While common symptoms of COVID-19 include fatigue, fever, dry cough and muscle aches newer signs and symptoms of the novel coronavirus have become increasingly recognized in recent weeks. Listed below are recently uncovered signs that should raise your suspicion of possible COVID-19 especially when accompanied by any COVID symptom.
Head/Brain: Stroke in young people (under the age of 50) has now been reported in New York. Symptoms include difficulty speaking, slurred of speech or sudden weakness on the left or right of the body. COVID-strokes appear to be due to formation of blood clots that block brain (cerebral) circulation. COVID induced blood clots can also form in the lower extremities (see “Legs” below).
Eyes: Pink eye (conjunctivitis) was shown early on to be associated with COVID-19 infection in up to one-third of patients identified in Wuhan, China where the virus originated. If you have pink eye and feel tired, achy or have a fever you need to contact your physician and self quarantine until you are tested, so you do not mistakenly pass this virus on to others.
Nose/mouth: Loss of the sense of smell and taste has been reported in 20% in an Italian study and is generally associated with a mild viral course. Once again, contact your physician if you have these symptoms and self quarantine until testing shows that you are not shedding the virus.
Lungs: Among the most dreaded complications of COVID-19 is the combination of a high fever and progressive shortness of breath; this is a worrisome sign of “double” pneumonia (both lungs infected) that can quickly progress to severe lung distress and placement on a ventilator. People at highest risk for this complication are older age (over 60 years) history of lung disease (COPD), diabetes, hypertension and smoking/vaping.
Heart: Approximately 10% with COVID-19 infection will have viral invasion of heart muscle. Symptoms include chest pain (or discomfort) and palpitations that can be due to cell injury and inflammation (myocarditis) and may lead to heart failure.
Gastrointestinal: About 1 in 3 with COVID-19 will experience diarrhea that can last 1-2 weeks. Nausea and vomiting are less common; those affected also tend to have a mild course. These GI symptoms can occur without a fever or cough and you can spread the virus to others without even knowing it. Therefore, it is important to contact your physician if symptoms persist for more than 48 hours and discuss whether you should be tested for COVID-19.
Legs: New swelling, pain and/or redness in the legs/calves may indicate development of a blood clot or deep vein thrombosis (DVT) that has now been associated with COVID-19. Another reported and very serious complication of this virus identified in China is temporary paralysis (Guillain-Barré syndrome); fortunately this person made a full recovery.
Fingers/Toes: As shown above, another recently identified sign of COVID-19 is the development of painful and tender “bumps” that appear on fingers and/or toes. They are referred to as chilblains (but are not frostbite). If you develop these bumps and do not feel well, please self-quarantine and await further advice from your physician in regard to testing. The bumps will generally last 2-3 weeks and then resolve; the overall COVID course tends to be mild in these cases.
Michael Miller, MD is Professor of Medicine, Epidemiology & Public Health at the University of Maryland School of Medicine in Baltimore, Maryland USA. He has conducted original research with numerous publications related to cardiovascular health His latest book is “Heal Your Heart: The Positive Emotions Prescription to Prevent & Reverse Heart Disease” published by Penguin Random House.
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