Friday, 23 October 2020

What are the symptoms of COVID-19?

Some people infected with the virus have no symptoms. When the virus does cause symptoms, common ones include fever, body ache, dry cough, fatigue, chills, headache, sore throat, loss of appetite, and loss of smell. In some people, COVID-19 causes more severe symptoms like high fever, severe cough, and shortness of breath, which often indicates pneumonia.

People with COVID-19 are also experiencing neurological symptoms, gastrointestinal (GI) symptoms, or both. These may occur with or without respiratory symptoms.

For example, COVID-19 affects brain function in some people. Specific neurological symptoms seen in people with COVID-19 include loss of smell, inability to taste, muscle weakness, tingling or numbness in the hands and feet, dizziness, confusion, delirium, seizures, and stroke.

In addition, some people have gastrointestinal (GI) symptoms, such as loss of appetite, nausea, vomiting, diarrhea, and abdominal pain or discomfort associated with COVID-19.

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These symptoms might start before other symptoms such as fever, body ache, and cough.

The virus that causes COVID-19 has also been detected in stool, which reinforces the importance of handwashing after every visit to the bathroom and regularly disinfecting bathroom fixtures.

What should you do if you think you may have a COVID-19 infection?

First, call your doctor.

If you do not have a doctor and you are concerned that you may have COVID-19, contact your local Ebais if you pay to the Caja or local private clinic. They can direct you to the best place for evaluation and treatment in your area.

It’s best to not seek medical care in an emergency room unless you have symptoms of severe illness. Severe symptoms include high or very low body temperature, shortness of breath, confusion, or feeling you might pass out.

How do you know if you have COVID-19 or the regular flu?

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COVID-19 often causes symptoms similar to those a person with a bad cold or the flu would experience. And like the flu, the symptoms can progress and become life-threatening. Your doctor is more likely to suspect coronavirus if:

  • you have respiratory symptoms and you have been exposed to someone suspected of having COVID-19, or
  • there has been a community spread of the virus that causes COVID-19 in your area.

How is someone tested for COVID-19?

A specialized diagnostic test must be done to confirm that a person has an active coronavirus infection. Most often a clinician takes a swab of your nose (or both your nose and throat). Some tests may be done using a saliva sample. The sample is then checked for the virus’s genetic material (PCR test) or for specific viral proteins (antigen test).

Antibody tests can tell if someone has been infected with COVID-19. But the infected person doesn’t begin producing antibodies immediately. It can take as long as three weeks for a blood antibody test to turn positive. That’s why it is not useful as a diagnostic test for someone with new symptoms.

Your health may never be the same after Covid-19

What is the difference between a PCR test and an antigen test for COVID-19?

PCR tests and antigen tests are both diagnostic tests, which means that they can be used to determine whether you currently have an active coronavirus infection. However, there are important differences between these two types of tests.

PCR tests detect the presence of the virus’s genetic material using a technique called reverse transcriptase polymerase chain reaction, or RT-PCR.

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For this test, a sample may be collected through a nasal or throat swab, or a saliva sample may be used. The sample is typically sent to a laboratory where coronavirus RNA (if present) is extracted from the sample and converted into DNA. The DNA is then amplified, meaning that many of copies of the viral DNA are made, in order to produce a measurable result. The accuracy of any diagnostic test depends on many factors, including whether the sample was collected properly, when during the course of illness the testing was done, and whether the sample was maintained in appropriate conditions while it was shipped to the laboratory. Generally speaking, PCR tests are highly accurate. However, it can take days to over a week to get the results of a PCR test.

Antigen tests detect specific proteins on the surface of the coronavirus. They are sometimes referred to as rapid diagnostic tests because it can take less than an hour to get the test results. Positive antigen test results are highly specific, meaning that if you test positive you are very likely to be infected. However, there is a higher chance of false negatives with antigen tests, which means that a negative result cannot definitively rule out an active infection. If you have a negative result on an antigen test, your doctor may order a PCR test to confirm the result.

It may be helpful to think of a COVID antigen test as you would think of a rapid strep test or a rapid flu test. A positive result for any of these tests is likely to be accurate, and allows diagnosis and treatment to begin quickly, while a negative result often results in further testing to confirm or overturn the initial result.

What are the differences between the nasal swab and saliva tests for COVID-19?

Samples for COVID-19 tests may be collected through a long swab that is inserted into the nose and sometimes down to the throat, or from a saliva sample.

The saliva test is easier to perform — spitting into a cup versus submitting to a swab — and more comfortable. Because a person can independently spit into a cup, the saliva test does not require interaction with a healthcare worker. This cuts down on the need for masks, gowns, gloves, and other protective equipment, which has been in short supply.

Either saliva or swab samples may be used for PCR tests, which detect genetic material from the coronavirus. Swab samples can also be used for antigen tests, which detect specific proteins on the surface of the coronavirus.
How reliable is the test for COVID-19?

Two types of diagnostic tests are currently available in the US. PCR tests detect viral RNA. Antigen tests, also called rapid diagnostic tests, detect specific proteins on the surface of the coronavirus. Antigen test results may come back in as little as 15 to 45 minutes; you may wait several days or longer for PCR test results.

The accuracy of any diagnostic test depends on many factors, including whether the sample was collected properly. For PCR tests, which are typically analyzed in a laboratory, test results may be affected by the conditions in which the test was shipped to the laboratory.

Results may also be affected by the timing of the test. For example, if you are tested on the day you were infected, your test result is almost guaranteed to come back negative, because there are not yet enough viral particles in your nose or saliva to detect. The chance of getting a false negative test result decreases if you are tested a few days after you were infected, or a few days after you develop symptoms.

Generally speaking, if a test result comes back positive, it is almost certain that the person is infected.

A negative test result is less definite. There is a higher chance of false negatives with antigen tests. If you have a negative result on an antigen test, your doctor may order a PCR test to confirm the result.

If you experience COVID-like symptoms and get a negative PCR test result, there is no reason to repeat the test unless your symptoms get worse. If your symptoms do worsen, call your doctor or local or state healthcare department for guidance on further testing. You should also self-isolate at home. Wear a mask when interacting with members of your household. And practice physical distancing.

What is serologic (antibody) testing for COVID-19? What can it be used for?

A serologic test is a blood test that looks for antibodies created by your immune system. There are many reasons you might make antibodies, the most important of which is to help fight infections. The serologic test for COVID-19 specifically looks for antibodies against the COVID-19 virus.

Your body takes at least five to 10 days after you have acquired the infection to develop antibodies to this virus. For this reason, serologic tests are not sensitive enough to accurately diagnose an active COVID-19 infection, even in people with symptoms.

However, serologic tests can help identify anyone who has recovered from coronavirus. This may include people who were not initially identified as having COVID-19 because they had no symptoms, had mild symptoms, chose not to get tested, had a false-negative test, or could not get tested for any reason. Serologic tests will provide a more accurate picture of how many people have been infected with, and recovered from, coronavirus, as well as the true fatality rate.

Serologic tests may also provide information about whether people become immune to coronavirus once they’ve recovered and, if so, how long that immunity lasts. In time, these tests may be used to determine who can safely go back out into the community.

Scientists can also study coronavirus antibodies to learn which parts of the coronavirus the immune system responds to, in turn giving them clues about which part of the virus to target in vaccines they are developing.

Serological tests are starting to become available and are being developed by many private companies worldwide. However, the accuracy of these tests needs to be validated before widespread use in the US.

Is a person who has been infected with coronavirus protected from becoming infected again?

Most people who are infected with the COVID-19 virus produce antibodies, which are proteins that make it harder for the virus to infect cells. But antibodies are only one part of the body’s immune response. T cells, for example, can destroy cells that are already infected. And memory B cells can quickly generate a strong antibody response to a virus the body has encountered before.

Antibody levels typically fall once the immediate threat of infection declines. Several new studies have found that COVID-19 antibody levels decline, but then stabilize and remain in the blood even two to three months after infection. Other recent studies found COVID-specific B cells and T cells in the blood, months after people recovered. This all suggests that the immune system would be ready to react quickly and strongly if re-exposed to the COVID-19 virus.

The laboratory evidence is promising. But the real evidence will come as more and more people who have recovered (rather than cells in a lab) are re-exposed to the virus.

Researchers in Hong Kong recently reported the first confirmed case of reinfection with the COVID-19 virus. The man was first infected in March, then declared to be recovered after two negative coronavirus tests. Four and a half months later, he tested positive for coronavirus on a saliva screening test administered at the Hong Kong airport upon his return from a trip to Europe. Scientists sequenced viral genetic material from the man’s two infections and found significant enough differences to suggest two separate infections.

The man had experienced mild symptoms during his first infection and had no symptoms the second time he was infected. It’s possible that while his immune system could not protect him against reinfection, it did help keep him from getting sicker during the second infection.

It’s far too early to make any generalizations. We cannot know from one case of reinfection (among tens of millions of people who have been infected) how strong an average immune response will be, or how long that immune response will last.

It’s also worth noting that someone who has been re-infected — even someone with no symptoms — has the potential to spread the virus to others. That means that everyone, even those who have recovered from coronavirus infection, should continue to wear masks and practice physical distancing.

How soon after I’m infected with the new coronavirus will I start to be contagious?

The time from exposure to symptom onset (known as the incubation period) is thought to be three to 14 days, though symptoms typically appear within four or five days after exposure.

We know that a person with COVID-19 may be contagious 48 to 72 hours before starting to experience symptoms. Emerging research suggests that people may actually be most likely to spread the virus to others during the 48 hours before they start to experience symptoms.

If true, this strengthens the case for face masks, physical distancing, and contact tracing, all of which can help reduce the risk that someone who is infected but not yet experiencing symptoms may unknowingly infect others.

If I get sick with COVID-19, how long until I will feel better?

It depends on how sick you get. Most people with mild cases appear to recover within one to two weeks. However, recent surveys conducted by the CDC found that recovery may take longer than previously thought, even for adults with milder cases who do not require hospitalization.

The CDC survey found that one-third of these adults had not returned to normal health within two to three weeks of testing positive for COVID-19. Among younger adults (ages 18 to 34) who did not require hospitalization and who did not have any underlying health conditions, nearly one in five had not returned to normal health within two to three weeks after testing positive for COVID-19. With severe cases, recovery can take six weeks or more.

Some people may experience longer-term physical, cognitive, and psychological problems. Their symptoms may alternately improve and worsen over time, and can include a variety of difficulties, from fatigue and trouble concentrating to anxiety, muscle weakness, and continuing shortness of breath.

How long after I start to feel better will be it be safe for me to go back out in public again?

The most recent CDC guidance states that someone who has had COVID-19 can discontinue isolation once they have met the following criteria:

  • It has been more than 10 days since your symptoms began.
  • You have been fever-free for more than 24 hours without the use of fever-reducing medications.
  • Other symptoms have improved.

Anyone who tested positive for COVID-19 but never experienced symptoms may discontinue isolation 10 days after they first tested positive for COVID-19.

Even after discontinuing isolation, you should still take all precautions when you go out in public, including wearing a mask, minimizing touching surfaces, and keeping at least six feet of distance away from other people.

Can people infect pets with the COVID-19 virus?

The virus that causes COVID-19 does appear to spread from people to pets, according to the FDA. Research has found that cats and ferrets are more likely to become infected than dogs.

If you have a pet, do the following to reduce their risk of infection:

  • Avoid letting pets interact with people or animals that do not live in your household.
  • Keep cats indoors when possible to prevent them from interacting with other animals or people.
  • Walk dogs on a leash maintaining at least six feet from other people and animals.
  • Avoid dog parks or public places where a large number of people and dogs gather.

If you become sick with COVID-19, restrict contact with your pets, just like you would around other people. This means you should forgo petting, snuggling, being kissed or licked, and sharing food or bedding with your pet until you are feeling better. When possible, have another member of your household care for your pets while you are sick. If you must care for your pet while you are sick, wash your hands before and after you interact with your pets and wear a face mask.

At present, it is considered unlikely that pets can spread the COVID-19 virus to humans. However, pets can spread other infections that cause illness, including E. coli and Salmonella, so wash your hands thoroughly with soap and water after interacting with your animal companions.

From Harvard Health Publishing,

Q Costa Rica
Q Costa Rica
Reports by QCR staff

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