the disease progresses (estimated to occur in up to 1/3 of cases).
  • Chills and possibly also shaking, may alternate with fever (estimated to occur in roughly 10% of cases)
  • Headaches, migraines (identified as one of the initial symptoms and sometimes one of the few symptoms reported in mild forms or sub-clinically symptomatic forms)
  • Sore throat (a common symptom, suspected to be one of the first clinically-relevant signs of COVID-19 infection)
  • Diarrhea (a less common symptom of COVID-19, or less commonly associated with respiratory-type infections, estimated to be present in less than 5% and up to 30% of COVID-19 cases).
    Note: Other Coronaviruses specific to cows, pigs and rabbits are known to cause diarrhea and digestive upset.
  • Abdominal pain (not very common, but may occur – notable symptom for COVID-19 diagnosis in conjunction with related symptoms)
  • Nausea and vomiting (not common or specific to COVID-19, but known to occur in a small percentage)
  • Loss of appetite, a symptom common in respiratory and digestive infections alike, estimated to occur in half or more of COVID-19 cases.
  • Loss of smell, a recently new symptom associated with COVID-19 infections, but whose prevalence is difficult to determine given that it’s one of the most common symptoms of seasonal allergies and the peak of the pandemic coincides with spring allergies.
  • Nasal congestion (low incidence)
    Also see my article on Cold vs Allergies: How to Tell the Difference and find out if your loss of smell, nose stuffiness and other symptoms could be attributed to seasonal allergies or a respiratory infection.
  • Loss of taste (unknown incidence)
  • Non-specific rashes, a symptom only recently attributed to COVID-19, but of unconfirmed incidence.

COVID-19 symptoms

More serious symptoms and complications of COVID-19 may include:

  • Chest pain or a feeling of chest tightness or pressure or heaviness on the chest, a symptom of more advanced disease, indicating pulmonary implications.
  • Lung damage causing indefinite lung function impairment that can take months to years to clear.
  • Low oxygenation due to COVID-19 related lung function impairment, resulting in symptoms such as blue lips and face.
  • Respiratory failure appearing as shortness of breath, rapid breathing or difficulty breathing, blueish skin. Requires ventilation.
  • Confusion and loss of consciousness, a symptom that requires immediate medical assistance. May present itself as poor orientation in time or space, delayed recognition of familiars, lethargy or even excessive sleepiness.
  • High white blood cell count and secondary infections, viral or bacterial, most notably pneumonia, and also sepsis.
  • Multiple organ damage, including kidney failure due to kidney injury, liver damage, heart damage and abnormal blood clotting leading to ischemic events. Complications of a more serious COVID-19 infection.

Note: COVID-19 is a disease that not only produces a wide range of symptoms (respiratory, gastrointestinal, cutaneous, systemic), but also produces infections of varying severity, with symptoms intensity differing from person to person.

  • How long till COVID-19 symptoms go away?

There are several visible patterns with regards to COVID-19 infections such as, for example, those with underlying chronic illnesses such as type 1 diabetes, high blood pressure, cancer or immune system conditions or the elderly being, on average, more likely to develop severe forms of the disease, experience a lengthier recovery time or relapses compared to otherwise healthy young adults. Depending on the age and general state of health of the person prior to COVID-19 infection, as well as immune system particularities which dictate disease severity, the symptoms may go away in 7-10 days or last for weeks and up to a month in most cases. There are also reports of partial and presumably temporary impairment of lung function in people who have experienced serious forms of the disease which is in line with the most severe of symptoms observed in COVID-19 patients, which is organ damage.

As such, COVID-19 symptoms can go away completely in under a month for most patients, but residual effects such as lung function impairment may last indefinitely (months to years). Residual lung function impairment is not specific to COVID-19 infections as it has been observed in severe cases of the flu and also common cold. As a side note, the common cold can be caused by a number of Coronaviruses, although the leading cause are Rhinoviruses. Overall, disease severity is a predicting factor for recovery time.

  • The takeaway

As with many infections, COVID-19 symptomatology may differ greatly from person to person, despite there being a standard of specificness. Some people may present with low-grade fever, a bit of a headache, an inconspicuous sore throat, some degree of nasal congestion or a runny nose, while others may develop a severe form with symptoms such as a high-grade fever, dry cough that does not go away or is so severe it interferes with sleep, chest pain or tightness, difficulty breathing, pneumonia, blood in the urine and other complications. Some are downright asymptomatic, while others may have had one or several fairly mild cold or flu-like symptoms that did not interfere with daily life in any way and went away as inconspicuously as they came about. Whatever the range or intensity of symptoms experienced, given the present situation, it is good to practice rigorous hygiene and wear gloves and face masks to protect both yourselves and others from what might or might not be a mere cold or flu.

This post was updated on Saturday / August 15th, 2020 at 9:55 PM