By observing the patients and exchanging information between them, the doctors were able to refine their knowledge of the symptoms of Covid-19. Even if they still admit that they are far from knowing everything. Update on what we know today.
Cough and fever… like rhinitis
Like common rhinitis, the coronavirus currently circulating causes "dry cough, fever, between 38 ° and 40 °, and headache." You can have one or the other of these symptoms, or all three ”specifies doctor Serge Smadja, president of SOS Doctors. This virus can also cause stomach aches and diarrhea, like "common" pathologies of winter.
Eight out of ten cases of loss of taste and smell
A new study made public this Wednesday, April 1, provides more information on the loss of taste and smell, one of the now known signatures of the virus. A group of ENT specialists from the International Federation of ENT Societies (Ifos) carried out a large survey of 417 patients infected with Covid-19, coordinated by Dr Jérôme Lechien of the ENT department at Foch Hospital in Suresnes ( Hauts-de-Seine) and by Pr Sven Saussez, ENT and researcher at the University of Mons (Belgium) with 33 ENT doctors and researchers in 12 European hospitals. Among the patients, there are 263 women (63%) and 154 men (37%). The results show that 86% of infected patients have partial or complete disturbances of smell and 88% of partial or complete disturbances of taste. They occur either before the onset of symptoms (general and ENT) (in 12% of cases), or during (65% of cases) or after (23% of cases). "Surprisingly, women are significantly more affected by these symptoms and this difference related to sex is statistically significant" specifies the study.
Good news, however, 44% of patients have already recovered their sense of smell within a short period of 15 days. The rest of the patients should be hopeful of recovery, which could happen within 12 months of the onset of symptoms (nerve recovery is a slow process). The researchers suggest that patients with loss of smell and taste be considered potentially infected with Covid-19 and therefore isolated for a minimum of 7 days (to be discussed with the attending physician). They also point out that the treatments usually given to treat loss of smell, namely oral or nasal corticosteroids (spray) are contraindicated in the context of these anosmias in connection with Covid-19 infection.
“Fatigue”, skin allergies… the response of the immune system
Health professionals also explain that some of the symptoms are not due to the virus itself, but to the reaction of our own immune system to aggression, a very variable reaction from one individual to another. "This is the case of great fatigue, exhausting, which is clearly a response of our immune system," said Professor Jean-Daniel Lelièvre, head of the infectious diseases department at the Mondor hospital in Créteil (Val-de- Marl). "Muscle pain" is part of the same phenomenon. For the same reason, some patients, but relatively rarely, develop allergic reactions on the skin, with the appearance of plaques and redness.
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Be careful in case of pollen allergies
It is also for this reason that with the progression of grass pollens, in this sunny spring period, allergic people must be particularly careful, faced with the risk of Covid-19, because their immune system is particularly stressed. “They must continue to take their antihistamine treatment. In case of asthma, you should not hesitate to consult if the symptoms worsen ”, adds Dr. Serge Smadja.
Breathing difficulty, to be taken care of very quickly
Certain Covid-10 symptoms should alert immediately. "Breathing difficulty" is one, as is "chest pain", which can be a precursor to a heart attack. "When our body's immune response to SARS-CoV-2 is very important, our lungs can be hampered to breathe and can no longer be effective," says Professor Lelièvre. "The patients then have the feeling of having shortness of breath, and of having great difficulty in breathing well". In this case, the patient must very quickly call his doctor, or the 15th, to be rescued, possibly with an additional supply of oxygen. This can be done in the hospital, clinic, or even, in some cases, at home. "The doctor will measure his heart rate and his respiratory rate, and decide on the response to put in place," adds Dr. Smadja.
What happens in severe forms
When severe forms of Covid-19 occur, the patient should be helped by breathing machines, in ward, or for more complex cases in intensive care. “You have to avoid pulmonary embolism. This is what happens when the pulmonary artery becomes blocked, and it causes cardiopulmonary arrest, "says Dr. Smadja. “Another fatal outcome is myocarditis. This happens when SARS-CoV-2 infects the heart muscle. "
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Most patients recover
Even if SARS-CoV-2 is very dangerous, it must be kept in mind that most of the time the patients recover. “Of all the people who are infected with Covid-19, only 20% will go to the hospital. The others will heal on their own. And of the population who will go to the hospital, only a third will go to intensive care. And it is estimated that one in two people will come out of intensive care, ”said Professor Lelièvre. Doctors still estimate that 90% of people will recover. "But the difficulty with Covid-19 is that it quickly infects many people, because before having crossed it, nobody is immune to it," adds Professor Lelièvre. And since there are currently no effective drugs, teams must rely on machines to restart the body when it is too assaulted.
A disease that lasts from one to three weeks
According to specialists, the duration of the disease is "at least a week, that's for sure." This usually lasts two weeks, and in some cases up to 21 days, ”says Dr Smadja. During this period, doctors often noted a worsening "between the 6th and the 9th day". But before symptoms appear, doctors believe that one is contagious during the previous fifteen days.
When to stay at home, when to call the doctor urgently?
"If you have any doubts about Covid-19 symptoms, you should call the doctor," says Dr. Smadja. After consultation, or teleconsultation, he must make his decision. "In general, if people have no other pathologies or particular risks, and they only have cough, fever and headache, they are told to stay at home, and to to confine. Concretely, this means isolating oneself as much as possible in a room, respecting barrier gestures, and wearing a mask so as not to contaminate those around you, for two weeks minimum, or even three. On the other hand, if the patient has the impression that his condition is getting worse, and, in particular, if he has difficulty breathing, he must then contact his doctor, or call 15. He will take it then in charge to find a suitable situation.
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