Is headache an indicator? What about fatigue? Here's what to know about how the infection presents itself.

Advertisement

We've all seen waves of COVID-19 crest and fall since the virus first appeared in the US, and now cases are climbing again as the Delta variant rips across the continent.

With only half of the US population fully vaccinated and a super-infectious variant on the loose, it's still important to know what COVID looks like. But have the signs and symptoms morphed over time? Is coughing still a common indicator? And what about loss of smell, skin rash, and fatigue?

To keep you up to date, we pulled together the latest information on symptoms. Here's what to watch for:

Sick attractive woman lying in bed feeling unwell with headache sore nose high temperature feeling fatigue and restless not being able to go to work in health care concept.
Credit: Getty Images

What are the symptoms of coronavirus?

Three symptoms—fever, cough, and shortness of breath—were initially recognized as core signs of COVID-19, and they remain among the list of things many people will experience over the course of the disease. Remember, though, that the signs of this illness can be quite diverse. In addition, how someone presents with COVID may depend on the severity of the disease.

The CDC has revised and expanded the list of symptoms more than once. Fever or chills, cough, and shortness of breath or difficulty breathing are still possible indicators. Other signs include fatigue; muscle or body aches; headache; new loss of taste or smell; sore throat; congestion or runny nose; nausea or vomiting; and diarrhea. 

On symptoms alone, COVID-19 can look a lot like the flu. Common flu symptoms include fever (or feeling feverish or having chills), cough, sore throat, runny or stuff nose, muscle aches, headache, and fatigue, says the CDC.

Shortness of breath is more common in people hospitalized with COVID-19 than individuals with milder cases of illness, CDC points out. Complaints of fatigue, headache, and muscle pain are more common among people with milder illness, who don't require hospitalization. Symptoms like sore throat and runny nose or nasal congestion may be the noticeable indicators in with milder disease.

The CDC's rundown of signs to watch for doesn't list every possible symptom. Although less common, COVID can affect your skin, for example, says the American Academy of Dermatology. COVID toes and fingers are among the different types of rashes that have been associated with the infection.

Keep in mind that many people walk around not knowing they have COVID because their symptoms are extremely mild, they think they have a cold, flu, or allergies, or they have no symptoms at all—in other words, they're asymptomatic.

What are the symptoms of the Delta variant?

Symptoms of the Delta variant, which originated in India, are slightly different than those of the first variant that spread through the US.

"COVID is acting differently now. It's more like a bad cold; people might think they've just got some sort of seasonal cold," Tim Spector, professor of epidemiology at King's College London, explains in a video released on YouTube by the COVID Symptom Study. He explains that the number one top symptom for those with the Delta variant is headache, and this is followed by sore throat, runny nose, and fever. "Those are not the old, classic symptoms," Spector says. "Number five is cough, [though] it's rarer." He adds that loss of smell isn't among the top 10 reported symptoms for those with the Delta variant.

If you've been vaccinated but experience a "breakthrough" infection, your symptoms are likely to be mild, if you have symptoms at all. That's according to the CDC, which recently investigated a cluster of breakthrough infections in Provincetown, Massachusetts. Among 469 COVID cases, 347 were fully vaccinated and, of those, 274 reported signs and symptoms, mostly cough, headache, sore throat, muscle pain, and fever.

What does COVID look like in older adults?

In the many months since the start of the pandemic, researchers have learned quite a bit about the disease. While fever, cough, and shortness of breath may be typical, many older adults have "atypical" presentations, recent observational studies and case reports suggest.

Case in point: A July 2021 report in the Journals of Gerontology. Researchers reviewed inpatient medical records for nearly 5,000 adults ages 65 and older who were admitted to 11 New York-area hospitals during March and April 2020. More than a third of the group presented with "atypical" symptoms, such as functional decline and altered mental status. They tended to be older, female, Black, non-Hispanic, and they were more likely to have dementia, diabetes, or both.

What are the symptoms of COVID in children?

Kids have symptoms similar to adults but most have mild or "cold-like" symptoms, according to Mayo Clinic. The list of possible symptoms includes the typical signs of COVID plus a few other signs, such as poor feeding or poor appetite.

With Delta cases surging, more children are getting infected, says Anthony Fauci, MD, chief medical adviser to President Biden. That's because Delta is more transmissible. "Even though the percentage is small, a certain percentage of children will require hospitalization, so quantitatively you will see more children in the hospital," he said during an August 12 White House COVID Response Team media briefing.

How does coronavirus progress?

The CDC explains that symptoms appear to arise in as few as two days after exposure to the virus or as long as 14 days. According to an analysis in the Annals of Internal Medicine, this estimated time frame is similar to the incubation period of SARS and MERS, which are also types of coronaviruses.

However, the progression of COVID-19 varies widely. Initially, some people have very mild symptoms, like headache or low-grade fever, while others experience no symptoms at all. Among people who develop severe disease, the CDC warns healthcare providers of "the potential for some patients with COVID-19 to rapidly deteriorate about one week after illness onset."

If you think you've been exposed to COVID-19 or are experiencing fever or other symptoms, such as cough or difficulty breathing, call your healthcare provider, the CDC suggests. Anyone who is having trouble breathing or experiencing other concerning symptoms, like chest pain, confusion, or bluish lips or face, ought to seek immediate medical care.

How can you protect yourself from COVID-19?

First and foremost, CDC advises people to get a COVID-19 vaccine ASAP. The vaccines authorized for use in the US can help protect you from COVID-19, the agency says. Getting your jabs can also reduce the risk of spreading the virus to others.

While vaccination remains the No. 1 means of controlling the pandemic, additional prevention strategies are needed to reduce transmission, , at least in the short term, says CDC. For example, people are urged to mask up in indoor public spaces in areas of "substantial" or "high" transmission. Masking is particularly important if you have a weakened immune system or if you have people in your household at increased risk for severe disease.

Even if you're fully vaccinated, you should still watch for possible symptoms, especially if you've been around someone who's sick, says CDC. If you, too, have symptoms, get tested and stay away from others.

The information in this story is accurate as of press time. However, as the situation surrounding COVID-19 continues to evolve, it's possible that some data have changed since publication. While Health is trying to keep our stories as up-to-date as possible, we also encourage readers to stay informed on news and recommendations for their own communities by using the CDC, WHO, and their local public health department as resources.

To get our top stories delivered to your inbox, sign up for the Healthy Living newsletter