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In the pre-pandemic era, a cough, body aches and overwhelming fatigue were a fairly clear sign of a bad cold or the flu. But given the rise in COVID-19 cases across the United States, you’re probably more concerned about the coronavirus if these symptoms start to appear, especially because COVID-19 has a higher death rate than the typical flu.
Everything we know about respiratory disease has certainly evolved throughout 2020, especially its symptoms. When the pandemic first struck, doctors put the country on high alert for three major red flags: fever, dry cough or shortness of breath.
The Centers for Disease Control and Prevention (CDC) now has a list of 11 official symptoms of COVID-19, which still do not include all possible signs of illness. But some symptoms seem to be more common than others, including a high fever, which prompts you to see a doctor over the phone.
But what if you feel sick in some other way and you born have a fever? Here’s everything doctors want you to keep in mind.
Backup: Why does COVID-19 cause fever, anyway?
On a very basic level, having a fever means your body temperature is higher than normal. However, a fever is different from a high temperature. The CDC and the medical community at large consider a temperature of at least 100.4 degrees Fahrenheit to be a real fever.
“A fever is the body’s natural response to infection, including COVID-19,” says infectious disease expert Amesh A. Adalja, MD, principal investigator at the Johns Hopkins Center for Health Security.
Here’s how it works: Your body temperature rises because your immune system tries to kill an unwanted pathogen, often a virus or bacteria, according to the United States National Library of Medicine. At your normal temperature, these pathogenic invaders can easily reproduce, but when things heat up, it becomes harder for them to survive.
Can you have COVID-19 without a fever?
It’s entirely possible. “Fever is one of the most common symptoms of COVID-19, but many people never have it,” says Richard Watkins, MD, infectious disease specialist and professor of internal medicine at Northeast Ohio Medical University.
Dr Adalja agrees. “Fever is part of a constellation of symptoms and it may or may not be present in an individual,” he says. “You can be symptomatic and not have a fever.”
A fever can also go up and down when you have COVID-19 (which is true with any illness), and it’s possible that someone infected with the virus will technically have a fever at some point without even having s ‘Report it, says Dr Adalja.
On the other hand, some people with COVID-19 have no symptoms at all, while others show unusual signs of the virus, including only gastrointestinal symptoms like diarrhea and vomiting. “Everyone’s immune system is different,” says Dr Adalja. In short, the virus can present itself in several ways, but these are the most common signs to be aware of:
- Fever or chills
- Cough
- Shortness of breath or difficulty in breathing
- Tired
- Muscle or body pain
- Headache
- New loss of taste or smell
- Sore throat
- Stuffy or runny nose
- Nausea or vomiting
- Diarrhea
Rarer symptoms, such as rashes and pink eyes, have also been linked to COVID-19.
What should you do if you have symptoms of COVID-19 without a fever?
“A lot of people with COVID-19 have a fever, but it’s not something that is foolproof,” says Dr Adalja. “It shouldn’t be used as the sole arbiter as to whether you have COVID-19 or not.”
If you have unusual symptoms but no fever, he still recommends quarantining yourself (isolating yourself at home) and calling your doctor for next steps. They will be able to guide you on tests, isolation guidelines, and the best treatment options for your personal situation. It is possible that you have a cold or the flu, but with an increase in cases it is best to be safe until you get more information from your doctor.
Many people diagnosed with COVID-19 will have mild illness and eventually feel better at home with plenty of rest, fluids, and over-the-counter pain relievers or cough medicine. If you have any of the following symptoms (or all severe symptoms that concern you), go to hospital immediately:
- Difficulty in breathing
- Persistent pain or pressure in the chest
- New confusion
- Inability to wake up or stay awake
- Bluish lips or face
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