From Head to Toe: Surprising Signs/ Symptoms of COVID-19

COVID-19, Health & Wellness


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/BrainStroke 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.

Complications of COVID-19: Are you at risk?

COVID-19, Health & Wellness


As shown by gas clouds that form after a sneeze, or after a cough, viral particles in the millions can be inhaled if you happen to be in its direct path and are not protected.  While social distancing of at least 6 feet reduces the likelihood of these weaponized viral air droplets invading your lungs during casual talking, this distance is not protective if the person you are speaking to (and who doesn’t know he/she is COVID-19 positive) sneezes or coughs in your direction; this is because viral particles can travel much farther than 6 feet (and in some cases 20-30 feet).  Therefore, the combination of at least 6-feet o of social distancing AND wearing snug, air-tight fitting masks in public will afford you greater protection/ reduce your risk of infection.

And while 4 out of every 5 who become infected with the virus completely recover without requiring hospitalization, a small percentage will become very sick (e.g., widespread pneumonia, inflammation of the heart, etc) and may require mechanical ventilation/ life support measures.

Listed below are the 10 groups at highest risk of COVID-19 complications.

  1. Residents of Nursing Homes of Long Term Care Facilities
  2. Older than age 65
  3. Lung disease: COPD or moderate-severe Asthma
  4. Cigarette smoking or vaping
  5. Immunocompromised
  6. Morbid Obesity (body mass index of 40 kg/m2 or greater)
  7. History of Heart Disease
  8. Diabetes or Hypertension (poorly controlled)
  9. Dialysis patients
  10. History of Liver Disease

Encouraging News: While we await results of ongoing clinical trials,  at least 2 potential therapies recently tested in critically ill COVID-19 show promise; one is the medication Remdesivir and the second is transfusing convalescent plasma, or blood containing COVID-19 antibodies from those recently infected.

Michael Miller, MD is Professor of Cardiovascular Medicine, Epidemiology & Public at the University of Maryland School of Medicine in Baltimore, Maryland USA.  He serves on the American Heart Association Leadership Council and his latest book is  Heal Your Heart: The Positive Emotions Prescription to Prevent & Reverse Heart Disease” published by Penguin Random House.