Covid-19: the order of appearance of symptoms is identified

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A new US study reveals the order in which the main symptoms of Covid-19 occur, the Sars-CoV-2 coronavirus infection.

Cough and fever are mentioned regularly and are known to be the main symptoms of Covid-19. However, the order in which they appear is less well known. And if some patients report having suffered from intestinal disorders first (especially children), a general trend is emerging, as revealed by a new American study, published August 13, 2020 in the journal Frontiers in Public Health.

Researchers from the University of Southern California (USC) examined data from 55,924 confirmed cases of Covid-19 in China, all collected by the World Health Organization (WHO) between February 16 and 24, 2020; as well as 1,100 cases collected between December 11, 2019 and January 29, 2020, collected by the China Medical Treatment Expert Group, through the National Health Commission of China. The scientists focused on easily discernible or objective symptoms (cough, fever, etc.) and excluded other reported symptoms, such as loss of smell, which is subjective and less obvious.

Believing that it will be difficult this winter to distinguish flu and Covid-19 in light of symptoms, the researchers compared symptoms caused by the coronavirus with 2,500 cases of influenza reported by European and US health authorities from 1994 to 1998, and symptoms of the other two known coronavirus diseases: Middle East respiratory syndrome (Mers) and severe acute respiratory syndrome (SARS).

The study found that symptoms of infection with the new coronavirus manifested most frequently in this order: fever, then cough, muscle pain, nausea or vomiting, then diarrhea. While the flu begins with a cough, Covid-19 begins with a fever, say the authors.

Furthermore, "the upper gastrointestinal tract (ie nausea / vomiting) appears to be affected earlier than the lower gastrointestinal tract (ie diarrhea) in Covid-19, which is the opposite of mers and SARS," the scientists found.

If they may seem anecdotal, these medical data are nevertheless crucial, because they can help patients and doctors to slow the progression of the epidemic, identifying the disease more quickly, isolating themselves from the first symptoms and taking the appropriate measures.

"Our results suggest that good clinical practice should involve recording the order of appearance of symptoms in Covid-19 and other diseases," the authors conclude. "If that systemic clinical practice had been the norm since the diseases of the past, perhaps the transition from a local epidemic to a pandemic could have been avoided," they add.

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