COVID-19 Symptoms

Symptoms of COVID-19 can vary from person to person. They may also vary in different age groups.

Some of the more commonly reported symptoms include:

  • new or worsening cough
  • shortness of breath or difficulty breathing
  • temperature equal to or over 38°C
  • feeling feverish
  • chills
  • fatigue or weakness
  • muscle or body aches
  • new loss of smell or taste
  • headache
  • gastrointestinal symptoms (abdominal pain, diarrhea, vomiting)
  • feeling very unwell

Children tend to have abdominal symptoms and skin changes or rashes.

Symptoms may take up to 14 days to appear after exposure to COVID-19.

You can infect others even if you aren’t showing symptoms

The virus can be spread to others from someone who’s infected but not showing symptoms. This includes people who:

  • haven’t yet developed symptoms (pre-symptomatic)
  • never develop symptoms (asymptomatic)

Treating COVID-19

If you’re concerned about your symptoms, self-monitor for any changes and consult your health care provider. They may recommend steps you can take to relieve your symptoms.

People who are hospitalized with COVID-19 and need breathing assistance may be treated with dexamethasone.

Telehealth Ontario 1-866-797-0000
Northwestern Health Unit www.nwhu.on.ca
COVID-19 hotline: 1-866-468-2240

Difference between quarantine and isolate

People are asked to quarantine or isolate to help prevent the spread of COVID-19 to others. Although these two words are often thought to mean the same thing, there’s an important difference.

Quarantine

If you have no symptoms and any of the following apply to you, you must quarantine for 14 days (starting from the date you arrive in Canada):

  • you’re returning from travel outside of Canada (mandatory quarantine)
  • you’re travelling to a province or territory that’s enforcing 14-day quarantine for all inter-provincial travellers
  • you had close contact with someone who has or is suspected to have COVID-19
  • you’ve been told by the public health authority that you may have been exposed to COVID-19 and need to quarantine

Isolate

You must isolate if any of the following apply:

  • you’ve been diagnosed with COVID-19, or are waiting to hear the results of a lab test for COVID-19
  • you have symptoms of COVID-19, even if mild, and you’ve been:
    • in contact with someone who has or is suspected to have COVID-19
    • told by public health that you may have been exposed to COVID-19
  • you’ve returned from travel outside Canada with symptoms of COVID-19 (mandatory)

How COVID-19 Spreads

COVID-19 spreads from an infected person to others through respiratory droplets and aerosols created when an infected person coughs, sneezes, sings, shouts, or talks. The droplets vary in size from large droplets that fall to the ground rapidly (within seconds or minutes) near the infected person, to smaller droplets, sometimes called aerosols, which linger in the air under some circumstances.

The relative infectiousness of droplets of different sizes is not clear. Infectious droplets or aerosols may come into direct contact with the mucous membranes of another person’s nose, mouth or eyes, or they may be inhaled into their nose, mouth, airways and lungs. The virus may also spread when a person touches another person (i.e., a handshake) or a surface or an object (also referred to as a fomite) that has the virus on it, and then touches their mouth, nose or eyes with unwashed hands.

Learn more about modes of transmission of COVID-19.

Risks of getting COVID-19

The risk of getting COVID-19 is evolving daily and varies between and within communities. Overall, the risk to Canadians remains high. This doesn’t mean that all Canadians will get the disease. It means that there’s already a significant impact on our health care system.

To stay healthy and to protect ourselves and others, we must be mindful of the ever-present risk of exposure to the virus. Some settings and situations increase the risk, such as being in:

  • closed spaces
  • crowded places
  • close-contact settings where you can’t keep 2 metres apart from each other
  • close-range conversations
  • settings where there’s singing, shouting or heavy breathing (for example, during exercise)

It’s particularly important to avoid settings where these risks overlap, such as closed spaces and crowded spaces where close-range conversations occur.

COVID-19 Reference Document for Symptoms

Ontario Ministry of Health outlines the symptoms, signs, and clinical features which have been most commonly associated with COVID-19. This information is current as of September 21, 2020 and may be updated as the situation on COVID-19 continues to evolve. If there is a discrepancy between this list and other guidance, this list should be considered as the most up to date.

When assessing for the symptoms below the focus should be on evaluating if they are new, worsening, or different from an individual’s baseline health status (usual state). Symptoms should not be chronic or related to other known causes or conditions (see examples below).

Common symptoms of COVID-19 include:

Fever (temperature of 37.8°C/100.0°F or greater)

Cough (that is new or worsening (e.g. continuous, more than usual if chronic cough) including croup (barking cough, making a whistling noise when breathing)
o Not related to other known causes or conditions (e.g., chronic obstructive pulmonary disease)

• Shortness of breath (dyspnea, out of breath, unable to breathe deeply, wheeze, that is worse than usual if chronically short of breath)
o Not related to other known causes or conditions (e.g., chronic heart failure, asthma, chronic obstructive pulmonary disease)

Other symptoms of COVID-19 can include:

Sore throat (painful swallowing or difficulty swallowing)
o Not related to other known causes or conditions (e.g., post nasal drip, gastroesophageal reflux)

Rhinorrhea (runny nose)
o Not related to other known causes or conditions (e.g., returning inside from the cold, chronic sinusitis unchanged from baseline)

Nasal congestion (stuffy nose)
o Not related to other known causes or conditions (e.g., seasonal allergies)

New olfactory or taste disorder (decrease or loss of smell or taste)
o Not related to other known causes or conditions (e.g., nasal polyps, allergies, neurological disorders)

Nausea and/or vomiting
o Not related to other known causes or conditions (e.g. transient vomiting due to anxiety in children, chronic vestibular dysfunction)

Diarrhea
o Not related to other known causes or conditions (e.g., Irritable bowel syndrome, inflammatory bowel disease, side effect of medication)

Abdominal pain that is persistent or ongoing
o Not related to other known causes or conditions (e.g., menstrual cramps, gastroesophageal reflux disease)

Atypical signs and symptoms of COVID-19 should be considered, particularly in infants and children, older persons, and people living with a developmental disability.

Atypical symptoms can include:

Chills

Headache that is new and persistent, unusual, unexplained, or long-lasting
o Not related to other known causes or conditions (e.g., tension-type headaches, chronic migraines)

Conjunctivitis (pink eye)
o Not related to other known causes or conditions (e.g., blepharitis, recurrent styes)

Fatigue, lethargy, or malaise (general feeling of being unwell, lack of energy, extreme tiredness) that is unusual or unexplained
o Not related to other known causes or conditions (e.g., depression, insomnia, thyroid dysfunction, anemia, malignancy)

Myalgias (muscle aches and pain) that are unexplained, unusual, or long-lasting
o Not related to other known causes or conditions (e.g., fibromyalgia)

Decreased or lack of appetite
o For young children and not related to other known causes or conditions (e.g., anxiety, constipation)

Atypical signs should be based on an assessment by a Health Care Provider, should not be explained by other known causes or conditions, and can include:

New or unusual exacerbation of chronic conditions (e.g. chronic lung diseases such as asthma, emphysema, or chronic obstructive pulmonary disorder)

Tachycardia (fast heart rate), including age specific tachycardia for children
o Not related to other known causes or conditions (e.g., atrial fibrillation)

Low blood pressure for age

Hypoxia (i.e. oxygen saturation less than 92%)
o Not related to other known causes or conditions (e.g., chronic obstructive pulmonary disorder)

Difficulty feeding in infants
o Not related to other known causes or conditions (e.g., gastroesophageal reflux disease, cleft palate)

Delirium (acutely altered mental status and inattention)
o Not related to other known causes or conditions (urinary tract infection, substance-related such as alcohol withdrawal, medication induced)

Increased number of falls in older persons

Acute functional decline (a sudden change in ability to function compared to baseline)
o Not related to other known causes or conditions (e.g. gradual decline over months due to a neurological disorder such as dementia or Parkinson’s disease)

Clinical features of COVID-19 that can be diagnosed by a health care provider include:

• Clinical or radiological evidence of pneumonia

Multisystem Inflammatory Syndrome in Children and Adolescents (MIS-C) less than 19 years old
Information on this syndrome and its temporal association with COVID-19 is still emerging and may evolve over time. An assessment for MIS-C should be done by a Health Care Provider. Please see the World Health Organization (WHO) Case Definition or the Canadian Paediatric Surveillance Program (CPSP) Case Definition for diagnostic criteria.

The WHO MIS-C preliminary case definition:

• Persistent fever for 3 or more days
AND two or more of the following:

• Rash or bilateral non-purulent conjunctivitis or muco-cutaneous inflammation signs (oral, hands, or feet).

• Hypotension or shock.

• Features of myocardial dysfunction, pericarditis, valvulitis, or coronary abnormalities (including ECHO findings or elevated Troponin/NT-proBNP),

• Evidence of coagulopathy (by prolonged PT, PTT, elevated d-Dimers).

• Acute gastrointestinal symptoms (diarrhea, vomiting, or abdominal pain).

AND

• Elevated markers of inflammation such as ESR, C-reactive protein, or procalcitonin.

AND

• No other obvious microbial cause of inflammation, including bacterial sepsis, staphylococcal or streptococcal shock syndromes.

AND

• Evidence of COVID-19 (RT-PCR, antigen test or serology positive), or likely contact with patients with COVID-19

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