Symptoms Or No, COVID Patients Have Same Viral ...
Influenza (Flu) and COVID-19 are both contagious respiratory illnesses, but they are caused by different viruses. COVID-19 is caused by infection with a coronavirus named SARS-CoV-2, and flu is caused by infection with influenza viruses. You cannot tell the difference between flu and COVID-19 by symptoms alone because some of the symptoms are the same. Some PCR tests can differentiate between flu and COVID-19 at the same time. If one of these tests is not available, many testing locations provide flu and COVID-19 tests separately. Talk to a healthcare provider about getting tested for both flu and COVID-19 if you have symptoms.
Symptoms or No, COVID Patients Have Same Viral ...
The digestive symptoms of COVID-19 likely occur because the virus enters the target cells through angiotensin-converting enzyme 2 (8), a receptor found in both the upper and lower gastrointestinal tract where it is expressed at nearly 100-fold higher levels than in respiratory organs (9). In addition, viral nucleic acid is detected in feces in over half of the patients infected with COVID-19 (4) and in nearly one-quarter of cases' stool samples test positive when respiratory samples are negative (6,10).
Disposition of study patients. There were 131 patients with digestive symptoms, each matched to one control patient who presented with respiratory symptoms only. Of these 262 patients, full historical and clinical data were available for 223 patients, of whom 206 had cleared the virus and were discharged from quarantine at the time this study was conducted, including 48 with digestive symptoms only, 69 with both digestive and respiratory symptoms, and 89 with respiratory symptoms only.
Illness duration (in days), including days before admission, total time in hospital before evidence of viral clearance, and total duration between symptom onset and viral clearance. Panel A provides data across the full study cohort. Panel B compares data between those with vs without diarrhea, demonstrating a longer disease course in those with diarrhea. Panel C focuses on those with digestive symptoms only and compares those with vs without diarrhea on presentation (no differences noted). Panel D repeats the same analyses in those presenting with Digestive + Respiratory symptoms, also showing no difference in the illness durations stratified by diarrhea. Panel E focuses only on those with digestive symptoms only and compares those with vs without fever on presentation (no differences noted). Panel F repeats the same analyses in those presenting with Digestive + Respiratory symptoms, also showing no difference in illness durations stratified by fever.
The longer disease course in patients with digestive symptoms might reflect a higher viral burden in these patients in comparison to those with only respiratory symptoms. Because the intestinal wall is invaded by COVID-19, there may be increased permeability and diminished barrier function, easier invasion of pathogens across a vast intestinal surface area, the presence of enteric symptoms such as diarrhea, and nutrient malabsorption (6). Recent evidence reveals that fecal nucleic acid is readily detected in the stool of patients with COVID-19 (4) and rectal swabs are also positive in some patients (15). Given the high prevalence of positive stools in patients with COVID-19, coupled with the correlation between diarrhea and stool positivity, we recommend routine real-time reverse transcriptase PCR testing of feces in patients with COVID-19, especially those presenting with digestive symptoms.
In addition, angiotensin-converting enzyme 2 expression is higher in the small intestine, duodenum, and colon than that in the lungs (9,16). Patients with digestive symptoms have more virus in the gut, based on our stool RNA testing results, and thus potentially greater opportunity to suffer direct damage on the gut mucosa. This might be another cause of digestive symptoms but should be further investigated.
Our study has limitations. First, although large enough to conduct valid comparisons among groups, the sample size remains limited; larger studies should be performed to further characterize digestive symptoms in patients with low severity COVID-19. Future research should include antibody testing on outpatients who developed new-onset digestive symptoms during the COVID-19 outbreak, but who might not have sought care or been tested at the time, to compare antibody titers with control groups who did not experience symptom during the pandemic.
Finally, this study does not directly confirm that viral particles in stool are infectious and capable of disease transmission, but our results offer more evidence that COVID-19 can present with digestive symptoms, that the virus is found in the stool of patients with diarrhea, and presents more indirect support of possible fecal transmission. Further research is vital to determine if COVID-19 can spread via the fecal-oral route.
In conclusion, we describe a unique subgroup of COVID-19 patients with low severity disease marked by the presence of digestive symptoms. These patients are more likely to test positive in stool RNA for COVID-19, to have a longer delay before viral clearance, and to experience delayed diagnosis compared with patients with respiratory symptoms. In some cases, the digestive symptom, particularly diarrhea, can be the initial presentation of COVID-19 and may only later (or never) present with respiratory symptoms. These data emphasize that patients with new-onset diarrhea after a possible COVID-19 contact should be suspected for the illness, even in the absence of cough, shortness of breath, sore throat, or even fever. These patients should self-quarantine and seek medical care if not already under evaluation. Optimally, testing for COVID-19 should be performed using both respiratory and stool samples, if available.
You cannot tell the difference between flu and COVID-19 by the symptoms alone because they have some of the same signs and symptoms. Specific testing is needed to tell what the illness is and to confirm a diagnosis. Having a medical professional administer a specific test that detects both flu and COVID-19 allows you to get diagnosed and treated for the specific virus you have more quickly. Getting treated early for COVID-19 and flu can reduce your risk of getting very sick. Testing can also reveal if someone has both flu and COVID-19 at the same time, although this is uncommon. People with flu and COVID-19 at the same time can have more severe disease than people with either flu or COVID-19 alone. Additionally, some people with COVID-19 may also be affected by post-COVID conditions (also known as long COVID).
If a person has COVID-19, it could take them longer from the time of infection to experience symptoms than if they have flu.FluTypically, a person may experience symptoms anywhere from one to four days after infection.Flu Symptoms
People at higher risk of complications or who have been hospitalized for COVID-19 or flu should receive recommended treatments and supportive medical care to help relieve symptoms and complications.
The National Institutes of Health (NIH) has developed guidance on treatment of COVID-19, which is regularly updated as new evidence on treatment options emerge. This includes antiviral treatment for non-hospitalized people at increased risk for severe COVID-19 and antiviral treatment for people hospitalized with severe COVID-19. People who are at increased risk of severe COVID-19 should seek treatment within days of when their first symptoms start.
If you have symptoms of coronavirus disease 2019 (COVID-19), it's important that you contact your health care provider right away for medical advice. But COVID-19, the common cold, seasonal allergies and the flu, also called influenza, cause many similar symptoms. So how can you tell if you have COVID-19? Understand the differences in symptoms that these illnesses cause. And find out how these illnesses spread, are treated and can be prevented.
Both COVID-19 and the common cold are caused by viruses. COVID-19 is caused by SARS-CoV-2, while the common cold is most often caused by rhinoviruses. All of these viruses spread in similar ways and cause many of the same symptoms. However, there are a few differences.
COVID-19 can cause shortness of breath or difficulty breathing. But seasonal allergies don't usually cause these symptoms unless you have a respiratory condition such as asthma that can be triggered by pollen exposure.
COVID-19 and the flu cause similar symptoms. The diseases also can cause no symptoms or cause mild or severe symptoms. Because of the similarities, testing may be done to see if you have COVID-19 or the flu. You also can have both diseases at the same time. However, there are some differences.
The initial evaluation for patients may include chest imaging (e.g., X-ray, ultrasound or computed tomography scan) and an electrocardiogram. Laboratory testing should include a complete blood count with differential and a metabolic profile, including liver and renal function tests. Although inflammatory markers such as C-reactive protein (CRP), D-dimer, and ferritin are not routinely measured as part of standard care, results from such measurements may have prognostic value.2-4
Several published reports have compared measurements of SpO2 and SaO2 in patients with and without COVID-19. The studies demonstrated that occult hypoxemia (defined as SaO2 92%) was more common in patients with darker skin pigmentation, which may result in adverse consequences.11-13 The likelihood of error was greater in the lower ranges of SpO2. In 2 studies, greater incidences of occult hypoxemia were observed in patients who were Black, Hispanic, or Asian than in patients who were White.11,12 In 1 of these studies, occult hypoxemia was associated with more organ dysfunction and hospital mortality.13
Asymptomatic SARS-CoV-2 infection can occur, although the percentage of patients who remain truly asymptomatic throughout the course of infection is variable and incompletely defined. The percentage of individuals who present with asymptomatic infection and progress to clinical disease is unclear. Some asymptomatic individuals have been reported to have objective radiographic findings consistent with COVID-19 pneumonia.20,21 041b061a72