Covid symptoms: everything we now know about the virus and its variants

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coronavirus symptoms covid signs children kids how long last less common
coronavirus symptoms covid signs children kids how long last less common

In the year since the coronavirus pandemic began to rip around the world our understanding of how the virus acts and the best ways of controlling it have increased enormously.

Our world has also changed beyond recognition. The UK is currently in its third lockdown but glimmers of hope are on the horizon. Infections and hospitalisations are beginning to fall from the peak seen at the beginning of 2021 and the pace of the UK's vaccination programme is to be celebrated. On Feb 22, Boris Johnson also announced a gradual roadmap for reopening that will see restrictions eased over four steps spread across at least four months.

However, the new more transmissible variants now circulating in the UK and elsewhere mean it is crucial that everyone keeps following the current rules.

There is also a lot that individuals can do to stop themselves picking up and spreading this disease. This practical guide will help you keep yourself and your family safe and tell you everything you need to know about this global pandemic.

What is the coronavirus?

Coronaviruses are a family of viruses that cause disease in animals. Seven, including the new virus, have made the jump to humans, but most just cause common cold-like symptoms.

Only two other coronaviruses – Middle East respiratory syndrome (Mers) and severe acute respiratory syndrome (Sars) – have been deadly but they did not spread on the same scale as Covid-19. They have killed more than 1,500 people between them since 2002.

What are the new variants?

Covid-19 has mutated into three "variants of concern", sparking fears over their rate of transmission and the efficacy of the vaccine regarding these new strains.

In the UK, a new mutant strain has been blamed for the surge in coronavirus cases seen since the beginning of the year. Scientists believe this strain - now dominant in the UK is 40 - 70 per cent more transmissible than the original and new data has also shown that it is more deadly than other circulating strains.

The latest research shows that this UK variant may also be mutating to be more like the South African variant, which was identified before Christmas.

Previously, it was thought the UK variant was still susceptible to vaccines. However, there are real concerns about it mutating to be more like the South African variant, which is less susceptible to the vaccine.

The South African variant has also now been identified in the UK with public health teams racing to test thousands of people in areas where cases have been detected. Health Secretary, Matt Hancock has vowed to "come down hard" on the new strain.

Another new variant has been identified in Brazil and this is responsible for a surge in cases that is threatening to overwhelm hospitals in the city of Manaus in the Amazon region. However, no cases have been identified in the UK so far.

What are the symptoms of coronavirus?

According to the World Health Organisation (WHO), the main symptoms of coronavirus usually include:

  • A dry cough

  • A temperature

  • Tiredness/lethargy

  • Shortness of breath (in more severe cases)

  • Loss of taste and smell

Some patients may have "aches and pains, nasal congestion, runny nose, sore throat or diarrhoea", WHO adds. "These symptoms are usually mild and begin gradually. Some people become infected but don’t develop any symptoms and don't feel unwell".

Loss of the senses of taste and smell has been defined as one of the key symptoms of coronavirus under official Government guidance.

However, 140 GPs in the UK have written in the British Medical Journal, urging the Chief Medical Officer to add include symptoms like a running or blocked nose, muscle pain, and headaches as criteria for a test.

They say at the moment they are having to encourage patients who turn out to have coronavirus to lie about their symptoms in order to access a test, which means that far too many cases are being missed.

The chart below identifies some of the most commonly reported symptoms.

What are the less common symptoms?

Other symptoms may include:

  • Aches or muscle pain

  • Congestion

  • Diarrhoea

  • Nausea or vomiting

  • Fatigue

  • Headache

  • Runny nose

  • Sore throat

  • Confusion or dizziness

  • Skin rashes

  • Chills

  • Conjunctivitis

However, there is disagreement among scientists whether some of these symptoms - such as diarrhoea - are linked to Covid-19.

How do I book a coronavirus test if I have symptoms?

If you have symptoms of coronavirus or have been asked to take a test, you can order a test online via the gov.uk website or by calling 119.

You will be asked to attend a testing centre, or alternatively, you can receive a home testing kit if you cannot get to a test centre.

In England, you must get a test within 7 days of showing symptoms. From day 8 of showing symptoms, you must go to a test site as it’s too late to order a home test kit.

How to report your Covid test result?

If you have received a home test (PCR) kit, you must register your kit online following the test so that the result can be sent to you.

If you have taken a rapid swab (lateral flow) test, you will receive your results within two hours. If you receive a positive result, you must report this to the NHS, by either registering it online or by calling 119.

How long do coronavirus symptoms last?

Because Covid-19 is so new there is a good deal of uncertainty around this. One detailed medical report of a waitress on the Diamond Princess cruise ship - a disease hotspot - who had a mild form of the disease showed that she displayed symptoms for 10 days. And a study of nine German patients who were also only mildly affected showed that they displayed symptoms for between eight and 11 days.

People with more severe forms of the disease will take longer to recover - a study of 138 patients who were hospitalised in China showed that some patients were in hospital for up to two weeks, although the average stay was 10 days.

Some people have been left with psychiatric problems, pain and fatigue for weeks after contracting Covid-19, known as long-Covid. There is no strict definition of this syndrome and research is ongoing.

What is the incubation period?

Symptoms are thought to appear between two and 10 days after contracting the virus, but it may be up to 24 days.

Most people (about 80 per cent) recover from the disease without needing special treatment. However, around one out of every six people (16 per cent) becomes seriously ill and develops difficulty breathing.

Older people, and those with underlying medical problems like high blood pressure, heart problems, lung complaints or diabetes are more likely to develop serious illness.

Is a rash a sign of coronavirus?

A skin rash is not yet recognised by the Government or the NHS as a symptom of coronavirus. Scientists have, however, said that rashes should be included as Covid symptoms after research carried out at King's College London.

Researchers at the university said that characteristic skin rashes and "Covid fingers and toes" can occur in the absence of any other symptoms, and so should be considered when diagnosing Covid-19.

Using data from the Covid Symptom Study app from 336,000 regular UK users, the King's College London research found that 8.8 per cent of people testing positive for the disease had experienced a skin rash as part of their symptoms.

This compared to 5.4 per cent of people with a negative test result, leading the study authors to write: "This study strongly supports the inclusion of skin rashes in the list of suspicious Covid-19 symptoms.

"Although it is less prevalent than fever, it is more specific of Covid-19 and lasts longer."

Is vomiting a coronavirus symptom?

According to the US Centers for Disease Control and Prevention (CDC), a fever, cough, shortness of breath, fatigue, sore throat, runny nose, muscle pain and body aches and a headache can all be symptoms of coronavirus and the flu.

Some people report vomiting and diarrhea, but this is thought to be more common to flu than the coronavirus - as it has not yet been listed as one of the symptoms of Covid-19 - and more common in children than adults.

Is diarrhoea a Covid symptom?

Diarrhoea is not listed as a symptom of Covid-19, and appears more commonly as a symptom of flu.

A report authored by gastroenterologists from Wuhan’s Tongji Medical College and California’s Cedars-Sinai Medical Centre found that over half of their coronavirus cases presented with some form of digestive issue, and nearly a quarter presented with only gastric symptoms for the entirety of their illness. This has led to the term "gastric coronavirus" being coined.

What are the symptoms in children and babies?

According to the NHS, the main symptoms of coronavirus in children are:

  • A high temperature

  • A new, continuous cough – this means coughing a lot, for more than an hour, or 3 or more coughing episodes in 24 hours

  • A loss or change to sense of smell or taste – this means they cannot smell or taste anything, or things smell or taste different to normal

The US CDC also suggests that parents watch for fever, runny nose, fatigue, muscle aches, vomiting and diarrhoea.

When should I seek medical help?

If you have difficulty breathing - for example, you are breathing hard and fast, then you should seek medical help. But do not go to a GP - call NHS 111. The NHS 111 website has a symptom checker and specific advice about what you should do in the event that you need to seek medical help.

If you have a fever and a cough - the main early symptoms of coronavirus - the government now advises that you self-isolate for seven days. However, if you live with others you and the people you live with will have to self isolate for 14 days. This will help protect others.

If you live alone, ask neighbours, friends and family to help you to get the things you need.

You do not need to call NHS 111 to go into self-isolation. But if your symptoms worsen during home isolation or are no better after seven days contact the NHS 111 online. If you have no internet access, you should call NHS 111.

For a medical emergency dial 999.

How to 'self-isolate' if you think you might have coronavirus

If you think you may have the virus, you should isolate or quarantine yourself for a minimum of ten days, or until symptoms have stopped.

This means you should:

  • Stay at home

  • Do not go to work and other public areas

  • Do not use public transport and taxis

  • Get friends and family to deliver food, medicines etc, rather than going to the shops

How is coronavirus spread and how can I protect myself?

The most important advice to follow is to stay at home and keep washing your hands.

Like cold and flu bugs, the new virus is spread via droplets when a person coughs or sneezes. The droplets travel for up to three metres, landing on surfaces which are then touched by others and spread further.

People catch the virus when their infected hands touch the mouth, nose or eyes.

It follows that the single most important thing you can do to protect yourself is to keep your hands clean by washing them frequently with soap and water or a hand sanitising gel.

Also try to avoid touching your mouth, nose or eyes with unwashed hands – something we all do unconsciously on average about 15 times an hour.

Other tips include:

  • Carry a hand sanitiser with you at all time to make frequent cleaning of your hands easy

  • Always wash your hands before you eat or touch your face

  • Be especially careful about touching things and then touching your face

  • Sneeze or cough into the crook of your elbow to prevent your hands being contaminated

  • Carry disposable tissues with you, cover your nose and mouth when you cough or sneeze and dispose of the tissue carefully (catch it, bin it, kill it)

  • If you do have to go to work remember social distancing rules and keep away from people

  • Wash your hands when you get in after you have been out

  • Regularly clean not only your hands but also commonly used surfaces and devices you touch or handle

How can I protect my family, especially children?

Children are a major vector for the spread of droplet-based viruses because they interact physically so much with each other and are not the best at keeping themselves clean.

The virus appears to impact older people more commonly but children can be infected and they can get severe illness, the government warns.

However, you can greatly lower the risk that children pose of spreading or catching viruses by:

  • Explaining to them how germs spread and the importance of good hand and face hygiene

  • Ensuring that they stick to the rules on social distancing so no meeting up with friends however bored they are getting

  • Keeping household surfaces clean, especially kitchens, bathrooms, door handles and light switches

  • Using clean or disposable cloths to wipe surfaces so you don't transfer germs from one surface to another

  • Giving everyone their own towel and making sure they know not to share toothbrushes etc

  • Keep your home dry and airy (bugs thrive in musty environments)

The Government is advising that people stay at home and practice social distancing. Stay at least three metres away from other people.

Do not go to work unless it's essential.

Are some groups of people more at risk than others?

While people of all ages are at risk of contracting the virus, older people and those with underlying conditions are more likely to develop serious illness.

Age should be considered “one of the most crucial features” for predicting how sick patients will become from the disease, according to a Harvard study, as it “far outweighs any comorbidity for determining risk”.

When controlling for age alone, patients aged 85 and over were eight times more likely to die than younger people.

The study also showed that a history of pneumonia is the biggest risk factor for death from Covid-19 after age, after analysing nearly 17,000 electronic health records of US patients who tested positive for coronavirus between March and November 2020.

The NHS separates those at risk into the clinically vulnerable and the clinically extremely vulnerable. The latter group includes people who may be immunocompromised, such as those on cancer treatment or those who have had bone marrow treatment. The clinically vulnerable is anyone over the age of 70 and people who have conditions such as diabetes or heart disease.

However, young people are not "invincible" as the WHO has warned and they must follow official advice. Many younger people who would be classed as having ha moderate disease - that is they were not hospitalised - would agree that Covid can be a very unpleasant illness.

Read more: Pneumonia biggest Covid risk factor behind age, Harvard study finds

Is there a vaccine for coronavirus?

Worldwide almost 200 coronavirus vaccine candidates are development, at least 15 of which are in human trials.

In the UK three vaccines have been approved, two of which - the Pfizer/BioNTech and Oxford University/AstraZeneca jabs - are now being administered. The Moderna vaccine, approved for use on January 8, will not be delivered until the spring.

The Pfizer vaccine has shown over 90 per cent efficacy at preventing Covid-19 in those without evidence of prior infection. The Oxford vaccine is about 70 per cent effective but easier to manufacture and distribute.

The UK has decided to delay the second doses of these vaccines in order to give as many people in at-risk groups as possible their first dose.

And two more Covid-19 vaccines could be approved for use in the UK within weeks as both the Novavax jab and the Johnson & Johnson shot have been shown to be effective in preventing moderate to severe Covid-19.

The UK has now secured more than 400 million doses of six different vaccine candidates. The only one yet to report final stage data is a jab developed by GSK and Sanofi - researchers reported disappointing results in December and final trials are now not expected until the end of this year.

As of February 25 the UK had administered over 19 million doses, with only Israel, United Arab Emirates and Chile vaccinating their populations at a faster rate.

It comes as Mr Johnson said every person aged over 18 will have been offered a coronavirus vaccination by the end of July, raising hopes of foreign holidays and the return of outdoor events by August.

Read more: From transmission to efficacy, the Oxford, Pfizer and other Covid vaccines compared

Workers at Incheon International Airport, in South Korea, spray antiseptic solution amid rising concerns over the spread of coronavirus - Suh Myung-geon/Yonhap
Workers at Incheon International Airport, in South Korea, spray antiseptic solution amid rising concerns over the spread of coronavirus - Suh Myung-geon/Yonhap

What is 'long Covid' and what are the long-term symptoms?

Many people who have been infected with the virus and recovered from its acute phase have had other lingering complaints, or what has become known as 'long Covid'. Symptoms of this often include tiredness and muscle aches.

Guidance issued by the NHS and seen by The Telegraph warns that lung disease is also likely to be an important consequence of Covid-19, in addition to an array of other long-term complications.

Anecdotal evidence suggests that weakness on being discharged from intensive care units is prevalent among more than half of Covid patients, with mild brain damage also persisting in approximately a quarter of the patients who suffer acute respiratory distress syndrome.

Whilst anyone who is critically ill is likely to suffer fatigue as they recover, the NHS guidance warns “patients who have had Covid-19 are reporting extreme fatigue beyond the usual reported levels”, and one in 10 patients could develop chronic fatigue.

The first parliamentary inquiry into the coronavirus pandemic heard from witnesses who spoke of lasting coronavirus symptoms, and found themselves being wiped out months after being first diagnosed with the virus.

An app developed at King's College London traces progress of more than 4 million Covid-19 patients in the United Kingdom, Sweden and the US. As well as the common symptoms are other effects, such as rash, fatigue, abdominal pain, headache and diarrhoea. Some people also report confusion, muscle pain, shortness of breath and a cough.

A loss of smell, known as anosmia, has been identified as a common symptom of Covid-19, but now some long Covid sufferers have developed a strange symptom where they smell fish and burnt toast constantly.

More than three quarters of coronavirus patients have at least one ongoing symptom six months after initially becoming unwell, a landmark Lancet study has found.

Some 1,265 of the 1,655 patients (76 per cent) patients studied reported at least one health complaint during the follow-up period.

The most common long-term symptoms were fatigue and muscle weakness, sleep difficulties, and anxiety or depression.

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