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COVID Symptoms Usually Appear Like This

Here's the order COVID symptoms typically happen, according to experts. 

While COVID has proven to be unpredictable and difficult to pinpoint what it's going to do next, one thing is clear. The virus affects everyone differently, but there are certain patterns of symptoms that appear to be common among patients. Eat This, Not That! Health spoke with Dr. Jagdish Khubchandani, MBBS, Ph.D., a professor of public health at New Mexico State University who explained the order of symptoms to watch out for and why they happen in a certain sequence. Read on—and to ensure your health and the health of others, don't miss these Sure Signs You've Already Had COVID.


Pattern of Symptoms Can Vary Based on Certain Factors

Doctor and covid-19 infected patient in bed in hospital.

Dr. Khubchandani says, "COVID-19 symptoms can be of a wide variety and also, can be similar to symptoms of other infectious diseases (e.g. seasonal flu). Not too many initial symptoms are peculiar to COVID-19 and there is no guarantee that any of the symptoms will appear first or later. The symptom appearance sequence has differed based on factors such as age and gender of patients studied, geographic region of the patients evaluated, type of variant, and whether the symptom reports came from a healthcare setting or via public/government database. However, the most common symptoms have been extensively studied now using information from hundreds of thousands of patients across the world."

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woman with cold and flu bad symptoms

Dr. Khubchandani states, "Across multiple studies from various parts of the world, fever has emerged as the most common symptom that is often the first symptom as well. Especially, for those who reach out to a healthcare provider/facility and are symptomatic, fever is seen in more than half of the infected individuals. This could be a key difference between COVID-19 and symptom appearances of other infectious diseases. For example, studies have suggested that fever could be the first symptom of COVID-19 infection whereas cough could be the first symptom of influenza. The challenge however is that fever is a very non-specific symptom that can occur with a wide range of diseases."

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Cough and Sore Throat


According to Dr. Khubchandani, In most studies worldwide, cough is closely followed by fever or may occur simultaneously. In the first year of the pandemic, a large study evaluated more than 50,000 cases of COVID-19 and found that cough could be the second most common symptom. However, when these researchers later evaluated the symptom patterns of the Delta variant, they found that patients in China were more likely to have fever followed by cough, but patients in the United States were more likely to have cough before fever. In essence, cough and fever could be the most common COVID-19 symptoms and the first ones to raise suspicion about being infected. The challenge however is that these two symptoms are also among the most common symptoms of flu and individuals should always get tested to confirm if they have COVID-19. Breathing difficulties may follow cough and sore throat and warrant urgent medical care. Hospitalizations for COVID-19 worldwide were triggered by breathing difficulties that occurred after coughing and sore throat. Having multiple symptoms with breathing difficulties and comorbid conditions are key predictors for poor outcomes or death following COVID-19 infections."

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Fatigue, Malaise, Body Pains

Moody young woman holding her neck

"Numerous studies throughout the pandemic suggest that infected individuals report symptoms of fatigue, weakness, general feeling of discomfort, or body pains (e.g. headaches, muscular pains, chest pain, etc.)," says Dr. Khubchandani. "All put together, these could be the third most common type of symptoms or a group of illness-related problems reported by patients. As the body continues to fight the virus, several proteins and chemicals are released in and by our blood cells that cause these symptoms." 

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​​Loss of Taste or Smell Sensation

woman trying to sense smell of half fresh orange, has symptoms of Covid-19

Dr. Khubchandani shares, "In the first year of the pandemic, these symptoms got a lot of attention as they were a surprise even for the scientific and medical community (especially, due to their prolonged duration). A review of more than 7,500 patients worldwide in the first year of the pandemic found that almost half of the COVID-19 patients reported some degree of loss of smell or taste sensations making these symptoms the fourth most common ones after fever, cough, and fatigue."

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Nausea/Vomiting or Diarrhea

Tired African-American man having headache after hard day, feeling exhausted

Dr. Khubchandani explains, "There has been considerable variation in research on nausea/vomiting and diarrhea as COVID-19 symptoms along with abdominal pain. While some studies suggest that diarrhea may appear first, some suggest that nausea/vomiting could be more common. For example, some studies suggest that COVID-19 infected people in the United States were more likely to have diarrhea before nausea/vomiting while some suggest that these symptoms are more common in hospitalized patients. Despite ranking low on the symptom list of COVID-19, these are symptoms that may not occur with seasonal flu or other common colds and should be considered a warning sign for COVID-19 infection."

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Get Tested

Nurse holding test tube with blood for 2019-nCoV.

"While these symptoms are warning signs for COVID-19 infections, they may not even occur in many individuals (e.g. asymptomatic infections)," Dr. Khubchandani reminds us. "Also, the only way to confirm the infection is with a test and individuals should go for testing as soon as they have any of these symptoms. The CDC along with other agencies have suggested that COVID-19 may resemble other respiratory infections or may even occur with other infections such as flu and testing is key for confirmation." 

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How to Stay Safe Out There

Doctor had just vaccinated a young female patient in the hospital.

Follow the public health fundamentals and help end this pandemic, no matter where you live—get vaccinated or boosted ASAP; if you live in an area with low vaccination rates, wear an N95 face mask, don't travel, social distance, avoid large crowds, don't go indoors with people you're not sheltering with (especially in bars), practice good hand hygiene, and to protect your life and the lives of others, don't visit any of these 35 Places You're Most Likely to Catch COVID.

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Heather Newgen
Heather Newgen has two decades of experience reporting and writing about health, fitness, entertainment and travel. Heather currently freelances for several publications. Read more about Heather
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