Researchers from the University of Southern California (USC) have identified the likely sequence in which Covid-19 symptoms first appear, which they hope will help physicians identify patients earlier and provide appropriate treatment.
One of the more difficult challenges of the Covid-19 pandemic is identifying who has contracted the disease and isolating it to contain further spread. Governments around the world have set up test, track and track systems to do just that. However, if we were able to identify cases earlier, we could reduce the number and size of case clusters, the researchers write in the journal Frontiers in Public Health.
With that goal in mind, biologists from USC sought to identify the sequence of Covid-19 symptoms so medical practitioners and members of the public know where to look, especially in the early stages of the disease. They also identified how the sequence of symptoms differs from similar viruses such as influenza and other coronaviruses, to aid in faster identification.
To do this, they looked at data from 55,924 cases of Covid-19 from the World Health Organization (WHO) and China from 16-24 February 2020, as well as 1,100 cases between 11 December 2019 and 29 January 2020, collected by the expert group for medical treatment of China. She focused on symptoms that were easy to recognize as objective, compared to other reported symptoms such as neurological effects including loss of smoking.
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“A person infected with Covid-19 is likely to experience symptoms in the order of fever, cough, nausea / vomiting, then diarrhea,” the authors revealed. “The least likely pathway begins with diarrhea and nausea / vomiting and is followed by cough, and finally fever.”
Distinguishing Covid-19 from flu can be especially challenging because we are going after flu season. To help with this, they compared the Covid-19 sequence of symptoms with 2,500 flu shots from US and European health authorities from 1994 to 1998 and the two known diseases of coronavirus Middle East Respiratory Syndrome (MERS) and Severe Acute Respiratory Syndrome (SARS).
Their model found that flu usually starts with a cough, while Covid-19, like other coronavirus diseases, starts with a fever. However, the timing and symptoms in the upper and lower gastrointestinal tract set Covid-19 apart from SARS and MERS.
“This sequence is especially important to know when we have overlapping cycles of diseases such as the flu that coincide with Covid-19 infections,” USC Professor Peter Kuhn said in a statement.
Although this is simply the most likely sequence of symptoms and some patients will differ (for example, a very small number of patients experience diarrhea as a first symptom), the team believes that this supports the idea that “fever should be used to screen for entry into facilities as regions begin to recover after the onset of spring 2020. “As new treatments are created and improved, they hope knowing the likely sequence of symptoms will save lives as people seek and are given treatments at an earlier stage. of the disease.
Although confident in their results, the team says that overall accuracy could be improved if doctors register the order of occurrence of symptoms; something that, somewhat surprisingly, is not yet standard practice.
“Our findings suggest that good clinical practice should be taken into account in recording the sequence of symptoms occurring in COVID-19 and other diseases,” the paper concludes. “If such a systemic clinical practice had been standard since ancient diseases, perhaps the transition from local outbreak to pandemic could have been prevented.”
