It was only a matter of time before the Centers of Disease Control and Prevention (CDC) added to this list. For a while, the “Symptoms of Coronavirus” list on their Coronavirus Disease 2019 (COVID-19) website stayed at three symptoms: fever, cough, and shortness of breath or difficulty breathing. Not anymore. The CDC has now added six more to bring the total to nine.
The six new additions are:
- Repeated shaking with chills
- Muscle pain
- Sore throat
- New loss of taste or smell
So if you have any of the nine listed symptoms, you may have a COVID-19 coronavirus infection. Or you may not. Unless you do. Such symptoms could be due to the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), except when they aren’t and something else is causing them. Got it?
Is all of this giving you a headache? Or is your headache from COVID-19? Probably not, if it just started from looking at the list. But if it continues, then maybe.
At least, if you have another diagnosis like an influenza, respiratory syncytial virus (RSV), or some other respiratory virus infection that can cause some of the above symptoms, you can be rest assured that you don’t have a COVID-19 coronavirus infection. Except when you have both types of infections at the same time. A research letter published in JAMA revealed that 20.7% of specimens that tested positive for SARS-CoV-2 also tested positive for one or more other pathogens as well. For the study, David Kim, MD, PhD, James Quinn, MD, MS, Benjamin Pinsky, MD, PhD, Nigam H. Shah, MBBS, PhD, and Ian Brown, MD, MS, from the Stanford University School of Medicine reviewed result from 1217 specimens from 1206 patients who were tested for SARS-CoV-2 and other respiratory pathogens with 116 (9.5%) of these turning out to be positive for SARS-CoV-2. Of the 24 specimens that had SARS-CoV2 and at least one other respiratory pathogen, 6.9% tested positive for rhinovirus/enterovirus, 5.2% for respiratory syncytial virus (5.2%), 4.3% for other coronaviruses besides the SARS-CoV-2, and a little over 3% for some type of influenza. So if you have another respiratory virus infection, you could still have COVID-19. In the words of Bill Lumbergh from the movie Office Space, “that’ll be great.”
How’s that for freaking confusing? As more and more reports emerge of people having different groups of symptoms, it has become increasingly clear that fever, cough, and respiratory symptoms are not the only things that you should be looking for if you are worried about COVID-19. It’s also becoming increasingly clear that the course of COVID-19 can be very variable and reminiscent of that Michael Scott quote from the television show The Office: “Sometimes I’ll start a sentence and I don’t even know where it’s going. I just hope I find it along the way.” Your course of symptoms, of course, may make sense, except when it doesn’t.
The CDC list is far from exhaustive. What symptoms you get can seem like a game of craps, in more ways than one. For example, Robert Glatter has written for Forbes about how stomach ache and diarrhea could be the first signs of COVID-19. I have covered for Forbes some of the eye symptoms that may be present. Then, there’s the letter to the Journal of The European Academy of Dermatology and Venerealogy that reported on two patients with COVID-19 who initially had only fever and urticaria, which is medical-speak for hives.
It would certainly be a lot easier if COVID-19 had a clear classic symptom like the measles (a rash), the chicken pox (vesicles, which are fluid-filled little sacs on your skin), or foreign accent syndrome (take a wild guess). But the lack of such a clear symptom means that making COVID-19 coronavirus testing much more widely available is all the more important. The CDC does provide an online Coronavirus Self-Checker to help you determine whether you should contact your doctor. However, this is not a way to diagnose COVID-19. Neither is an app nor asking other people on Facebook. The only way to really diagnose COVID-19 is to get the cotton swab up the nose and to the back of your throat test to check the gunk for the RNA of the virus.
So far, other things on the CDC Symptoms of Coronavirus website haven’t really changed. It still indicates that you may begin experience symptoms two to 14 days after being exposed to the virus. And the list of emergency warning signs still includes trouble breathing, persistent pain or pressure in the chest, new confusion or inability to arouse, and bluish lips or face. If you have any of these symptoms, you may have severe COVID-19 that requires immediate medical attention. Unless of course, something else is causing these symptoms and you don’t have COVID-19. Either way get real medical attention as soon as possible.