More than a year into the coronavirus pandemic, experts have unraveled so many mysteries about how to treat the virus and prevent it. But at the same time, SARS-CoV-2 is always changing as new variants emerge. And accordingly, the ways in which the virus affects people seem to be shifting as well.
Here’s a quick rundown of some of the most common COVID-19 symptoms doctors are seeing right now, and how vaccines and variants fit into this picture.
The most common symptoms — such as cough, fever, and loss of taste and smell — are all still pretty much the same.
Since the COVID-19 pandemic began, the most common symptoms of the virus included a cough (often dry), shortness of breath, a fever of 100 degrees or higher, and the sudden loss of taste and smell.
Those, however, are by no means the only frequent symptoms. People also report everything from headaches to diarrhea, all of which are listed on the Centers for Disease Control and Prevention’s rundown of common possible symptoms.
For the most part, that list of the most common symptoms hasn’t really changed. “The symptoms are really the same as before. It’s the headache, cough, fatigue, runny nose, fever — those kind of generalized flu-like symptoms,” said Jonathan Leizman, chief medical officer of Premise Health, a health care company headquartered in Tennessee.
The emergency warning signs of COVID-19 have also stayed pretty much the same. Those include issues like trouble breathing, persistent chest pain or pressure, and new mental confusion.
With the delta variant, some people’s symptoms might look more like a common cold.
The delta variant (B.1.617.2) is circulating widely around the globe and is now the main strain here in the United States; it’s hitting areas with high numbers of unvaccinated Americans particularly hard.
There is some initial evidence that the symptoms associated with delta might be a bit different than those with the original SARS-CoV-2 virus, though experts caution that it remains too early to say definitively.
“The information we’re getting from the U.K. and Europe and some initial surveys here in the United States is that the delta virus infection seems to be more likely to produce symptoms that are more typical of a common cold,” said William Powderly, co-director of the Division of Infectious Diseases at Washington University School of Medicine in St. Louis, which has recently seen a big uptick in COVID-19 cases and hospitalizations. “That’s a sore throat, mild cough and nasal congestion.”
“The symptoms we were seeing earlier on, which were much more like lower respiratory and fever, are less common,” Powderly added. “That isn’t to say they don’t happen. But there does seem to be a shift in the frequency and type of symptoms being reported.”
Experts don’t yet understand why the symptoms might be slightly different. It could be simply that there are now more infections in younger people, Powderly said. At the same time, researchers are exploring how variants classified as “of concern” and “of interest” — including delta but also lambda and others — might be different in terms of their ability to be transmitted or to make people more or less sick.
The newer coronavirus variants could be making people sicker.
While some people infected with the delta variant have symptoms that are in line with a common cold, there is also preliminary evidence suggesting that other people’s symptoms may be “more intensely felt” with delta, Leizman said.
“We have seen that hospitalization rates are seemingly increased in younger populations with the delta variant,” he offered as an example.
But at this point, there’s no scientific consensus on whether the delta variant is likely to make people sicker than the initial strain, simply because it (and other variants) are so new. The best we have at this point are one-off studies, surveys or even just anecdotal information from the field.
“There’s now data coming out of England and Scotland showing that the severity of the disease may be increased, and it may be leading to an increased risk of hospitalization,” said Carlos Malvestutto, an infectious disease specialist at Ohio State University’s Wexner Medical Center.
“People who are not vaccinated are particularly vulnerable because the new variants — and particularly the delta variant — transmits faster and may be causing more severe disease,” Malvestutto added.
Symptoms tend to be mild in those who are fully vaccinated.
While the vast majority of new cases and hospitalizations occur in those who have not been vaccinated against COVID-19 (around 99% of new infections in some parts of the country), so-called “breakthrough cases” do occur among those who’ve received both shots of either of the Pfizer-BioNTech or Moderna vaccines or the Johnson & Johnson single-dose vaccine.
But the symptoms people experience in those instances tend to be relatively mild, according to the data that’s available at this point. About a third of people who got infected after being fully vaccinated were totally asymptomatic, for example. The CDC now only tracks breakthrough cases that result in hospitalization or death, so there’s just not really robust data looking at how many people experience milder symptoms post-vaccine (or no symptoms at all), nor is there clarity about what variant those people may have caught. Still, there have been high-profile breakthrough infections in the news, like the New York Yankees cluster or entertainment reporter Cat Sadler, who recently said she had contracted COVID-19 after vaccination.
Ultimately, however, the goal of vaccination is not only to reduce transmission but to also drastically reduce hospitalizations and deaths — and the vaccines have done just that.
“The vast majority of individuals who are fully vaccinated do not have those severe consequences of disease, which makes us think the symptoms might be more mild in general for individuals who are fully vaccinated,” Leizman said.
Breakthrough cases also remain rare. As of mid-July, the CDC said that more than 157 million people in the United States had been fully vaccinated. There have been about 5,000 patients with COVID-19 vaccine breakthrough infections who were hospitalized or who died — though not all of those cases were directly attributed to COVID-19.
Which is why health experts are adamant that getting vaccinated is the best thing people can do to keep themselves and others safe — and to avoid developing any kind of symptoms at all.
“I’m in a state where we’re seeing a significant uptick in hospitalized patients … and they’re all people who have not been vaccinated, which is really hard and devastating, because these are completely preventable,” Powderly said.
Experts are still learning about COVID-19. The information in this story is what was known or available as of publication, but guidance can change as scientists discover more about the virus. Please check the Centers for Disease Control and Prevention for the most updated recommendations.