As the COVID-19 pandemic treads into its third winter, Chicago health experts noted on Tuesday that newer variants can bring changes in symptoms and mutations are possible heading into the coming months.
Still, the latest BA.5 variant remaining the top driver of cases in the United States, but as new omicron-specific booster shots become readily available, health officials are watching for the next variant to emerge.
While upper respiratory symptoms remain the most tell-tale sign of the virus, some changes in symptoms have been observed as the virus has evolved.
"We see a lot of things happening with the virus changing, you know," said Dr. Isaac Ghinai, a medical director for the Chicago Department of Public Health who oversees COVID-19 testing and laboratory surveillance. "Omicron and its sub-lineages are an example of the virus changing a bit, and there are indications that different lineages of the virus can cause slightly different symptoms."
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Ghinai said that differences in symptoms may also be impacted by the introduction of vaccines and their subsequent widespread utilization nearly one year into the pandemic.
"There are some indications for example, with omicron that the loss of taste and smell is less common than it was with some of the earlier lineages. All of this is also impacted probably by the fact that many more people are vaccinated than they were before," Ghinai said.
Regardless of the changes in symptoms, Ghinai said getting vaccinated and boosted can significantly improve symptoms of the virus if infected.
"Certainly, the severity of symptoms if you're vaccinated is much less and the severity of symptoms if you're boosted is even less, so that can kind of change how it looks," Ghinai said.
As for the symptoms that often stick around the longest? A cough.
"That's the thing that's going to last the longest, almost always," Chicago's top doctor Allison Arwady said at a press conference earlier this month. "A cough tends to be the most lingering effect. That's true whenever you have any viral infection. You can be feeling totally better, and you're still going to have some irritation."
According to Johns Hopkins Medicine, early symptoms of COVID typically include fatigue, headache, sore throat or a fever.
A study by researchers at the University of Southern California found fever may be first, as well as a cough and muscle pain. Then, those infected will likely experience nausea, vomiting or diarrhea. Unlike other respiratory illnesses such as MERS and SARS, COVID patients will likely develop nausea and vomiting before diarrhea, the researchers found.
Digestive symptoms, in some instances, may be the first sign someone has contracted COVID. They have been known to develop at the beginning of an infection, with respiratory symptoms possibly following a day later, according to an article from Emerson Health.
Still, some symptoms, such as shortness of breath, have become less prevalent as the virus continues to mutate. Dr. Sharon Welbel, the director of Hosptial Epidemiology and Infection Control for Cook County Health said earlier this month that fevers and coughs have become more common symptoms in recent months.
"In terms of symptoms and what people have it's been so incredibly heterogeneous," Welbel said. "I find with omicron we do know that still the most common is fever, cough - not so much shortness of breath anymore."
Experts do caution patients that the severity, or even the type, of initial symptoms can vary widely from person to person. "I think it's really variable depending from person to person," Welbel said. "It depends on age, it depends on comorbid illness, it depends on vaccine status, if one has been infected before potentially their you know, immune system is revved up more... So, I think that there's no way to protect it to predict it."
The CDC says that the median time for the appearance of symptoms in a patient with the different lineages of omicron could be just three days.
In general, symptoms will typically appear 2-to-14 days after exposure to the virus, according to the CDC. How long they last, however, can depend on the person, the severity of their infection and whether or not they end up with long COVID.
"Some people say they feel better in a day, some people say they still have lingering symptoms after three weeks," Welbel said.
Symptoms of the virus include:
-Fever or chills
-Shortness of breath
-Muscle or body aches
-New loss of taste or smell
-Congestion or runny nose
-Nausea or vomiting
Patients are urged to seek emergency medical attention if they experience:
-Persistent chest pain or pressure
-Inability to wake or stay awake
-Pale, gray, or blue-colored skin, lips, or nail beds