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What are the symptoms of COVID-19 ?

Text updated on 2020-09-20

SARS-CoV-2 coronavirus infection is very often asymptomatic. But it can also trigger a wide range of symptoms, from an influenza-like condition to respiratory distress that can lead to death. Even in mild cases, it is important to perform a diagnostic test to limit the contagion.

Primarily: mild fever, dry cough, and breathing difficulties.

Secondarily: headache, sore throat, runny nose, congested nose, aches and pains, fatigue, diarrhea, conjunctivitis, skin rash on the trunk (noticed in 20% of cases in Italy). Sometimes also loss of taste and smell.

Very rare: prolonged fever, frostbite, other vascular symptoms, multisystemic inflammatory syndrome in children and adolescents.

The incubation time(from the time you catch the virus to the time you develop symptoms) averages 3 to 7 days. Most people who are hospitalized will recover. Typically, the unrecovered die either very quickly (~1-2 days) or after 2 weeks (~13.5 days).

Lethality rate of infected persons: In France, as of April 14, 2020, it is estimated that 2.5% of infected persons must go to hospital for respiratory distress and 20% of them, or 0.5% of all infected persons, die. This case-fatality rate of infected persons, estimated at 0.5%, is identical to that calculated in New York City (0.5%). It is close to the estimate based on serological tests in Gangelt in Germany (0.37%) and lower than the minimum estimated rate in Italy (0.8%).

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Description of the symptoms of COVID-19.

Yang, P., Wang, X. COVID-19: a new challenge for human beings. Cell Mol Immunol (2020).

Analysis of symptoms in 1,099 patients with COVID-19 in China. Although 90% of patients symptomatic of COVID-19 end up with a fever, it is present in less than 50% of cases at the time of hospital admission. Therefore, it is the mild symptoms that are the most important to detect at the onset of symptoms.

Guan, W. J., Ni, Z. Y., Hu, Y., Liang, W. H., Ou, C. Q., He, J. X., ... & Du, B. (2020). Clinical characteristics of coronavirus disease 2019 in China. New England journal of medicine, 382(18), 1708-1720.

Rash observed in Italy.

Recalcati, S. (2020), Cutaneous manifestations in COVID-19: a first perspective. J Eur Acad Dermatol Venereol. Accepted Author Manuscript.

An estimate of hospitalization rates and case severity was established in France as of April 14, 2020, based on the analysis of 71,903 confirmed COVID-19 cases leading to 10,129 deaths.

Salje, H., Kiem, C. T., Lefrancq, N., Courtejoie, N., Bosetti, P., Paireau, J., ... & Le Strat, Y. (2020). Estimating the burden of SARS-CoV-2 in France. Science.

Serological study in the village of Gengelt, an initial cluster in Germany where a festival had taken place and where 80% of the population had been screened for the presence of antibodies indicating an infection with SARS-CoV-2. Original article in German: https://www.land.nrw/sites/default/files/asset/document/zwischenergebnis_covid19_case_study_gangelt.pdf

Vorläufiges Ergebnis und Schlussfolgerungen der COVID-19 Case-Cluster-Study (Gemeinde Gangelt).

Epidemiological study providing information on the mortality rate of confirmed cases in Italy.

Task force COVID-19 del Dipartimento Malattie Infettive e Servizio di Informatica, Istituto Superiore di Sanità. Epidemia COVID-19, Aggiornamento nazionale: 23 aprile 2020

This study, posted on April 20, 2020 estimates that in New York City, the mortality rate was 0.5% from February to April 2020, while the minimum mortality rate related to COVID-19 in Italy was approximately 0.8% with a total of 50,000 people (instead of the 25,000 declared) dying from the disease.

Modi, C., Boehm, V., Ferraro, S., Stein, G., & Seljak, U. (2020). Total COVID-19 Mortality in Italy: Excess Mortality and Age Dependence through Time-Series Analysis. medRxiv.

Unusual spring frostbite has been observed in children and young adults in the United States and Europe: these symptoms have been identified in a few people with COVID-19.

Landa, N., Mendieta-Eckert, M., Fonda-Pascual, P., Aguirre, T. (2020) Chilblain-like lesions on feet and hands during the COVID-19 Pandemic. International J. of Dermatology. April 24.

Multisystemic Inflammatory Syndrome in Children and Adolescents observed in a cohort in Italy.

Verdoni L, Mazza A, Gervasoni A, et al. An outbreak of severe Kawasaki-like disease at the Italian epicentre of the SARS-CoV-2 epidemic: an observational cohort study. Lancet 2020

Further reading