COVID-19 Symptom Progression

(As known today and supported with evidence)

I have been frustrated by the flood of misinformation, dangerous myths, and fear-based speculations that seem ever present during this crisis. As such, I have put together some of what is known today, as supported by published evidence.

First off, no disease follows a specific set of rules or guidelines for presentation.  COVID-19 is no different.  It is heterogeneous, meaning the symptom presentation is diverse and will differ for each patient.

The median incubation period is 5 days.

Day 1:  The first symptoms appear. These symptoms can include fever, fatigue, dry cough, poor (or loss of) appetite, muscle pain, and shortness of breath. Although fever has been reported as a common symptom, it is not necessarily the first symptom to appear.  

The loss of taste or smell in the early days has been reported anecdotally, as of today it is not yet supported by evidence.

Day 5: If the patient will develop difficulty breathing, the evidence shows it generally occurs around day 5. 

Day 7 or 8: Respiratory failure will develop during day seven or eight.  This is generally when hospital admission takes place.  As of today, the research indicates that approximately 25% will progress to this point and require hospital admission.

Day 10: This is generally the period where intubation and mechanical ventilation may be required if the infection progresses.

Day 24-30: If a patient becomes dependant on mechanical ventilation, recovery will likely take place approximately 14 days after intubation.

Stay healthy, stay inside if you are not an essential service, practice social distancing — always!

Sources:

Lauer, S. A., Grantz, K. H., Bi, Q., Jones, F. K., Zheng, Q., Meredith, H. R., Azman, A. S., Reich, N. G., & Lessler, J. (2020). The Incubation Period of Coronavirus Disease 2019 (COVID-19) From Publicly Reported Confirmed Cases: Estimation and Application. Annals of Internal Medicine. https://doi.org/10.7326/M20-0504

Novel Coronavirus Pneumonia Emergency Response Epidemiology Team. (2020). The Epidemiological Characteristics of an Outbreak of 2019 Novel Coronavirus Diseases (COVID-19) – China, 2020. China CDC Weekly, 2(8), 113–122. https://doi.org/10.3760/cma.j.issn.0254-6450.2020.02.003

World Health Organization. (2020). Coronavirus (COVID-19) events as they happen. Emergencies. https://www.who.int/emergencies/diseases/novel-coronavirus-2019/events-as-they-happen

Photo by Anna Shvets used under Pexels license.

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