Whether you’ve had a “bad cold” this winter or have recently endured a cough that would not stop, it is only natural to ask yourself if you may have had COVID-19 without realizing it. This is especially true now that infectious disease experts say the virus probably had already spread before cities began closing and placing social distancing orders.
“As the weeks go by, it has become clear that this is a virus that was widespread throughout our country, especially in more populated areas, earlier than we thought,” says William Schaffner, MD, an infectious disease specialist and professor at the Vanderbilt University School of Medicine.
So, could you have COVID-19 without realizing it? It is possible. “Most people who have coronavirus have an uncomplicated case of infection, and it can be differentiated from the cold or flu,” explains infection control expert Amesh A. Adalja, MD, senior scholar at the Johns Hopkins Center for Health Security . Plus, some people have no symptoms at all – up to 40% of infections, according to estimates from the Centers for Disease Control and Prevention (CDC).
Unfortunately, there is no way to know with 100% certainty if that disease you treated last winter was COVID-19 or if you are at some point picking up an asymptomatic case. But experts say some signs may be tip-offs that you may already have COVID-19. Here are the best to know, plus what it means for immunity.
1. You had a “severe cold” in early 2020.
Beginning in the pandemic, people believed that COVID-19 only began circulating in the US in late February and March. New research from the University of Texas suggests otherwise. For the study, scientists analyzed throat swings taken last winter in people who had suspected flu cases. These swabs were performed in Wuhan, China (where the novel coronavirus originated) and Seattle, Washington (where the first case of COVID-19 in the US was confirmed).
The researchers discovered that for every two cases of the flu, there was one case of COVID-19. As a result, they believe that COVID-19 probably arrived in the US around Christmas.
‘It took longer to get out to rural areas, so if you were on a farm this winter and you had the snuff, you probably would have just caught a cold. If you were in New York City or another big city, you would have a COVID infection and never knew it, ”says Dr. Schaffner.
It can be difficult to distinguish colds from a mild form of COVID-19 without a test, depending on what symptoms you are experiencing, he says, but colds typically do not cause breathing, severe headaches as gastrointestinal symptoms as COVID-19 can. Here is the full list of the official symptoms of the CDC:
- Fever or cold
- Cough
- Shortness of breath or difficulty breathing
- Wurgens
- Muscle as body pain
- Hollepine
- New loss of taste or smell
- Sore throat
- Congestion as a runny nose
- Nausea or vomiting
- Diarrhea
2. You have lost your sense of smell or taste at one point.
Loss of smell and taste has been a major feature of COVID-19. Although this symptom does not occur to everyone, Dr. Adalja points out that it is now strongly associated with the novel coronavirus.
Preliminary data from the American Academy of Otolaryngology-Head and Neck Surgery (AAO-HNS) found that, in COVID-19 patients who lost their sense of smell, 27% had “some improvement” within about seven days, while most were better within 10 days.
Note: It is also possible to temporarily lose these senses with other respiratory conditions, such as colds, the flu, a sinus infection, or even with seasonal allergies. But experts say the symptom can hang in some people and take months to recover from COVID-19.
3. You are dealing with unexplained hair loss.
This has not been widely investigated in the context of COVID-19, but many people who have recovered from the virus report problems with hair loss. Actress Alyssa Milano, who has been suffering from COVID-19 symptoms for months, shared a video of herself on Instagram in early August and repeatedly brushed large lumps of hair after she showered.
Members of Survivor Corps, the Facebook support group for people who have COVID-19, also talked about experiencing hair loss months after recovering from the virus. It comes from a condition known as telogen effluvium, and it can be caused by many factors, including pregnancy, extreme stress, weight loss, and diseases other than COVID-19, says Dr. Adalja.
It is unlikely that you would just lose more hair than normal without having other COVID-19 symptoms, such as cough or fever, says Dr. Adalja. It is also important to note that hair loss can occur due to stress in general, he says – and that has been a lot of stress due to the pandemic. If you experience hair loss, it is possible that it is due to an unknown COVID infection, a buildup of stress at uncertain times, or some other underlying problem.
4. You sometimes feel like you are breathing.
Research published in the journal JAMA has found that people with COVID-19 may have side effects from the virus, including breathing. It is not entirely clear why at this point or how long this may take, but it is probably due to persistent inflammation in the lungs.
“This is one of the known lingering effects in people who were diagnosed with COVID-19,” says Dr. Schaffner. “If you have this, well, maybe that disease you experienced earlier was actually COVID.” If you experience shortness of breath, call your doctor for primary care for guidance or ask for a referral to a pulmonologist. They can often prescribe medications and treatments, such as an inhaler, that can help, says Dr. Schaffner.
5. You have a cough that will not go away.
A lingering cough is another symptom that people who participate in the JAMA study reported. The cough is often dry, which means that nothing comes up, such as mucus or mucus, says Dr. Adalja. This is fairly common: CDC data found that 43% of people who had COVID-19 still had a cough 14 to 21 days after receiving a positive test for the virus.
6. You are true, really wurch.
This is one of the biggest lingering effects after a person has COVID-19, according to the JAMA to study. That study found that 53% of patients said they struggled with fatigue around 60 days after they first showed signs of the virus.
“We see some people who have a mild illness, who have been tired for a while,” says Dr. Adalja. But, he says, it’s not entirely clear now why this is happening. It could be how a person’s immune system reacts to the virus, or it could just be the way the virus works in the body.
Keep in mind that fatigue is a very common problem and can be a sign of many different health problems (including, of course, not getting enough sleep). Like hair loss, people who have experienced fatigue from COVID-19 in the past would also have other symptoms of the virus, says Dr. Adalja.
7. You have unusual symptoms that seem to last forever.
Experts stress that COVID-19 is still a new virus, so doctors and scientists are learning more and more about it. Research into the lasting effects of the virus is ongoing, and it is difficult for doctors to say at this time that having certain symptoms may mean you have a COVID-19 infection, while others do not, says Dr. Adalja.
It is worth mentioning that some people have experienced heart problems after contracting the virus. One small study of 100 people recovering from COVID-19 that was published in JAMA Cardiology performed MRIs on previous patients and found that 78% had some sort of abnormal heart condition, independent of any pre-existing condition. This also did not seem to link to severity of illness, the researchers found. That could appear in many different ways, including random heartbeats, says Dr. Schaffner, but it may also not be noticeable.
Of course, there are plenty of other complications that experts may not even know about yet. If you are feeling and your symptoms are persistent, says Dr. Schaffner that it’s a good idea to have it checked by your doctor, whether you think it’s related to COVID-19 or not.
What about an antibody test?
While an antibody test can tell you if you have COVID-19, they are not exactly known for their accuracy. “Antibody tests are getting better, but there are a lot of antibody tests out there that are still unreliable,” says Dr. Schaffner. The Food and Drug Administration (FDA) issued an emergency use permit for these tests in the spring, but later withdrew certain tests due to “significant clinical performance issues.”
The CDC also emphasizes that antibody tests “are not 100% accurate and may prevent some false positive results as well as false negative results.” Thus, it is possible to test positive for COVID-19 antibodies, but not really have them.
This comes down to several factors. First, there are other coronaviruses that are known to cause colds, and these can be picked up by your antibody test, which will damage the results. What’s more, if you are only in the first days of infection, antibodies may not be detected at all because your immune system has not yet built up a response. (Learn more about COVID-19 antibodies here.)
Does it mean that you have COVID-19 in the past that you do not get infected again?
Although the above signs may be an indication that you have COVID-19, they can also be caused by other diseases. “Sure, a lingering cough and fatigue are known to be a result of flu – just because you have them does not mean you had COVID-19,” says Dr. Schaffner.
Finally, in short if you have a positive test for COVID-19 when you are sick, it is difficult to know with total certainty if you have the virus. Still, “there are definitely people who are infected and not noticed,” says Dr. Adalja.
With all of this in mind, there’s one important thing to remember: Even if you’ve had COVID-19 in the past, that does not necessarily mean you will not get infected again. The CDC specifically states that it is currently unclear if humans can be re-infected with the virus – and the first case of reinfection was just confirmed in Hong Kong.
So, even if you suspect that you contracted COVID-19 before the pandemic actually hit, it is important to continue to practice prevention methods such as wearing a mask, washing your hands regularly, and exercising social distance if you can, both to protect yourself and others.
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