Symptoms of Covid-19

Interesting informal analysis from a community survey: https://docs.google.com/document/d/1KmLkOArlJem-PArnBMbSp-S_E3OozD47UzvRG4qM5Yk/edit#.

An Analysis of the Prolonged COVID-19 Symptoms Survey by Patient-Led Research Team
The survey was primarily distributed to the Body Politic COVID-19 Support Group on Slack, the Facebook Survivor Corps group, and through other personal social media accounts. The survey received 640 responses and was open from April 21st to May 2nd, 2020.
Click to expand...
It's very ad hoc but still an impressive effort. Formal studies of this will be very slow as this is low on everyone's radar. Good idea to put it out there quickly.

Highlights:
  • Almost half of the respondents (47.8%) were not tested (denied testing or did not have access to a test) and the other half were nearly split between those who tested negative (yet still presented COVID-19 symptoms) and those who tested positive for COVID-19.

  • Respondents who reported testing positive were tested earlier in their illness on average (by day 10) than those who reported testing negative (on average tested by day 16). This difference between the two populations is statistically significant. This could reinforce the importance of testing symptomatic people early. See the Testing Section for additional information.

  • Over half of respondents (57.8%) listed at least one pre-existing condition, with the most prevalent conditions being asthma and vitamin D deficiency. Our analyses suggest pre-existing asthma might prolong recovery time. See the Pre-existing Conditions Section, and Recovery Timecourse Section for additional information.

  • The vast majority of participants with symptoms experienced fluctuations both in the type (70% reporting) and intensity (89% reporting) of symptoms over the course of being symptomatic. See the Nature and Severity of Symptoms Section for additional information.

  • At the time they took the survey, 90.6% of the respondents had not recovered (Recovery was Self-Interpreted for this Survey). For the 60 respondents who had recovered, the average length of time of being symptomatic was 27 days. The respondents who had not recovered had been experiencing symptoms for an average of 40 days, with a large proportion experiencing symptoms for 5-7 weeks. Our “survival analysis”, shows that the chance of full recovery by day 50 is smaller than 20%. See the Recovery Timecourse Section for additional information.

  • On Symptoms (See the Symptoms Section for additional information)
    • A slightly elevated temperature (above 98.6°F but below 100.1°F) was more commonly reported than higher temperatures (100.1°F and above).

    • In addition to the more widely recognized COVID-19 symptoms such as fever/elevated temperature, cough, and shortness of breath, the other symptoms that were highly reported by participants included fatigue (varying in severity), brain fog/concentration challenges, chills/sweats, trouble sleeping, and a loss of appetite. It is interesting to note that neurological symptoms were consistently reported by patients for eight weeks, specifically brain fog/concentration challenges and trouble sleeping.

    • Patients from this survey indicate that their first week of experiencing symptoms had milder/fewer symptoms than weeks 2 and 3. Gastrointestinal symptoms and chills/sweats seem to occur more often in weeks 1-2 and respiratory symptoms appear relatively consistent through weeks 3-4.

    • Top 10 symptoms reported over the course of the 8 weeks by this group ranked by highest to lowest are: mild shortness of breath, mild tightness of chest, moderate fatigue, mild fatigue, chills or sweats, mild body aches, dry cough, elevated temperature (98.8-100), mild headache, and brain fog/concentration challenges.

    • For this group, when comparing respondents that tested positive versus negative, only 2 of 62 symptoms (loss of smell and loss of taste) came back statistically significant, even when accounting for the point at which the respondent was tested. All other symptoms, including dry cough, loss of appetite, shortness of breath, tightness of chest, elevated temperature, fever (100.1 or greater), GI symptoms, lung burn, elevated heart rate and tachycardia, brain fog/concentration challenges, and dizziness, were not statistically different between the groups reporting positive test results and negative test results.

    • Neurological symptoms are being underreported in the media. These include brain fog, concentration challenges, memory loss, seizures, dizziness and problems with balance, various forms of insomnia, and others. Brain fog and concentration challenges were a more common symptom than cough during most weeks, as was insomnia.
  • Most of the respondents were not hospitalized. Many did visit the ER/urgent care to seek treatment, but they were not admitted to or stayed overnight at a hospital. See the Hospitalization Section for additional breakdowns and for further detail on this topic.

  • The response of respondents' satisfaction to medical care was varied with a small percentage being very satisfied with their medical care. Respondents who have been offered follow-ups and check-ins by phone, video, or chat from medical staff have reported that they felt supported independent of their treatment being medically effective. Respondents who felt unsupported often reported having been dismissed or misdiagnosed by health professionals. They were told to stay home, and sometimes denied resources such as prescriptions and further testing. Respondents that felt somewhat supported reported receiving conflicting outlooks and advice from different medical staff. In some cases, switching to another health care provider or specialist resulted in better support. See the Support by Medical Staff Section for additional information.

  • The decision to share personal stories about COVID-19 experiences was fairly split. Many have chosen to share privately, and some changed their mind as time went on. See the Sharing on Social Media Section for additional information. Those who shared reported wanting to help others based on their experiences, wanting to attract more support from people just like them, and wanting to educate and contribute to remove stigma. Those that didn’t share on social media explained they chose not to out of fear of being stigmatized, especially by work; because they did not want to mislead with false information if they were not tested or received a false negative test; because they did not have enough energy nor time to deal with responses; and because they wanted to stay private.
  • Respondents had a major decline in physical activity since contracting the virus. Before being symptomatic, 67% of respondents said they were very/moderately physically active. At the time of the survey, 65% reported now being sedentary or mostly sedentary.
Click to expand...

“I can't do any [exercise] my HR goes up very quickly and I get shortness of breath.”


“I have not had strength to return to physical activity. I did work in my house and 2 days later had a fever again after being 12 days fever free.”


“I am trying but my lung capacity is still so low that just walking has me gasping for air.”


“The one time I tried to do a regular exercise, I was too out of breath after 1/4 my usual time so I stopped early. That was probably 3-4 weeks ago.”


Based on anecdotal reports, we speculate that post viral chronic fatigue syndrome plays a role in the decrease of physical activity. We also recognize that a shift in physical activity levels may be in part due to a change in lifestyle with new quarantine and self-isolation guidelines. Further research can be done to compare activity data against a larger population.
Click to expand...
As is predictable, the confusion and uncertainty mixed with disbelief are causing quite a lot of distress. So much for the belief that diagnosing this is what causes the unhelpful beliefs...

The survey is obviously biased in favor of those who did not recover, so this is only representative of that subset of unfortunates.
At the time they took the survey, 90.6% of the respondents had not recovered. For the 60 respondents who had recovered, the average length of time spent being symptomatic was 27 days. The respondents who had not recovered had been experiencing symptoms for an average of 40 days, with a majority experiencing symptoms for 5-7 weeks.
Click to expand...

The report evaluated 62 symptoms and still got written answers:
The symptoms section had a write-in question to add any symptoms other than the above list that respondents thought were related to COVID-19. Over 200 other symptoms were reported.

The most common written in symptoms mentioned multiple times included (starting from most common): chest pain, tinnitus, heart palpitations, back pain (both upper and lower), stiff neck/neck pain, coldness in extremities and other body parts, eye burning, joint pain, diarrhea, kidney pain, muscle spasms, fizzing/gurgling in lungs, spleen pain/upper left abdominal pain under the rib, metallic taste, sinus congestion, dry nose/mouth/throat, leg pain, lump in throat, body vibration/tingling, and flare-ups of pre-existing conditions (including endometriosis, tendonitis, stomach ulcers, breast tissue that had undergone radiation, herpes, and shingles).
Click to expand...
Other notable but less commonly written-in symptoms include petechiae, changes to the ear/ear canal (including pressure, blockage, burning, and swelling), being woken up by shortness of breath, migraines, yeast infections/thrush, mouth ulcers, low temperature, exercise intolerance, rib pain, spine pain, changes in menstruation, high blood pressure, changes to the eye (including eye discharge and redness on the outside of the eye), costochondritis, constipation (one case lasting four weeks), bowel obstruction, and gassiness/bloating, and seizures/fainting.

Other sensory symptoms mentioned included sensitivity to light, blurry vision, double vision, sensitivity to noise, phantom smells, enhanced sense of smell, and loss of hearing (in one case, for three weeks).
Click to expand...
(Ramsay's research flashing in the background)
 
Last edited:
U.K. will now be using loss of smell or taste as a symptom of COVID-19. (See NHS announcements).

so that means you need to have one of the following:
-fever
-continuous cough
- loss of smell or taste

to have suspected coronavirus (and presumably, to get a test).

However we know from other countries & from the symptom tracker app that many DON’T have these symptoms And still have coronavirus. So although they’ve recognised loss of smell and taste (only a few months too late...), It’s still not enough.
 
Hallelujah. How many weeks ago was it that I read about the anecdotal evidence about anosmia in, I think, the Washington Post? Feels like a couple of months. Just think of all the people who have become unnecessarily infected in the interim :( Better late than never.
 
Merged thread

Coronavirus: 'Baffling' observations from the front line - article from BBC News 23/05/20

When you talk to intensive care doctors across the UK, exhausted after weeks of dealing with the ravages of Covid-19, the phrase that emerges time after time is, "We've never seen anything like this before."

They knew a new disease was coming, and they were expecting resources to be stretched by an unknown respiratory infection which had first appeared in China at the end of last year.

And as the number of cases increased, doctors up and down the UK were reading first-hand accounts from colleagues in China, and then in Italy - in scientific journals and on social media - about the intensity of infection.

"It felt in some ways like we were trying to prepare for the D-Day landings," says Barbara Miles, clinical director of intensive care at Glasgow Royal Infirmary, "with three weeks to get ready and not a great deal of knowledge about what we would be facing".

But what arrived in the UK as winter turned into spring took even the most experienced ICU specialists by surprise.

https://www.bbc.co.uk/news/52760992
 
Last edited by a moderator:
In a growing number of patients, the brain has also become a serious cause for concern among senior doctors who've been exchanging information on a daily basis for weeks. "We now know that large numbers of patients are having significant inflammation of the brain," observes Hugh Montgomery.

"The inflammation presents with everything from delirium and confusion, even more than we would normally expect in ICU, to fits and what we call diffuse encephalitis."
Click to expand...
Lack of oxygen and damaged blood vessels are clearly part of the equation. But evidence is mounting that many organs are being attacked by the virus directly, and it is striking that the most common underlying conditions involved with Covid-19 are not respiratory problems like asthma.

Instead, they are vascular conditions that affect the veins and the arteries - high blood pressure, diabetes and heart disease, along with associated factors such as gender, obesity and in particular old age.
Click to expand...
One leading theory focuses on ACE-2, a protein which sits on the surface of many types of cells and helps regulate blood pressure. It is ACE-2 that the coronavirus uses to enter the body and infect healthy cells. Some people may be genetically predisposed to having more ACE-2 receptors in their body, and may therefore be more likely to fall seriously ill with Covid-19.

Further evidence to support this theory can be found in the number of seriously ill patients who develop gut problems, which suggests the virus can also attack the lower digestive tract where there are plenty of ACE-2 receptors. It looks likely that ACE-2 is also responsible for the high incidence of kidney failure.
Click to expand...
They know the failure of lungs has certainly been the biggest cause of Covid deaths in intensive care, but it is not the only one. That means what has been done in the past may not always be the right thing to do for this particular illness.
Click to expand...
 
"The inflammation presents with everything from delirium and confusion, even more than we would normally expect in ICU, to fits and what we call diffuse encephalitis."
Click to expand...

It may not be relevant to this thread, or even correct, but I know I've seen ME sometimes mentioned in conjunction with "diffuse encephalitis" or a "diffuse inflammation of the brain," such as here in a 2007 article written by Malcolm Hooper.

The importance of a diffuse inflammation associated with ME has been found in autopsy examinations of spinal cord and brain tissue and underlines the importance and accuracy of its designation as an inflammatory illness involving the central nervous system and new understandings of neurogenic pain also provides a mechanism for the severe pain experienced by many people with ME.
http://www.investinme.org/Documents/Journals/Journal%20of%20IiME%20Vol%201%20Issue%201.pdf
Click to expand...

I've also seen this idea dismissed on the basis that encephalitis is too deadly to be associated with ME, though there are mild forms of viral encephalitis that only cause flu-like symptoms. Perhaps the objection is to the notion of a chronic encephalitis.
 
Sly Saint said:
One leading theory focuses on ACE-2, a protein which sits on the surface of many types of cells and helps regulate blood pressure. It is ACE-2 that the coronavirus uses to enter the body and infect healthy cells. Some people may be genetically predisposed to having more ACE-2 receptors in their body, and may therefore be more likely to fall seriously ill with Covid-19.
Click to expand...

I've long been suggesting that ACE2 dysregulation is the key problem, but I doubt very much that it is genetics that will explain the variance.
 
I've been pretty confused about the effect, one way or the other, of taking ACE (Angiotensin-converting enzyme) inhibitors or ARB's (Angiotensin II Receptor Blockers) vis-a-vis COVID-19.

This pre-print paper out of Yale University has not been peer-reviewed yet, but in a study of about 10,000 patient records it found that -
The use of ACE inhibitors and ARBs was not associated with the risk of hospitalization or mortality among those infected with SARS-CoV-2. However, there was a nearly 40% lower risk of hospitalization with the use of ACE inhibitors in the Medicare population.
Click to expand...
[my bold]

So, the only effect seems to be that ACE inhibitors reduce hospitalizations by almost 40%, if you're over 65 (which would be good news, if confirmed).

The paper: https://www.medrxiv.org/content/10.1101/2020.05.17.20104943v1

Article about the paper: https://news.yale.edu/2020/05/27/se...ce-inhibitors-have-lower-hospitalization-risk


Of course, the views on this could all change by tomorrow...


 
Forbin said:
So, the only effect seems to be that ACE inhibitors reduce hospitalizations by almost 40%, if you're over 65 (which would be good news, if confirmed).
Click to expand...

well, they're tracking an association, so we don't know that it's a causal relationship. Very likely those of Medicare age who took them were different than those who didn't take them in multiple ways.
 
dave30th said:
well, they're tracking an association, so we don't know that it's a causal relationship. Very likely those of Medicare age who took them were different than those who didn't take them in multiple ways.
Click to expand...

True. If nothing else, taking an ACE inhibitor implies you have an ongoing relationship with a doctor - although that would also be true for ARB's, which showed no effect.
 
Forbin said:
True. If nothing else, taking an ACE inhibitor implies you have an ongoing relationship with a doctor - although that would also be true for ARB's, which showed no effect.
Click to expand...
I doubt the wisdom of taking ACE inhibitors without checking one's blood sodium levels, as they tend to reduce them, in my own case very significantly - I ended up with severe hyponatraemia. Just saying for anyone who doesn't know.
 
It goes without saying that no one should even consider starting or stopping a medication based on a single study that has not even gone through peer review yet.

I just thought the paper represented an interesting contradiction to earlier speculation I'd seen suggesting that ACE inhibitors might somehow make COVID-19 worse. That's what I meant when I said that the views on this could all change again tomorrow.
 
Wits_End said:
Apparently another 3 symptoms have officially been added to the list:

http://www.msn.com/en-gb/health/med...-had-virus/ar-BB163xPT?li=AAnZ9Ug&ocid=ASUDHP
Click to expand...
Finally GI symptoms. Took them long enough. At this pace they'll have them all sometime by 2025. You know, with genuine patient-led medicine, this would go much faster. It's tedious having to wait for people to catch up to things that have been obvious for months.

It's interesting to see runny nose because initially there was a belief that it was not part of it, as in almost an exclusionary factor likely hinting at another respiratory infection.
 
You must log in or register to reply here.
Back
Top Bottom