The manifestations of the new coronavirus last between 7 and 14 days. Yet some people experience symptoms 20 days, sometimes longer, after infection …
[Updatedon18[Misàjourle18 May 2020 at 11:10 am]The new coronavirus is benign in 80% of cases. According to WHO, the main symptoms are: “aches and pains, nasal congestion, headache, conjunctivitis, sore throat, diarrhea, loss of taste or smell, rash or discoloration of fingers of the hand or foot. ” For many, these prodromes disappear after 7 or even 14 days. However, an epidemiological study carried out by the CHRU of Tours has shown that 80% of hospitalized patients present at least one symptom one month after their discharge from hospital. This phenomenon of “persistent symptoms” is gaining momentum on social networks in the form of “# after D20” and “# after D60”. Patients report pulmonary pain, burning sensations, numbness, tachycardia, headache, respiratory disorders, general weakness … Asked by the site “Why doctor“Benjamin Wyplosz, infectious disease specialist in the infectious and tropical diseases department of Bicêtre Hospital, said:” All of these cases are worth exploring. You have to take an interest in these people and understand what they have. “To explain these” Covid sequelae “, several tracks are mentioned, in particular post-traumatic syndromes and post-viral diseases.” Many questions arise. run tests and proceed with elimination. But these people should not think that we are abandoning them, we are caught in the flow of problems that arise gradually, “added the infectious disease specialist. Professor Jean-Paul Stahl, infectious disease specialist at CHU Grenoble, said: “We are going to conduct a study on the condition of the patients 6 months after the first symptoms.”
According to WHO, the incubation time of the virus – that is, the time between infection and the first symptoms – ranges from one to 14 days. In more rare cases, symptoms can appear overnight. The first signs of the virus are: fever, dry cough and fatigue. These symptoms, most often mild, appear gradually, sometimes by a mild cough, or by a simple headache. Some people with the virus even sometimes have zero symptoms. It is the asymptomatic form of this infectious disease.
According to UNICEF “In children and young people, the effects of the virus are relatively mild, a very small proportion of them being in serious or critical condition due to the coronavirus.” In most cases, the infection is not very symptomatic or asymptomatic. If young children and babies are less affected than adults by Covid-19, they can be infected, and therefore transmit the disease.
However, pediatricians warn of the appearance of a condition close to Kawasaki disease, a vascular syndrome affecting young children, which incidentally killed its first in France on May 14. Doctors said the nine-year-old victim had contracted the coronavirus. Symptoms include severe abdominal pain, fever, diarrhea, rashes, etc. All of these are common symptoms with Covid-19. Among the few cases hospitalized for these symptoms in Ile-de-France, some have tested positive for the Chinese virus. “They did not all present typical respiratory symptoms at the initial phase. We see them arriving in a second time with a little more frustrating forms which were not described in children: digestive disorders, fever, deterioration of the general state but not necessarily notion of respiratory distress “, explained on RMC Pierre-Louis Léger, head of the pediatric neonatal resuscitation service at Trousseau Hospital in Paris.
As with seasonal flu, fever and body aches are very common symptoms of Covid-19. The level of fever varies from one individual to another, but generally the coronavirus causes a fever higher than 38 °. If you want to fight fever or pain, prefer paracetamol to anti-inflammatory drugs and ibuprofen, which are suspected of worsening symptoms in case of coronavirus. If in doubt, stay home and call your doctor.
Covid + patients have a dry, sometimes oily cough. Aurore Jégu-Pétrot, nurse, reported on BFMTV that this cough, if it becomes unmanageable, should alert: “When you see that you cough to choke on it you tell yourself that you are going to need respiratory aid” … However, in the majority of cases, this cough goes out by itself. WHO advises calling your doctor if you have a dry cough.
Several ENTs alerted the authorities in mid-March of the appearance of a new symptom: anosmia (loss of smell). These losses of smell would seem to be a pathognomonic symptom, a clinical sign which alone can establish the diagnosis. This symptom is the only specific presentation of the new coronavirus. Dr. Corré, ENT at the Rothschild Foundation Hospital in Paris, theorized: “The SARS Cov-2 virus is attracted to the nerves: when it enters the nose, instead of attacking the mucosa as does the usual rhinoviruses, it attacks the olfactory nerve and blocks odor molecules. ” The doctor assured: “In the current context, if you have an anosmia without a stuffy nose, you are Covid positive, it is not worth going to get tested.”
Shortness of breath is another symptom of the coronavirus which can be a signal of worsening of the disease, which attacks the respiratory tract and can lead to severe pneumonia. This complication occurs in some patients from the seventh day, with a renewed fever, sometimes after a slight improvement phase. Shortness of breath often happens suddenly and occurs at the slightest physical exertion, such as moving around or showing the stairs. To detect it if in doubt, measure your breathing rate. Beyond 20 to 25 breaths per minute, it is a tachypnea (increased respiratory rate) and it may be advisable to consult a doctor if you have other symptoms.
A Chinese study, published in theAmerican Journal of Gastroenterology, arranged that patients with coronavirus may also be affected by digestive disorders. The study reports that out of 206 Covid-19 cases tested, with an average age of 55, “almost half (48.5%) went to hospital for various digestive disorders such as than diarrhea (29.3%), vomiting (8%) or abdominal pain (4%) “. Even more surprising, some patients (seven) had digestive problems … but no respiratory symptoms, which are the most common signs of the new coronavirus.
General practitioners and dermatologists have observed an increase in patients with frostbite and hives. According to National Union of Dermatologists-Venereologists (SNDV) these symptoms may be associated with the new coronavirus. “In view of the large number of this type of lesion at this time, it is certain that one must evoke the Covid in this particular case”, explained Dr Luc Sulimovic, dermatologist in liberal and president of the national union of dermatologists- venerologists at Doctor Daily. And to specify: “Some patients are asymptomatic while others have weak pulmonary signs”. The union stressed: “the potential contagiousness of the patient if this acrosyndrome turns out to be a symptom of Covid-19.”
The coronavirus infection becomes worrying that people are “breathing faster than normal,” reported Dr. Pauti, who tells his patients to call 15 as soon as they notice shortness of breath. These brutal aggravations often occur between the seventh and the fourteenth day. They result in a form of bilateral pneumonia, with a very specific radiological aspect. “On CT, we can be almost certain” that it is the Covid-19, said Pauline, hospital doctor in the Paris region.
Jessica J Manson, specialist in inflammatory phenomena at University College Hospital, London, estimated in the medical journal The Lancet : “Evidence is accumulating to suggest that some of the patients suffering from severe forms of Covid-19 are subject to cytokinic shock syndrome.” In theory, in case of infection cytokines allow regulation of the immune action. However, with the “cytokine storm”, we observe a runaway of this system which leads to a hyper-inflammatory reaction.
The new coronavirus can affect the kidneys. Alan Kliger, nephrologist at the Yale School of Medicine, encrypted in the Washington Post : “Almost half of those hospitalized for covid-19 have blood or protein in their urine.” More alarmingly, a survey reported by the newspaper reports that 14 to 30% of intensive care patients in New York and Wuhan (China) lose their kidney function and require dialysis. Individuals with kidney disease are more prone to these worsens. Indeed, they often have problems with diabetes, hypertension or cardiovascular disease. However, Dr. Brad Rovin, director of the nephrology department at Ohio State University, notified RFI that “many cases who have never had kidney disease before develop severe kidney damage.” He explained, “Depending on the severity and duration of the infection while fighting Covid-19, these patients may develop chronic kidney disease.” Dr. Brad Rovin said, “I think we will see the long-term consequences of this disease in nephrology departments.”
Some patients with Covid-19 have neurological conditions. A study published in the journal of theAmerican Medicine Association (Jama) reports that out of 214 Chinese patients 36% had neurological symptoms, ranging from loss of smell to nerve pain, to seizures and strokes. If these landmarks losses are sometimes due to the lack of oxygen in the blood, some health professionals suggest other hypotheses. The first is due to an abnormal immune response – a “cytokine storm” – which causes inflation in the brain called autoimmune encephalitis. The second is a direct brain infection: viral encephalitis. In order to find out the origin of these disorders, a data collection project is underway.
In addition, American doctors have noted an increase in strokes in young and middle-aged Covid + patients. In order to document this phenomenon, the Washington Post reported that three major US medical centers are preparing to release data. Pascal Jabbour, neurosurgeon at Thomas Jefferson Hospital, said that many cases have unusual characteristics. Usually clots appear in the arteries that carry blood away from the heart. However, in Covid-19 patients, clots also form in the veins and are more difficult to treat. Sherry H-Y Chou, a neurologist at Pittsburgh University Hospital, hypothesized that these conditions were caused by “friendly fire”, that is, a disproportionate immune response. If you notice symptoms of a stroke (dizziness; numbness and sagging of part of the face, arm, leg or part of the body; speech problems …) contact 15 as quickly as possible.
Coronavirus can cause different levels of sequelae. Xavier Lescure, professor and infectious disease specialist at Bichat hospital in Paris, explained on FranceInfo : “We do not think there are any sequelae for people who have had weak symptoms”. On the other hand, in severely affected patients, the consequences will be indelible. The lungs are the first organs affected. A 3D video (carried out by researchers at the George Washington University Hospital in the United States) reveals that the lung tissue is very largely damaged in severely affected patients. Keith Mortman, head of the thoracic surgery department, theorized: “When this inflammation subsides, it leaves scars on the lungs and creates long-term damage. This can deteriorate a patient’s breathing capacity in the future.” Autopsies confirm that severely affected patients develop pulmonary fibrosis. Xavier Lescure explained: “We see that people who die have large lesions linked to lung inflammation.”
The deconfinement was accompanied by a new procedure for people symptomatic of Coivd-19. “If you have symptoms suggestive of Covid-19 infection (cough, fever, difficulty breathing, loss of taste or smell), do something about it, don’t wait for it to pass. Contact your doctor or contact the 15 to refer you to an available doctor. He will then ask you questions and, if he considers it necessary, prescribe a screening test, “said in his intervention from May 7, Olivier Véran. Pending the results, the potential patient must isolate himself at home or at the hotel. If the test is positive, the isolation should continue “up to two days after healing of symptoms, that is to say on average for 8 to 10 days,” said the Minister of Health.
It is sometimes difficult to know how to react to symptoms suggestive of Covid-19. To overcome certain questions, the Government has put online a survey to better guide potential patients. With the same objective of reassuring patients, the National Medicines Agency (ANSM) has for its part posted a survey simple which allows to know the effects of a treatment on the Chinese virus. The AlloCovid platform, launched at the end of April, is a tool used to refer patients. Available by phone, on 0 806 800 540 (price of a local call), this service does not require a smartphone or an internet connection. A telephone bot asks you a series of questions, often closed, about your general condition. AlloCovid “allows, via a questionnaire of three minutes maximum, to any citizen to be informed and well oriented, 24 hours a day and 7 days a week, on what to do in case of symptoms, stay at home, call his treating doctor or, if necessary, to call without waiting for 15 “, explained to Parisian, Professor Xavier Jouven, cardiologist and researcher at Inserm.
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