Coronavirus Symptoms: When to seek help

Manish Nandy

The symptoms that you have the novel coronavirus that causes Covid-19 are few and appear 2-14 days after exposure to the virus, according to the CDC. To identify those symptoms and act upon them is critical.

"We're emphasizing fever plus a notable lower respiratory tract symptom -- cough or trouble breathing," said infectious disease expert Dr. William Schaffner.

Fever

Fever is a key symptom. It's really not a fever until the temperature reaches 100 degrees Fahrenheit (37.7 degrees Celsius) for children and adults.

There are misconceptions about fever. Average daily temperature is 98.6 ̊ F (37 ̊C) but it goes up and down during the day. So, 99.0 ̊F or 99.5 ̊F is not a fever.

Take temperature in the late afternoon and early evening. Your temperature goes up in the late afternoon and early evening -- it's a common way that viruses produce fever.

Cough

Coughing is another key symptom, but it's not just any cough, said Schaffner. It should be a dry cough that you feel in your chest.

"It's not a tickle in your throat. You're not just clearing your throat. It's not just irritated. You're not putting anything out, you're not coughing anything up," Schaffner said.

"The cough is bothersome; it's coming from your breastbone or sternum. and you can tell that your bronchial tubes are inflamed or irritated," he added.

Difficulty breathing

Shortness of breath can be a third -- and very serious – manifestation. It can occur on its own, without a cough. If your chest becomes tight or you begin to feel as if you cannot breathe deeply enough to get a good breath, that's a sign to act, experts say.

"If there's any shortness of breath immediately call your health care provider, a local urgent care or the emergency department," said American Medical Association president Dr. Patrice Harris. "If the shortness of breath is severe enough, you should call 911," Harris added.

In addition, the CDC lists emergency warning signs as a "persistent pain or pressure in the chest," "bluish lips or face" -- which indicates a lack of oxygen -- and any sudden mental confusion or lethargy and inability to rouse. Get medical attention immediately, the CDC says.

Flu and cold symptoms

This trifecta of symptoms -- fever, cough and shortness of breath -- are not the only signs of sickness.

Many other symptoms can resemble the flu, including headaches, digestive issues, body aches and fatigue, which can be severe. Still other symptoms can resemble a cold or allergies, such as a runny nose, sore throat and sneezing.

Most likely you simply have a cold or the flu -- after all they can cause fever and cough too. One possible sign that you have Covid-19 is if your symptoms, especially shortness of breath, don't improve after a week but worsen.

Unusual symptoms

The American Academy of Otolaryngology-Head and Neck Surgery has said that, in early stages, symptoms of anosmia, or lack of sense of smell, and dysgeusia, or lack of taste, should be used to identify possible infection. Medical literature indicates that a sudden loss of smell may be associated with respiratory infections.

Another unusual symptom is conjunctivitis, a highly contagious condition also known as pink eye. Conjunctivitis is an inflammation of the thin, transparent layer of tissue, called conjunctiva, that covers the white part of the eye and the inside of the eyelid. It affected
1-3% of infected people in China and a pink eye could be one more sign that you should call your doctor if you also have fever, cough or shortness of breath.

A study in China also described milder cases in which the initial symptoms were digestive issues such as diarrhea, often without fever.

What should you do?

The current guidance is that if you have mild symptoms like those of cold and flu, stay at home and try to manage them, with rest, hydration and the use of fever-reducing medications.

If you are over age 60, since immune systems weaken as we age, or if you are pregnant, one should call the healthcare provider, according to the CDC.

Infections are riskier if you have underlying health conditions such as diabetes, chronic lung disease or asthma, heart failure or heart disease, sickle cell anemia, cancer, kidney disease with dialysis, a body mass index (BMI) over 40 (extremely obese) or an autoimmune disorder. Such people should contact their physician early for even mild illness. Even the young are at higher risk if they have underlying health issues.

How to be evaluated

If you have no symptoms, please do not ask for testing or add to backlog of calls at testing centers, clinics, hospitals. But people who have important symptoms should reach out to be evaluated.

Where should you go?

If you have insurance and you're looking for a provider or someone to call or connect with, there's always a number on the back of your insurance card. If you go online, there is information for patients.

If you don't have insurance, you can start with the state health department or the local community health centers. Some states have a 800 hotline number.

If there is a testing and assessment center near you, you can go there directly, but notify them that you're coming. Otherwise, call your healthcare provider and they will direct you what to do.

Back to Home Page

Apr 3, 2020