How Can You Find Out If You Have Hiv – Visualization of terms related to various health problems. Many patients with Covid-19 report a completely different set of symptoms. Zack Freeland /; Getty Images
What are the signs that you have contracted the coronavirus? This is a surprisingly difficult question to answer, and one that hinders the fight against the disease.
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The Centers for Disease Control and Prevention updated its guidelines at the end of April, including a new loss of taste or smell as a symptom of Covid-19, as well as signs such as colds, repeated colds, muscle pain, sore throat and headache . This is in addition to fever, cough and shortness of breath, which are considered more common.
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Some patients infected with SARS-CoV-2, the virus that causes Covid-19, have experienced symptoms such as vomiting, rashes and lesions on the toes. In some people, the symptoms of Covid-19 overlap with those of other illnesses, such as the flu, making these infections difficult to distinguish without tests. And some infected patients report no symptoms.
“As this pandemic unfolds, it is becoming very clear that the symptoms of Covid vary greatly from person to person, and there are many symptoms that we did not previously think were associated with Covid,” said Andrew Chan, a professor. of Immunology and Infectious Diseases at the Harvard T. Chan School of Public Health. “As a result, it really set back our ability to identify people with Covid infections, and probably led to a lot of people walking around with Covid and not knowing it.”
That has made the response to the crisis even more frustrating and confusing for health officials, especially in the United States, where testing for the virus remains rare. Symptoms are external signs of the disease and in extreme cases can serve as an example for investigation. Many hospitals are already telling patients with Covid-19 symptoms to assume they have the virus and self-isolate without first testing for the virus.
A cluster of symptoms can highlight an emerging hotspot for the virus in a population. But without a clear idea of how Covid-19 manifests itself, it is difficult to even approach the true extent of the pandemic. And without understanding what to look for, it is difficult for healthcare professionals to take the right precautions and offer the right treatments to their patients.
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As a result, many communities have been forced to resort to crude, overarching and destructive measures to contain the pandemic, such as shelter-in-place orders. Lifting these restrictions will require a major effort to test the population for the virus, track movement and build healthcare capacity with beds, ventilators, masks and workers. Yet there are parts of the US that are lifting even these crude measures to limit the spread of Covid-19.
Still, researchers are coming up with new ways to track the virus by going back to patient records to see what signs are associated with the disease. They also ask people to self-report their symptoms and track them using a mobile app. They find that some mild symptoms that are easy to brush off can be harbingers of disease. This knowledge could help slow the pandemic and reveal new approaches to fighting the virus.
Many of the guidelines for Covid-19 symptoms are based on what scientists have learned from past cases, particularly in China, where the virus emerged and spread rapidly in January and February. For example, the World Health Organization reviewed more than 55,000 confirmed cases of Covid-19 in China. In February, they found that the most common symptoms were fever (87.9 percent of confirmed cases) and dry cough (67.7 percent), followed by fatigue (38.1 percent), sputum production (33.4 percent), shortness of breath (18.6 percent). ), sore throat (13.9 percent) and headache (13.6 percent).
But the patients they looked at didn’t necessarily represent everyone who had the virus — just those who were tested and treated. In the study, about 80 percent of patients had mild to moderate disease, 13.8 percent had severe disease, and 6.1 percent were in critical condition.
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It is likely that many infected patients with very mild or no symptoms were not included in the study, which would mean that their symptoms (or lack thereof) were underrepresented in these statistics.
Other studies have shown that symptoms such as gastrointestinal problems can predict the disease. A previous peer-reviewed study of 204 patients in China found that more than half of them experienced symptoms such as diarrhea, vomiting and abdominal pain.
Another preliminary study, this time from Germany, found that some patients with Covid-19 had symptoms more like a cold, such as a runny nose. Researchers from Italy have also reported that feelings of discomfort and malaise are linked to Covid-19. And doctors in the US have described neurological symptoms such as confusion and seizures in some Covid-19 patients, especially the elderly.
These vague and sometimes contradictory symptoms may reflect how the virus interacts with underlying medical conditions in some patients, such as diabetes and high blood pressure, or simply differences in susceptibility. Such variations are a phenomenon doctors have seen in other infections.
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“For example, with flu most people have fever, body aches and malaise. But a smaller proportion of people will present with diarrhea and vomiting,” David Pride, associate director of microbiology at the University of California, San Diego, said in an email. “What we’re experiencing with Covid-19, is probably just a reflection of what we see in a number of other diseases where it affects a group of people differently.”
There is also a wide range in how severe Covid-19 can be, even within specific subgroups. There are elderly patients who have not passed the virus. There are children who have died from it.
Many of these less common symptom reports still require more extensive validation before they can be used as clinical guidelines. But they illustrate how confusing it can be for patients and doctors to detect Covid-19 without proper testing.
Before the CDC guidelines changed, there were complaints that anosmia, the loss of smell, and ageusia, the loss of taste, could indicate a Covid-19 infection. Utah Jazz player Rudy Gobert, who tested positive for the virus, said on Twitter that it was one of his most noticeable symptoms. The son of British sports broadcaster Gary Lineker drank vinegar and lemon juice on Instagram to show his loss of taste after contracting Covid-19.
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Doctors at the British Rhinological Society said in March they had “noticed a rapidly increasing number of reports of a significant increase in patients with anosmia in the absence of other symptoms”. Researchers from the University of Newcastle wrote in the BMJ: “There is now enough evidence to take this symptom more seriously.”
Researchers from Great Britain and the United States have recently supported this idea with data. Using a Covid symptom tracker app for smartphones, launched on March 24, researchers combined daily reports from more than 2.6 million users (2.45 million in the UK and 168,000 in the US) about their symptoms or their absence. In a May 11 article in the journal Nature Medicine, they found that a peculiar loss of taste and smell is strongly associated with a positive test for Covid-19.
“The strongest association between any of these symptoms and a positive test was loss of smell and taste,” said Tim Spector, a professor of molecular epidemiology at King’s College London, who co-authored the study with Harvard’s Andrew Chan.
During the study, 7,178 app users reported testing positive for Covid-19. And 65 percent of them said they lost their sense of smell and taste. This is a higher rate than app users with COVID-19 reported fever or any other symptoms.
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The likely mechanism here is related to how the SARS-CoV-2 virus works. Researchers from the US and the UK reported in a previous study that the virus attacks cells associated with smell in the nasal passages of both mice and humans. This “may lead to anosmia or other forms of olfactory dysfunction,” the researchers wrote.
Spector cautioned that not tasting coffee or smelling wildflowers is not a definitive sign of Covid-19. Loss of taste and smell is associated with other upper respiratory tract infections as well as some allergies. In most cases, the loss of these feelings is not permanent.
That’s why Spector’s team used data from their app to build a model of which combination of symptoms is most closely associated with a positive test for the virus, rather than studying individual symptoms.
Using the model, Spector and his team estimated that among the 800,000 app users who self-reported symptoms but were never tested for Covid-19, about 140,000, or 17.5 percent, were likely infected with Covid-19 . 19. virus.
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“As this pandemic unfolds, it is becoming very clear that the symptoms of Covid vary quite a bit from person to person.”
Spector said that such symptom tracking in places where adequate testing is lacking could at some point serve as an early warning of a rising wave of Covid-19 — and potentially allow infected people to take precautions
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