A study conducted by the University of Southern California and published in the Frontiers in Public Health says that a fever is the most likely first symptom, followed by a cough and then muscle pain.
"Our results support the notion that fever should be used to screen for entry into facilities as regions begin to reopen after the outbreak of Spring 2020," the study said.
The next most likely symptoms to appear are nausea and/or vomiting and diarrhea.
“The upper GI tract (i.e., nausea/vomiting) seems to be affected before the lower GI tract (i.e., diarrhea) in COVID-19, which is the opposite from MERS and SARS,” the scientists wrote.
Fever and cough are frequently associated with a variety of respiratory illnesses, including Middle East respiratory syndrome (MERS) and severe acute respiratory syndrome (SARS). But the timing and symptoms in the upper and lower gastrointestinal tract set COVID-19 apart.
“This order is especially important to know when we have overlapping cycles of illnesses like the flu that coincide with infections of COVID-19,” said Peter Kuhn, professor of medicine, biomedical engineering, and aerospace and mechanical engineering at the USC Dornsife College of Letters, Arts and Sciences. “Doctors can determine what steps to take to care for the patient, and they may prevent the patient’s condition from worsening.”
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The first nine symptoms listed for the virus identified by the Centers for Disease Control and Prevention (CDC) were:
- Shortness of breath or difficulty breathing
- Muscle or body aches
- New loss of taste or smell
- Sore throat
In late June, the CDC added three new symptoms for COVID-19:
- Congestion or runny nose
- Nausea or vomiting
The list does not include all possible symptoms, the CDC notes.
The CDC had initially listed three symptoms for COVID-19: fever, cough and shortness of breath/difficulty breathing.
In late April, it added chills/repeated shaking with chills, muscle pain, headache, sore throat and new loss of taste or smell.
- Trouble breathing
- Persistent pain or pressure in the chest
- New confusion
- Inability to wake or stay awake
- Bluish lips or face
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