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University of Nebraska Medical Center

What Is the Order of COVID Symptoms This Fall?

Very Well Health

COVID-19 infections are expected to rise again now that fall is here and winter won’t be far behind. New variants like Eris (EG.5) and Omicron BA.2.86 are making the rounds, and many people are wondering if they’ll cause worse illness or different symptoms, and which symptoms they might experience first.

Experts say that COVID symptoms have pretty much stayed the same, though the ones you get and the order in which you get them can vary. Here’s what to expect.

According to experts, COVID symptoms have actually been shockingly consistent from variant to variant.

Renuga Vivekanandan, MD, an infectious disease expert and the assistant dean of strategy and accreditation at Creighton University’s School of Medicine, told Verywell that COVID symptoms for this fall do not appear to have changed much from what they were last year and include:

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10 comments

  1. THERESA SASSER says:

    I have all the above symptoms. Been going since Wed 10/24/23. Was some better Saturday,went & walked to the mailbox got short of breath. Had to go inside & laid down the couch. Then abt 2hrs later all the other symptoms came back.

    1. James Lawler says:

      Hi Theresa, I really hope you got yourself tested for COVID-19. And flu and RSV for that matter. Early treatment makes a big difference in preventing severe disease.

      James Lawler, MD, MPH, FIDSA
      Global Center for Health Security
      University of Nebraska Medical Center

      1. Carrie Sheibal says:

        Dr. Lawler, you mentioned early treatment. I thought there is no treatment for Covid because it is a virus? Is there a treatment? And I don’t mean preventative.

        1. James Lawler says:

          Hi Carrie,
          The idea that we have no treatments for viruses is a myth. There are excellent antiviral treatments for many viruses, such as HIV and hepatitis C. We also have excellent treatments for SARS-CoV-2, the virus that causes COVID-19. As with many infections, early treatment is the key to success – that is why testing when you have symptoms is so important. The most effective treatment for early COVID-19 (when you are well enough to be treated outside the hospital) is the antiviral drug Paxlovid (nirmatrelvir/ritonavir). This drug is taken by mouth twice daily, and studies show it reduces the chances of ending up in the hospital by almost 90% in high-risk individuals. It also appears to reduce the risk of long COVID and adverse post-COVID health conditions. Paxlovid can have problematic interactions with other medications, and while most can be managed by dose adjustment with help from a physician or pharmacist, a very small percentage of people are unable to take Paxlovid. In this case, the best alternative is the antiviral drug remdesivir. It is almost as effective as Paxlovid in clinical trials, but it requires daily intravenous infusion for 5 days, which has to be done in a doctor’s office or infusion center. A third alternative is the oral drug molnupiravir, but it appears to be less effective in preventing severe COVID than either Paxlovid or remdesivir, so I recommend this drug only as a last resort.

          James Lawler, MD, MPH, FIDSA
          Global Center for Health Security
          University of Nebraska Medical Center

    2. James Seery says:

      Isn’t it true that Doctors are finding it increasingly difficult to distinguish Covid from allergies or the common cold… congestion, sometimes sneezing, usually a mild sore thr
      oat,”

      1. James Lawler says:

        Hi James,
        Infection with the SARS-CoV-2 virus can present with a wide spectrum of illness, from mild symptoms similar to a common cold or allergies to full-blown pneumonia. Some people may have no noticeable symptoms at all. Some people have predominantly non-respiratory symptoms such as diarrhea. We probably miss the diagnosis in many of these latter patients. Most patients who develop severe COVID lung disease start with a few days of cold or flu-like symptoms. Therefore, it is very important to test for COVID immediately when someone develops symptoms, so we can treat infection early and avert severe disease and hospitalization. A molecular (PCR or NAAT) test for COVID is the only way to diagnose or rule-out COVID with confidence. A rapid antigen test is only useful if positive in a person with symptoms. In any other circumstance, the result of an antigen test Is uninterpretable.

        James Lawler, MD, MPH, FIDSA
        Global Center for Health Security
        University of Nebraska Medical Center

  2. Cheryl Slocum says:

    I just tested positive for Covid yesterday. Is there a place I’m supposed to report it? Or is this it?
    Or maybe the Urgent Care facility will report it.

    1. James Lawler says:

      Hi Cheryl,
      Sadly, most public health authorities have no way of capturing + COVID antigen tests. This is one reason why our current official case counts so dramatically under-represent true rates of COVID-19 in the community.

      James Lawler, MD, MPH, FIDSA
      Global Center for Health Security
      University of Nebraska Medical Center

  3. Judie O’Guin says:

    I started feeling bad October 9th; dx with COVID October 12th. In the beginning it was just icky feeling running 101 temp., nauseous, diarrhea then about 2 days later I got a headache worse than my migraines and that would not quit, shortness of breath, plaxovid left a god awful taste in my mouth weak etc. every time I think I’m ( always a low grade temp 99-100.8 getting better. Today my my temp is 101.2 I start and it feels like the first week. I’ve had tge boosters, this is my 3rd time and the worst time

    1. James Lawler says:

      Hi Judy, some people can have long courses of acute COVID infection, even with Paxlovid treatment. Although the evidence is clear that Paxlovid dramatically reduces the odds of severe infection. With recurrent fever and worsening symptoms, it is important to rule out secondary bacterial pneumonia or another infection (such as flu). If you are feeling worse after initial improvement, you should consult your doctor. And yes, Paxlovid often gives people an awful taste in the mouth. Some people report that hard candies help. But it is a small price to pay to stay out of the hospital and reduce your odds of long COVID.

      James Lawler, MD, MPH, FIDSA
      Global Center for Health Security
      University of Nebraska Medical Center

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