COVID-19 symptoms can be all or nothing: 'This virus just has the whole kit and caboodle'

Cincinnati Enquirer staff writer Ann Sacker explains the steps you should take if you believe you have the novel coronavirus. USA TODAY

For Elizabeth Schneider, her bout withthe coronavirus began with a scratchy throat, exhaustion and a headache. Then came fever, chills and nausea. But she never had shortness of breath or coughing.

Charlie Campbell’s 89-year-old dad had a cough and irregular heart rate and was briefly on oxygen before he recovered. 

Amy Driscoll first experienced shortness of breath and her chest felt constricted.

For Bill Houser, a Superior Court judge in Kitsap County, Washington, the symptoms came on overnight.

People who contract COVID-19, the disease caused by the new coronavirus sweeping the globe, can experience a broad range of symptoms and have very different experiences.

Some have no symptoms at all. By far the largest group present with fever and other symptoms. Most will get better on their own. About 15% of those infected go on to have severe illness and must be hospitalized. Another 5% become so ill they must be treated in an intensive care unit.

The most common symptoms for those who get them, according to Johns Hopkins Medicine, are fever, cough, shortness of breath when they first get sick, and muscle pain or fatigue. 

Others have reported less common symptoms, including sore or scratchy throat, headache, a productive cough, and nausea or diarrhea.

Schneider of Seattle had a front-row seat for the range of symptoms when a large group of her friends were exposed to the virus at a party on Saturday, Feb. 22. 

Schneider, 37, woke up Tuesday a little tired and groggy. She went to work but by midday began to feel as if she was coming down with a bad cold.

“I had a headache and body aches and a little fever,” she said.

She got home and took a nap. When she got up her temperature was 101. There was no cough, shortness of breath or tightness in her chest. But she kept getting sicker.

“That evening my temperature spiked up to 103 and I started shivering uncontrollably. I could barely brush my teeth and take out my contacts and go to bed,” she said.

She took over-the-counter cold medicine and went to sleep. By morning, her temperature was down to 101. She spent the next two days in bed, sleeping and drinking lots of water. She slowly got better, with only a low temperature and tiredness toward the end. But it wasn't until 12 days later that she felt truly well, she said.  

From 'really sick' to not 'really lousy'

In Hudson, Ohio, Driscoll's experience with the illness started out in much the same way. The 48-year-old suddenly started feeling tired and feverish March 11 at work. When she got home that night, her temperature was elevated, so she took Motrin and went to sleep.

She woke up in the middle of the night coughing, and her chest hurt.

“It was hard to get a breath in and my chest felt constricted,” Driscoll told the Akron Beacon Journal, part of the USA TODAY Network. “It was like nothing I had ever quite experienced.”

She went to the hospital the next day and was immediately put in isolation. By Friday, Driscoll's temperature was 102 and she had tested positive for COVID-19. She remained hospitalized for two days, on IV fluids, pain medications and fever reducers, before she was well enough to be sent home.

As late as March 17, nearly a week after her first symptoms, Driscoll was still exhausted and dealing with fatigue and headaches.

“I was really sick,” she said. “I was really scared there for a little while about how sick I was.”

Houser woke on March 13 with a temperature over 100 degrees, sore throat and a cough, after feeling fine when he'd gone to sleep the night before. 

He told the Kitsap Sun, part of the USA TODAY Network, that it felt similar to the flu but not as bad.

"The last time I had the flu. I felt really lousy. I haven’t felt really lousy with this," he said.

Houser said his fever went away in short order and he experienced some body aches, but not too much. A week later he said he still had a cough and had never felt short of breath. Mostly he felt more tired than usual, and has been napping.

"It just was different," he said when asked to compare it to a case of the flu.

'I was sleeping 19 hours a day'

For Noelle Ruiz, 27, it began March 10 with a 101-degree fever. She took Tylenol and rested. After about a day the fever subsided. She still had a headache and cough; she felt pressure in her sinuses but had no sniffles. Later in the week, she developed chest pain when she breathed but still didn’t think it was COVID-19.

Only six days later did the worst of the symptoms hit.

“I was sleeping 19 hours a day. I felt nauseous. When I’d get up to go to the kitchen, I’d run out of breath. It was like I was doing exercises, but I’d only walked the distance of the room,” she said from her home in Los Altos, California.

“I couldn’t really take a deep breath. I didn’t feel like I had enough air in my lungs,” she said.

Ruiz had another set of symptoms appearing in some of those infected. "I lost taste, food wasn’t appetizing, I couldn’t smell anything," she said. 

While it's unknown how many people infected experience a loss of sense of smell, called anosmia, or a loss of taste known as ageusia, doctors are finding the symptoms reported by some COVID-19 patients.

It was the shortness of breath that finally triggered Ruiz doctor to test her. She learned Sunday she was positive for the coronavirus. .

Ruiz is pretty sure she got it from her mother-in-law, who got sick a week before her and went on to develop pneumonia. She was admitted to the hospital, put on oxygen and recovered after a few days and is now quarantined in her apartment.

For Ruiz things never got that bad, but only now is she beginning to feel normal after almost two weeks of being sick. For her, COVID-19 wasn’t as severe as the full-on flu but did really take it out of her.

“The biggest symptoms to me were how tired I was and how much sleep I needed," she said. "And the tightness in my chest. It was just weird that it took six days for the more COVID-like symptoms to hit me."

One party, a plethora of symptoms

Back in Seattle, when Schneider finally had the energy go on Facebook, she saw many of her friends who’d been at the Saturday night party and come down with the same thing. They began chatting online and wondered if they’d all gotten the coronavirus. It was early in the outbreak and there were few definitive cases.

A dozen of them formed a group on Facebook, and seven were tested. All came back positive for SARS-CoV-2, the virus that causes COVID-19. Schneider, a bioengineer, was fascinated by the vast range of experiences they all had.

One of her friends who tested positive for the virus had no symptoms at all, but his employer’s rules required he be tested because he’d likely been exposed. Another had only a little congestion in her chest and felt a little tired, Schneider said.

No one among the group had respiratory symptoms except in a few cases where people had a dry cough or tickle at the back of their throat toward the end of their illnesses. One had shortness of breath and body aches, headache and exhaustion, but no fever. Another came down with a low-level pneumonia, an inflammation of the lungs that can be caused by infection. 

Schneider had all the symptoms save shortness of breath – high fever, fatigue, body aches, headache, nausea, diarrhea and lack of energy – and it took her about nine days to start feeling herself again.

All of her friends have recovered and no one was hospitalized, for which they're all thankful. Schneider's takeaway was the virus can manifest in so many ways that it’s hard to pin down.

For her, it felt like a really bad case of the flu. Others didn’t even know they had it.

“I think this virus just has the whole kit and caboodle," she said. "It all varies depending on how bad you get it.” 

Contributing: Andrew Binion, Kitsap Sun, Jennifer Pignolet, Akron Beacon Journal.


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