Wednesday, May 27, 2020

Additional Symptoms of COVID-19

by Dr. Iva Lloyd, ND

A common question over the last month is whether or not a specific symptom could indicate COVID-19.  The focus of Public Health and the media has been on the three most common symptoms, that is tiredness, fever and cough.  Tiredness is the most common symptom with about 68% of people experiencing it, followed by 60% of people having a dry cough and 56% of people experiencing fever, especially in the early stages of COVID-19.

An interesting symptom that has received a lot of focus over the last few months is loss of smell.  There are a number of research articles that indicate that an early indicator of contracting COVID-19 appears to be anosmia, or loss of smell.  The loss of smell does not appear to be correlated with how severe the symptoms of COVID-19 will be as there are some individuals that only experience a loss of smell, whereas others have digestive and/or respiratory symptoms as well.  Some people experience an altered sense of taste which can be associated with the altered sense of smell.

There are a number of other symptoms that are commonly experienced in those that tested positive for COVID-19.  Digestive symptoms such as loss of appetite, diarrhea and nausea are common in 44% to 55% of individuals that tested positive.  Muscle and joint pain and headaches are also common in about 45% of individuals.

What Does This Mean?

Based on:
Many of the symptoms associated with COVID-19 are common symptoms that people experience all the time.  The chart to the right highlights the frequency (by percentage) that the following symptoms were experienced in 202 individuals with mild to moderate symptoms (age range from 20-89 years with a median age of 56) that tested positive for COVID-19.  The results in this study were similar to those reported in a number of other studies from around the world.

A symptom that is not on the chart, but was the focus of the study was loss of smell and/or taste. The study found that 64% of those that tested positive also reported an altered sense of smell and/or taste.

The presence of any one symptom does not necessarily mean that you are dealing with COVID-19.  For example, many people commonly experience headaches, digestive issues or muscle pain and other symptoms on an ongoing basis.

Four Phases of COVID-19

There are four stages to COVID-19: prevention, infection, inflammation and recovery.  A person's ability to move through the four phases determines how sick they get and how long it takes them to recover, if infected.
  1. Prevention.  Public health policy is primarily focused on the prevention phase with their recommendations for social distancing, washing hands, disinfecting surfaces and wearing masks when unwell or unable to social distance.  The naturopathic profession adds to this by emphasizing the importance of focusing on overall health and addressing lifestyle factors as a means of ensuring that you are equipped to handle life challenges, including viruses and other pathogens when you encounter them.  It is also important to work with your naturopathic doctor or other health professional if you have or suspect underlying health issues such as diabetes, cardiovascular disease, chronic inflammation, obesity, respiratory conditions or other lifestyle-related conditions that might impact your ability to heal.
  2. Infection.  When someone feels that they have become infected it is important to get tested and to follow the recommendations given.  The chart above highlights the symptoms that may be associated with being infected.  If you do experience any of these symptoms and they are new to you or are accompanied with an overall sense of being unwell, it may be beneficial to get tested.
  3. Inflammation.  The inflammatory phase is the one that appears to be the most concerning for COVID-19.  The fatality risk associated with COVID-19 is associated with the tendency in some people for an excessive or persistent inflammatory response. When the inflammatory response is high the symptoms are apparent and if they result in shortness of breath or difficulty breathing it is important to seek medical care directly.  At times, the inflammatory response is more low-grade and persistent. In this case the symptoms are less extreme, but can weaken a person overtime. 
  4. Recovery.  The aim of the recovery phase is to resolve inflammation in order to inhibit tissue damage and to restore and optimize functioning in the body.  Continual clinical surveillance, such as blood work, is an important step to ensure that the body has fully recovered after being sick with COVID-19 or any other infection.

When Are Your Symptoms A Concern?

Research continues to point to the fact that the majority of those that have COVID-19 will not have any noticeable symptoms or will experience mild symptoms that resolve without medical intervention. Trusting your innate healing ability is a foundational principle of naturopathic practice.  It is also true that if the body is struggling to recover, you will have symptoms that will help to guide your medical practitioner to determine the cause.

If your symptoms come on suddenly AND you feel exhausted or unwell for more than three days it would be worthwhile to contact your medical practitioner or Public Health and get tested.  It may also be concerning if your symptoms are accompanied by a loss or altered sense of  smell that doesn't seem to resolve. This study also highlighted that an altered sense of taste and/or smell often proceeded other symptoms.

In naturopathic practice we acknowledge the "never-well-since" aspect of any illness or accident. Generally speaking the body is designed to handle life's stressors and challenges and to heal, but at times it gets stuck and the body doesn't recovery properly.  This healing process can become stuck due to nutrient deficiencies, other underlying conditions, medications or environmental factors and at times it is unable to heal due to the psychological impact of the injury.  Anytime that a person feels that they have "not been well since  . . . ", it is important to talk to your naturopathic doctor or other health practitioner to figure out what needs to be addressed for the body to heal.  If someone feels that they were unwell earlier this year and that they haven't fully recovered it would be helpful to have laboratory tests done to ensure that the inflammatory phase of COVID-19 was properly resolved and that the body has fully recovered from COVID-19

COVID-19 is a new disease and the information that we have on it is changing and evolving all the time.  What is the most important is your overall health and safety.  If you have any questions, please talk to health practitioner.

Associated Blogs

Don't Wait Until You're Sick To Get Healthy

Food And Immune Health

A Crash Course on Respiratory Health


Giacomo Spinato, Cristoforo Fabbris, Jerry Polesel, et al. Alterations in Smell or Taste in Midly Symptomatic Outpatients with SARS-CoV-2 Infection. April 22, 2020.  JAMA doi:10.1001/jama.2020.6771

Yanuck SF, Pizzorno J, Messier H, Fitzgerald KN. Evidence Supporting a Phased Immuno-physiological Approach to COVID-19 From Prevention Through Recovery. Integrative Medicine: A Clinician's Journal.  May 2020

Maggini S, Pierre A, Calder P. Immune Function and Micronutrient RequirementsChange over the Life Course. Nutrients. 2018.

Marinosci A, Landis B, Calmy A. Possible Link Between Anosmia and COVID-19: sniffing out the truth.  Eur Arch Otohinolaryngol. 2020 April 17. 1-2.  PMID: 32303881.