Symptoms and risks

Coronavirus Vaccine

On December 11, 2020, the Food and Drug Administration granted emergency authorization use in the U.S. of the Pfizer/BioNTech COVID-19 vaccine for those 16 years of age and older. Within a week, Moderna was also granted an EAU in the U.S.. Both the Pfizer and Moderna vaccines require two doses, administered a few weeks apart.

Priority allocation of the doses has been given to health care workers and the elderly. It is estimated that it will be spring or summer before the general public will have acess to the vaccines. There are still unanswered questions regarding their safety in pregnant women.

COVID-19 may be a vascular disease more than a respiratory one

Though the coronavirus attacks the lungs first, it can infect the heart, kidneys, liver, brain, and intestines as well. Some research has suggested that COVID-19 is a vascular disease instead of a respiratory one, meaning it can travel through the blood vessels. This is the reason for additional complications like heart damage or stroke.

Scientists have a few theories about why some coronavirus patients take a rapid turn for the worse. One is that immune systems overreact by producing a «cytokine storm» — a release of chemical signals that instruct the body to attack its own cells.

Dr. Panagis Galiatsatos, a pulmonary physician at Johns Hopkins Bayview Medical Center, compared that process to an earthquake — generally, it’s the falling buildings that kill someone, not the quake itself.

«Your infection is a rattling of your immune system,» he said. «If your immune system is just not well structured, it’s just going to collapse.»

Coronavirus Transmission

How does the coronavirus spread?

SARS-CoV-2, the virus, mainly spreads from person to person.

Most of the time, it spreads when a sick person coughs or sneezes. They can spray droplets as far as 6 feet away. If you breathe them in or swallow them, the virus can get into your body. Some people who have the virus don’t have symptoms, but they can still spread the virus.

You can also get the virus from touching a surface or object the virus is on, then touching your mouth, nose, or possibly your eyes. Most viruses can live for several hours on a surface that they land on. A study shows that SARS-CoV-2 can last for several hours on various types of surfaces:

Cases can be life threatening

Mild cases of COVID-19 are thought to last approximately 2 weeks, said Cutler.

“Fortunately, the vast majority of cases are mild,” he said.

Almost nobody dies of the common cold. And most seasonal allergies are more annoying than dangerous.

Influenza, however, causes between 12,000 and 61,000 deaths per year in the United States.

COVID-19 has the potential to cause even more fatalities because it’s easily transmitted, the population lacks any immunity to the disease, and complications in serious cases may include life threatening pneumonia.

If you’re feeling sick or you think you have been exposed to COVID-19, you should self-quarantine for at least 2 weeks to prevent further spread of the disease, according to the Centers for Disease Control and Prevention (CDC).

Severe symptoms of COVID-19 that require immediate medical attention include difficulty breathing, persistent pain or pressure in the chest, confusion or inability to arouse, or bluish lips or face, the latter indicating a shortage of oxygen in the bloodstream, according to the CDC.

“Around one out of every six people who gets COVID-19 becomes seriously ill and develops difficulty breathing,” the WHO said. “Older people and those with underlying medical problems like high blood pressure, heart problems, or diabetes, are more likely to develop serious illness.”

Past Coronaviruses

Are coronaviruses new?

Coronaviruses were first identified in the 1960s. Almost everyone gets a coronavirus infection at least once in their life, most likely as a young child. In the United States, regular coronaviruses are more common in the fall and winter, but anyone can come down with a coronavirus infection at any time.

The symptoms of most coronaviruses are similar to any other upper respiratory infection, including a runny nose, coughing, sore throat, and sometimes a fever. In most cases, you won’t know whether you have a coronavirus or a different cold-causing virus, such as a rhinovirus. You treat this kind of coronavirus infection the same way you treat a cold.

Have there been other serious coronavirus outbreaks?

Coronaviruses have led to two serious outbreaks:

• Middle East respiratory syndrome (MERS). About 858 people have died from MERS, which first appeared in Saudi Arabia and then in other countries in the Middle East, Africa, Asia, and Europe. In April 2014, the first American was hospitalized for MERS in Indiana, and another case was reported in Florida. Both had just returned from Saudi Arabia. In May 2015, there was an outbreak of MERS in South Korea, which was the largest outbreak outside of the Arabian Peninsula.

• Severe acute respiratory syndrome (SARS). In 2003, 774 people died from an outbreak. As of 2015, there were no further reports of cases of SARS.

Despite symptoms, it’s not the flu

COVID-19 is not the flu.

As one of a class of pathogens known as coronaviruses, it’s actually more closely related to the common cold than the seasonal flu.

However, despite some overlap, the typical symptoms of COVID-19 are more similar to the flu (fever, cough, sore throat, runny or stuffy nose, muscle or body aches, headaches, fatigue) than the common cold (runny or stuffy nose, sore throat, cough, congestion, slight body aches, mild headache, sneezing, low-grade fever, malaise).

“In terms of differentiating between flu and COVID-19, it can be almost impossible to distinguish,” Dr. Jake Deutsch, co-founder and clinical director of Cure Urgent Care centers and Specialty Infusion in New York. “That’s why people are recommended to have flu vaccinations so it can at least… minimize the risk of flu in light of everything else. Fevers, body aches, coughing, sneezing could all be equally attributed to them both, so it really means that if there’s a concern for flu, there’s a concern for COVID-19.”

If you have a mild case of COVID-19, the flu, or a cold, treatment is geared toward management of symptoms, said Cutler.

“Generally, acetaminophen is recommended for fevers,” he said. “Cough drops and cough syrups can also help keep mucus secretions thinner. If there is associated nasal congestion, antihistamines may be useful.”

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Coronavirus Risk Factors

Anyone can get COVID-19, and most infections are mild. The older you are, the higher your risk of severe illness.

You also a have higher chance of serious illness if you have one of these health conditions:

• Chronic kidney disease
• Chronic obstructive pulmonary disease (COPD)
• A weakened immune system because of an organ transplant
• Obesity
• Serious heart conditions such as heart failure or coronary artery disease
• Sickle cell disease
• Type 2 diabetes

Conditions that could lead to severe COVID-19 illness include:

• Moderate to severe asthma
• Diseases that affect your blood vessels and blood flow to your brain
• Cystic fibrosis
• High blood pressure
• A weakened immune system because of a blood or bone marrow transplant, HIV, or medications like corticosteroids
• Dementia
• Liver disease
• Pregnancy
• Damaged or scarred lung tissue (pulmonary fibrosis)
• Smoking
• Thalassemia
• Type 1 diabetes

The most concerning symptom: shortness of breath

Once symptoms appear, some early signs should be treated with more caution than others. 

«I would of course always ask about shortness of breath before anything, because that’s somebody who has to be immediately helped,» Megan Coffee, an infectious-disease clinician who analyzed the Wenzhou data, told Business Insider.

Patients who develop ARDS may need to be put on a ventilator in ICU. Coffee estimated that one in four hospitalized COVID-19 patients wind up on the ICU track. Those who are ultimately discharged, she added, should expect another month of rest, rehabilitation, and recovery.

But viewing coronavirus infections based on averages can hide the fact that the disease often doesn’t progress in a linear fashion.

«Courses can step by step worsen progressively. They can wax and wane, doing well one day, worse the next,» Coffee said. «An 80-year-old man with medical issues can do quite well. Sometimes a 40-year-old woman with no medical issues doesn’t.»

This story was originally published February 21, 2020. It has been updated over time with additional research findings.

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Allergies have chronic symptoms

COVID-19, like the flu or common cold, is an acute illness, meaning people feel fine until symptoms start showing up.

Allergies, on the other hand, “are usually chronic, presenting with symptoms off and on for weeks, months, or even years,” Dr. David M. Cutler, family medicine physician at Providence Saint John’s Health Center in Santa Monica, California, told Healthline.

Experts also noted that, in most parts of the country, it’s not allergy season yet.

“Allergies should not cause a fever or body aches,” Arthur said. “Generally, no cough unless you have a lot of nasal drainage.”

Allergies also may cause wheezing, she added, especially in people with asthma.

“Allergy symptoms tend to vary with the environment: worsening with exposure to dust, pollen, or animal dander, whereas cold symptoms tend to persist regardless of time of day, weather, locality, or other environmental factors,” Cutler said.

Also, as with COVID-19, “Colds are more likely to have generalized symptoms like fever, headache, and body aches, whereas allergies usually affect only the respiratory tract,” Cutler said. “Allergy symptoms tend to improve with antihistamine and other allergy-specific medication. Colds are more likely to respond to decongestants, acetaminophen, fluids, and rest.”

With some schools reopening, the CDC issued new guidelines in mid-August on the differences in symptoms between COVID-19 and seasonal allergies.

The agency noted that things such as shortness of breath, coughing, fatigue, headache, and sore throat can be symptoms of either COVID-19 or allergies.

Itchy eyes and sneezing are generally only symptoms of allergies.

Fever, muscle aches, a loss of taste or smell, nausea, and diarrhea are associated with COVID-19 and not allergies.

The CDC recommends that all people wear cloth face masks in public places where it’s difficult to maintain a 6-foot distance from others. This will help slow the spread of the virus from people without symptoms or people who do not know they have contracted the virus. Cloth face masks should be worn while continuing to practice physical distancing. Instructions for making masks at home can be found here. Note: It’s critical to reserve surgical masks and N95 respirators for healthcare workers.

Coronavirus Diagnosis

Call your doctor or local health department if you think you’ve been exposed and have symptoms like:

• Fever of 100 F or higher
• Cough
• Trouble breathing

In most states, testing facilities have become more readily available. While some require an appointment, others are simply drive-up..

A swab test is the most common method. It looks for signs of the virus in your upper respiratory tract. The person giving the test puts a swab up your nose to get a sample from the back of your nose and throat. That sample usually goes to a lab that looks for viral material, but some areas may have rapid tests that give results in as little as 15 minutes.

If there are signs of the virus, the test is positive. A negative test could mean there is no virus or there wasn’t enough to measure. That can happen early in an infection. It usually takes 24 hours to get results, but the tests must be collected, stored, shipped to a lab, and processed.