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Covid-19 Primary Care Resources

Symptoms and Signs

Emerging evidence on symptoms and signs of Covid-19, and formal case definition from PHE

This information is sourced from Imperial College London:

  • Trial results from Imperial College London’s REACT-1 study were published in a               preprint report in February 2021
  • Over one million people took throat and nose swabs at home and filled out a questionnaire detailing any symptoms they may have had
  • Symptoms including chills, loss of appetite, headache and muscle aches were strongly linked with being infected with Covid-19
  • Having any of these symptoms – or the classic ones of fever; loss of taste or smell; or a new persistent cough – was associated with Covid infection
  • The more of the symptoms people showed, the more likely they were to test positive

This information on case definition and clinical features are both sourced from Public Health England (PHE):

Case definition:

Diagnose suspected Covid in patients who are well enough to remain in the community and meet the following criteria:

new continuous cough

or high temperature

or a loss of, or change in, normal sense of taste or smell (anosmia)

Clinical features:

  • Covid-19 presents with a range of symptoms of varying severity
  • Asymptomatic infection also occurs often although frequency is not defined
  • More common symptoms are fever, a new and continuous cough, shortness of breath, fatigue, loss of appetite, anosmia (loss of smell) and ageusia (loss of taste)
  • Non-specific symptoms include shortness of breath, fatigue, loss of appetite, myalgia, sore throat, headache, nasal congestion, diarrhoea, nausea and vomiting
  • Atypical symptoms, such as delirium and reduced mobility, can present in older and immunocompromised people, often in the absence of a fever

Of people who develop symptoms, current data indicate that 40% have mild symptoms without hypoxia (problems with the level of oxygen in the blood) or pneumonia, 40% have moderate symptoms and non-severe pneumonia, 15% have significant disease including severe pneumonia, and 5% experience critical disease with life-threatening complications

Critical disease includes acute respiratory distress syndrome (ARDS), sepsis, septic shock, cardiac disease, thromboembolic events, such as pulmonary embolism and multi-organ failure

Clinicians should be alert to the possibility of atypical presentations in patients who are immunocompromised

See also:

When to notify public health

Revised rules for self isolation