Aaron Hartman, MD (YouTube, Jun 24, 2020) summarizes emerging data—largely from a UK symptom-tracking app with >3 million users—about typical and atypical COVID-19 symptoms and their expected durations. Key points: many infections are asymptomatic (estimated 50–80%); most symptomatic people recover within ~2 weeks (some up to a month), but ~10% have prolonged symptoms lasting weeks to months (case report up to 11 weeks). Atypical symptoms (loss of smell/taste, prolonged shortness of breath, delirium, GI symptoms, prolonged headaches, chest pain) are common and often persist but generally resolve over time; loss of smell occurs in ~60% and may indicate active upper-respiratory viral shedding. The speaker also describes simple smell tests (mint, cinnamon, coffee, citrus).
Questions this video answers
Between 50% and 80%.
Approximately 85% will survive.
Over 3 million users.
Most recover and become symptom-free within about two weeks (some within three weeks to a month).
About 10% experience prolonged symptoms; a case report described symptoms lasting up to 11 weeks.
Chapters
You. It's great to be with everybody again. So this video is going to be talking about some new data on COVID 19 symptoms. Over the last several months we've seen a lot of atypical symptoms in my clinic. People with loss of smell, taste, people with shortness of breath lasting several weeks. And there really hasn't been any data to really help us, guide us as far as how long people should be sick. And, and there's some recent data that's coming out of the UK now for those of you who have been following. You all know that the United Kingdom probably is one of the better sources of data for this in the English speaking world. They have one big medical system, they've been tracking this and the source of this data, which I'll be posting mostly on YouTube and probably some other social media places as well, and the links will be attached there. So just either look here or wherever you're looking at this, maybe go over to YouTube. But the United Kingdom has actually done a great job tracking this and they put an app out there that over 3 million people were able to track their symptoms. And so what they did is they actually have a website now that actually kind of gives you information about the symptoms, what to expect, length, etc. And that's where this information comes from. So it's one thing for a lot of physicians to anecdotally see patients, to see how they progress and have their own personal clinical experience. It's another to have a database of over 3 million people give you some information. That's what this is we're going to talk about today. So in the main impetus for this is just people coming back 4, 6, 8, 10 weeks later with some residual symptoms and just not quite knowing where to go with them. So maybe this is normal for some patients. So before I go into this though, I do want to state a few, few major points that I don't, don't want to miss. I don't want to major on the minors. I want to major on the majors. This, this might be a little more about some of the minors. So the first major is that between 50 and 80% of people who get this will have no symptoms. So I want that just to sink in for a second. That data point has not really changed a whole lot. Anywhere between 50 and 80% of people who get exposed to this will not have symptoms. The second major point to think about is 85% of those who are over 80 years of age will survive this. So if you're over 80, 85% of people will survive this. And the last part is that this is the reason that I'm even doing this is if you've gotten sick during this whole time, from December till now, you had a lot of weird symptoms. Cough, shortness of breath, a loss of smell, diarrhea, nausea, maybe even some neurological symptoms, headaches, maybe it was Covid, you know, and that's kind of the point of this, this video. So, so the summary of the data is as follows. First of all, people who, most people who get exposed this, most people will get over this within, within two weeks. If you get symptoms okay, some people within three weeks up to a month. But most people recover with two weeks be symptom free. So that was the first big data point. But about 10% of people actually, actually will prolong and have longer symptoms up to as long as there was a case report that I'll talk about later on 11 weeks. Now you have to realize when I say 11 weeks, you know, roughly three months. That's putting us back to March. So this may change as we go forward. We're still very fairly new in this whole process. Again, 1 in 10 people will be sick for much longer, but most are better about 40 days, the vast majority by two weeks. There will be some people up to 11 weeks of symptoms. So there's major symptoms and typical and atypical symptoms. So the typical symptoms are fatigue, headache, cough, fever, joint pain, sore throat. So all the typical flu, like cold, typical coronavirus, adenovirus kind of stuff, nothing of note. However, the atypical symptoms are the ones I want to talk about and focus on. Loss of smell. Delirium is actually there are some rare cases of strokes, chest pain for more than three weeks, shortness of breath lasting three plus weeks, diarrhea, GI tract symptoms, nausea, prolonged headaches. These are some of the atypical symptoms we're seeing last for quite a long time. And the interesting part about that is the atypical symptoms, if you have them and they linger, you're more likely to. These people are the people that are eventually going to get over this. It's the people who progress to get worse and worse and worse who get hospitalized by day 19 to 21. Those are the ones who do poorly. So if you're at four to six weeks still with atypical symptoms, you're going to recover. It just might take some time. So what else we talked about that the interesting thing about the sense of smell as well, about 60% of people will lose their sense of smell throughout the course of this disease, and it may last for several weeks, be as short as a few days, and may last several weeks. I've seen some patients lose their sense of smell and it's lasted. The longest I've seen is about three and a half weeks so far in my clinic. If you do lose your sense of smell, this coronavirus actually hangs out in the upper respiratory tract more than the lower respiratory tract, which is your typical pneumonia. So if you. Some of the initial British data from back in March was showing that if you did lose your sense of smell, you are most likely infectious with this. So if you lose your sense of smell, you should not be around people. It is a good indicator of being infectious. And there are ways you can test your sense of smell. Some people don't realize that they actually complain of loss of taste. They don't realize they've lost their ability to smell. They may just notice that the food doesn't taste quite as well. The typical scents I will use in my office to test scent smell are mint, cinnamon, coffee and some kind of citrus. Those are things that most people can identify. Cinnamon is actually a really great one as well. There is actually a peanut butter test that is used for diagnosing Alzheimer's disease. Some people can use that. But the point is, like, if you notice these strong smells, your sense of smell is probably, well, intact. So I think that's the big thing, is that we're seeing these atypical symptoms. Go on. Please look at the links if you want more information about some of the nuance of this. But if you've been sick for four to six weeks, residual headaches, some shortness of breath, smell issues, just not feeling quite right, then you may be having these atypical symptoms of COVID And to be honest with you, looking at some of the literature we're looking at suggesting 40, 50% of patients will be in this atypical group. And I've seen a lot of people going back to as far as getting sick in December who were having these atypical symptoms. And something I was looking at this past weekend actually looked at some Italian cases. You know, actually we had the COVID was already in Italy in December and we already talked about before that it was in France in December as well. So most likely it was already here somewhere because that was when I started seeing some of these bizarre cases. So the last case is actually a case report. And again, there'll be a link to this on YouTube and hopefully we can get this on the other social media outlets. Some of the social media outlets, it's really hard to get more than you can only do one link. Any more than that and they kind of, they do weird things to your posts. So for those of you looking for the links, they'll definitely be in YouTube, but other places as well. But this is a case report of someone who started having atypical symptoms. Like a usual. Well, they started like a usual flu. About four weeks into it, while all their family and friends were turning around, they actually getting sicker. They started losing sense of smell, being short of breath, fatigued, some of the shortness of breath was going on and off. One of the key things though was at 11 weeks they were still having bouts of diarrhea on and off. And the interesting thing about this particular case is that with diarrhea, it is one of the places where we know COVID 19 likes to attach where the ACE2 receptor is. It also likes the kidney, the heart, the lungs and the vasculature. So if this person was still having these symptoms, they were probably most likely still infectious to a certain degree, which again is atypical. And at 11 weeks, it took about 11 weeks for their symptoms to resolve. So, you know, this is. I have a feeling that the more and more we learn about this, we're going to learn that these atypical cases are more and more not atypical, but they actually are probably more normal than we expect. So hopefully it was helpful. Main reason for this is just I'm seeing a lot of people not quite sure what's going on with them. They may have had these atypical cases of COVID 19. So please feel free to share with your families and friends. We continue to do posts to update you on things we feel are pertinent and you all take care and be safe.
