What are the symptoms of the most recent COVID-19 (Coronavirus Disease 2019) strain?

COVID-19 Symptoms: Current Strain Presentation

The most common symptoms of COVID-19 remain fever, dry cough, and shortness of breath, with fever occurring in over 44% of patients at presentation (rising to 88% after admission), though gastrointestinal symptoms including diarrhea (7.7%), nausea/vomiting (7.8%), and abdominal pain (2.7%) are also documented manifestations. 1, 2, 3

Primary Respiratory Symptoms

The core symptom triad includes:

• Fever - documented in 44-100% of cases at presentation, remains the most typical symptom 1, 2, 3
• Dry cough - one of the three cardinal symptoms 1, 2, 3
• Shortness of breath (dyspnea) - present in the majority of symptomatic cases 1, 2, 3

Additional Respiratory and Upper Airway Symptoms

• Fatigue - commonly reported alongside respiratory symptoms 1, 3
• Nasal congestion and runny nose - may or may not be present 1
• Sore throat - documented as an associated symptom 1

Gastrointestinal Manifestations

Gastrointestinal symptoms occur in less than 10% of COVID-19 patients overall but are clinically significant:

• Diarrhea - most common GI symptom at 7.7% (95% CI: 7.2%-8.2%), with reported ranges of 1-36% across different populations 1, 4, 5
• Nausea/vomiting - occurs in 7.8% (95% CI: 7.1%-8.5%) of patients 1, 5
• Abdominal pain - present in 2.7% (95% CI: 2.0%-3.4%) of cases 1, 5
• Anorexia - reported as an additional GI manifestation 1

The mechanism involves SARS-CoV-2 binding to ACE2 receptors abundantly expressed in gastric, duodenal, and rectal epithelia, which may explain GI symptom presentation 1, 5

Neurological and Sensory Symptoms

• New loss of taste or smell (anosmia/dysgeusia) - recognized as a distinctive COVID-19 symptom 1, 3
• Headache - commonly reported 1, 2
• Altered mental status, agitation, and confusion - may occur, particularly in severe cases 3, 6

Systemic Symptoms

• Chills and repeated shaking with chills - part of the systemic inflammatory response 1, 2
• Muscle pain (myalgia) - documented in up to 66.6% of patients in some cohorts 1, 2, 6

Cardiac Symptoms (When Myocardial Involvement Occurs)

• Chest pain or chest discomfort - may indicate myocarditis or myocardial involvement 1
• Palpitations - associated with cardiac complications 1
• Postexertional fatigue - can persist beyond acute infection 1

Important Clinical Considerations

Geographic variation exists: Studies outside China report higher rates of GI symptoms (up to 20%) compared to Chinese populations 1, 5

Asymptomatic presentation: A significant proportion of infected individuals may be completely asymptomatic yet still transmit the virus 2, 7

Symptom onset timing: The average incubation period is 5 days, with 97.5% of symptomatic patients developing symptoms within 11.5 days of exposure 2

Atypical presentations: Some patients may present with predominantly GI symptoms before or without respiratory symptoms, requiring high clinical suspicion 1, 4

Severity spectrum: Symptoms range from mild (or absent) to severe respiratory failure requiring mechanical ventilation, with approximately 5% of all patients and 20% of hospitalized patients requiring intensive care 2

Physical Examination Findings

• Mild cases: May show no positive physical signs 1
• Severe cases: Shortness of breath, increased respiratory rate (tachypnea), moist rales in lungs, weakened breath sounds, dullness on percussion, and altered tactile speech tremor 1