A more inclusive list of warning signs

By Kelly Sargent

As the number of novel coronavirus cases has risen — as of April 13, 2020 nearly 2 million confirmed cases and 120,000 deaths worldwide; almost 600,000 cases in the US and 23,000 deaths — doctors have recognized more potential warning signs than those first identified. In addition to taking as many precautions as you can, such as frequent, thorough hand-washing and physical distancing, monitoring your health and those of loved ones is vital. Here's a more comprehensive list of possible symptoms.

1. Fever 
The World Health Organization reported that 88% of individuals infected with COVID-19 experienced a fever. But what temperature qualifies as having a fever? The 98.6 degree Fahrenheit benchmark we've grown up memorizing as 'normal' was arrived at in the mid-1800's, and it's been gradually dropping throughout the population ever since. It's now the exception rather than the rule. In fact 75% of us have a normal body temperature lower than that, so it's important to know what 'normal' is for you. My husband's, for example, runs steadily at about 97.7. Most adults are considered feverish when their temperature hits 100 F. Fever often elevates in the late afternoon or early evening which makes that an ideal time to check.

2. Difficulty breathing
Although shortness of breath isn't usually an early symptom of coronavirus infection, it's an extremely serious one. Medical experts say that it's important to seek medical attention if you can't breathe deeply enough to take in a normal breath or if you experience persistent pain or pressure in your chest. Some patients have reported feeling as though a tight band was bound around their upper chest constricting their ability to fully inflate their lungs. 

3. Dry Cough
A persistent cough is another prevalent warning sign, but doctors say that it's not just any cough; it's not a tickle in your throat or the urge to clear your throat. It's a dry cough that feels as though it emanates from underneath your sternum deep inside your chest. 

4. Chills and body aches
In journalist Chris Cuomo's case, he was shaking so violently from the chills he had that he chipped a tooth, and his body aches were so severe that he felt beaten up. It may be difficult for those with less pronounced symptoms to distinguish coronavirus chills and achy muscles and joints from flu symptoms. One gauge: if your symptoms don't improve after about a week, but get worse instead, it may be a sign that you're dealing with the coronavirus and not the flu.

5. Inability to wake up
The CDC warns that sudden confusion or the inability to wake up to full alertness, especially in conjunction with other critical signs such as bluish lips and fever, has a high probability of being a medical emergency. Call 911.

6. Digestive issues
In the initial months of the coronavirus pandemic, diarrhea and other digestive symptoms didn't seem to be warning signs. But as the infection has spread yielding more cases and more data, a study revealed there was a subset of milder cases for which the initial symptoms were digestive issues and didn't include a fever. 

7. Pink eye
Researchers from China and elsewhere found that about 1% to 3% of those infected with COVID-19 had conjunctivitis, a highly contagious condition also known as pink eye. Conjunctivitis isn't a case of everyday bloodshot eyes. A nurse on the frontlines of the residential nursing home in Washington state where dozens died at the onset of the US outbreak said her coronavirus-infected patients looked almost as though they had red eye shadow on the outside of their eyes. 

8. Loss of smell or taste
The American Academy of Otolaryngology-Head and Neck Surgery issued a report saying that losing the ability to smell, called anosmia, or the ability to taste are also potential warning signs of COVID-19. Anosmia in particular has been seen in patients without any other symptoms who test positive. Analysis of milder cases in South Korea reported that in 30% of patients the major symptom was a loss of smell, and in Germany more than two-thirds of confirmed cases had anosmia.

9. Extreme fatigue
A World Health Organization study found that nearly 40% of patients out of nearly 6000 COVID-19 cases they analyzed, had experienced extreme fatigue. Chris Cuomo said he was so exhausted that he would he would take what he thought was a 10-minute nap when it had actually been three and half hours. 

10. Headache, sore throat and congestion
The same WHO report also found that almost 14% of the confirmed COVID-19 cases they analyzed suffered headache and sore throat, and 5% experienced nasal congestion, symptoms that can be difficult to distinguish from a cold or flu, so consider the totality of how you're feeling — and don't panic. 

Be especially alert to the more common and serious symptoms as you monitor your health and that of those you love, and until this is behind us, stay home as much as you possibly can and be careful!​

---