What to expect: COVID-19 symptoms

Kristine Sabillo, ABS-CBN News

Posted at Mar 17 2020 07:55 PM | Updated as of Mar 18 2020 02:27 PM

A patient in a biocontainment unit is carried on a stretcher at the Columbus Covid 2 Hospital in Rome, Monday. Alessandra Tarantino, AP

MANILA — There has been a lot of discussion about how COVID-19 is different from the seasonal flu or the common cold, especially with many people heading to hospitals in the hopes of being tested.

Should you stay at home and nurse your cough or should you go to the nearest hospital to be properly treated? Here’s what we learned from experts and health organizations on what to expect if you are infected with COVID-19.

COMMON SYMPTOMS

A report from the World Health Organization and China Joint Mission on the COVID-19 published in February said that of the 55,924 laboratory-confirmed cases it recorded, 87.9% had fever and 67.7% had dry cough. A third had fatigue (38.1%) and sputum production (33.4%). Other symptoms recorded were shortness of breath (18.6%), sore throat (13.9%), headache (13.6%), myalgia or arthralgia or joint and muscle pain (14.8%), chills (11.4%), nausea or vomiting (5%), nasal congestion (4.8%), diarrhea (3.7%), hemoptysis or coughing up of blood (0.9%) and conjunctival congestion or eye problems (0.8%).

DAY 1-3 FIRST SYMPTOM

Many studies found out that the median incubation period of COVID-19 is 4 or 5 days. The first symptoms experienced are fever, fatigue and dry cough. Some also experience muscle or joint pain. 

A very small percentage of patients experienced diarrhea and nausea two or three days before developing fever and difficulty breathing.

People who experience any of these symptoms are advised to stay at home and observe. However, if you have recently traveled to a country with local transmission of COVID-19 or have been in contact with a confirmed case then you will be considered a person under investigation. 

Those with mild symptoms can undergo home quarantine, according to the Department of Health. But those who are elderly, pre-existing conditions (cardiovascular disease, diabetes, cancer, chronic lung disease, and immunosuppression) and severe manifestations such as difficulty breathing should go to a hospital to be tested. 

DAY 4-6

Around this time, symptoms may have worsened. Some of those infected will start to experience difficulty breathing.

DAY 7

Based on a study from Wuhan, China, patients with severe cases, on average, are brought to the hospital by the 7th day. Although another study from Singapore said patients there were admitted to the hospital 4 days after the first symptoms show.

Most cases, however, are mild and do not require hospitalization. It is better to consult a doctor if you are experiencing symptoms.

DAY 8

Patients with severe or critical cases can develop acute respiratory distress syndrome (ARDS), a kind of lung damage that causes fluid to fill the lungs. This can be fatal. Under a CT scan, patients with COVID-19 have lungs that show white patches or “ground glass opacity” because of the fluid.

It is around this time that some cases, even those that are mild, are diagnosed as pneumonia.

DAY 10

Worsening symptoms such as abdominal pain and anorexia or lack of appetite by Day 10 often result in the patient being admitted to the intensive care unit (ICU) of the hospital.

Some critical cases develop other types of organ dysfunction such as acute cardiac injury acute kidney injury. A few also experience septic shock or liver dysfunction.

Only a small fraction of those with COVID-19 develop these severe symptoms. According to the World Health Organization, an average of 81% of the cases are mild, 14% are severe and 5% are critical.

The median hospital stay for those who recover, according to a study from Wuhan, is 10 days.

DAY 14

According to the joint WHO-China report, mild cases recover within 2 weeks but those with severe or critical disease recover in 3-6 weeks.

There are more than 180,000 confirmed COVID-19 cases worldwide, based on the John Hopkins University’s COVID-19 Interactive Map. Of that number 79,000 have already recovered and more than 7,000 have died.


References:
https://www.who.int/docs/default-source/coronaviruse/who-china-joint-mission-on-covid-19-final-report.pdf
https://www.nejm.org/doi/full/10.1056/NEJMoa2002032
https://jamanetwork.com/journals/jama/fullarticle/2761044
https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(20)30211-7/fulltext
https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(20)30528-6/fulltext
https://www.cdc.gov/coronavirus/2019-ncov/hcp/clinical-guidance-management-patients.html