What are the earliest symptoms of COVID-19?
Anika H. Ahmed, MD
COVID-19 has a long incubation period of 2-14 days, before any symptoms appear. On average it takes 5-6 days for symptoms to appear in someone infected with COVID-19, but they can appear as late as 14 days after being infected. It has a wide range of symptoms, and the symptoms can vary from individual to individual in duration, severity, and clinical discomfort. The common earliest symptoms seen in COVID-19 are the following:
1) Coughing – most of the patients have a dry cough that can vary between mild to severe.
2) Sore throat – a scratchy throat with discomfort in swallowing.
3) Fever – usually starts as a low-grade fever of 99F and can then spike to over 100F. Close monitoring of temperature by maintaining an hourly temperature chart is helpful in monitoring and studying the pattern of the fever.
4) Headache – especially felt more with high fever and body aches.
5) Muscle pains and body aches – many will experience generalized body aches, in particular muscle aches and pains as a first symptom, a warning that one is not well and is harboring a virus.
6) Chills and rigors – as the temperature spikes up and down, most of those infected with COVID-19 will have the chills and a feeling of being cold followed by rigors too.
7) Loss of sense of taste and smell – many patients early on complain of developing a loss of sense of taste and smell. Anyone who has noticed a sensory loss of taste or smell should keep a close eye out for any additional symptoms, as this can be the first early sign of the COVID-19 infection.
8) Shortness of breath – can develop in patients in the initial stages, which is mainly due to the reaction of the immune system. Some of it is due to the direct effect of the virus on the lungs and most of it is also due to the reaction of the patient’s immune response to the virus, which brings immune cells to the lungs, leading to inflammation and, in severe cases, respiratory distress.
The above symptoms can be seen in patients as mostly mild, leading to recovery in a couple of days to a week or so. However, in contrast, after a formal diagnosis, some can move from mild to severe symptoms, recover slightly or a lot, and then again get severe symptoms 7-10 days later, most likely due to the cytokine storm of the immune system. A cytokine storm refers to the overreaction of the immune system on exposure to the virus that starts an inflammatory reaction. Mostly in the beginning it starts as a cold and is asymptomatic, and then exhibits early symptoms of a dry cough, headache, and a fever with chills, resulting in more severe symptoms of pneumonia. The key here is that once symptoms appear one must remain hydrated and rest well with immediate, complete isolation from everyone!