Not everyone who has COVID-19 will have a cough. Shandy Dearth, director of the undergraduate epidemiology program at IU-Purdue University Indianapolis Richard M. Fairbanks School of Public Health, said some people only have a fever before their case takes a downturn.
While a fever, cough and fatigue are stronger indicators of COVID-19, other symptoms can either be a sign of the coronavirus or a complication developed after having the virus, IU experts say. Symptoms and complications won’t look the same for everybody.
“That’s one thing that’s scary about this virus is there is no guarantee,” Dearth said. “So everyone can behave a little differently with this.”
Dearth said although people have done a great job of not overwhelming the healthcare system, people should not hesitate to contact or see a healthcare provider if they have immediate concerns.
Red flags for emergency visits include turning blue, chest pains, shortness of breath, becoming less conscious or passing out, while having a fever and respiratory illness, Cole Beeler, medical director of infection prevention at IU Health University Hospital in Indianapolis, said.
Other complications and symptoms include, but are not limited to, pneumonia, loss of taste or smell, muscle aches or chills.
A newer complication of the virus is a rash on the feet, or "COVID toe", which is more common in children, Beeler said. Because kids often get rashes from various sources, Dearth suggests consulting a pediatrician if a kid has any rash combined with a respiratory problem.
It’s unclear if these rashes are caused directly by the virus or by the immune system, but they can show up with varying degrees of severity, Beeler said. Rashes do not automatically mean someone has COVID-19, but they can come from complications of the virus, such as Kawasaki disease, which can also cause a fever, Beeler said. Kawasaki disease is one of the leading causes of heart disease in the U.S., so if a child is diagnosed with it, the child will need to be monitored for any long-lasting effects, Dearth said.
“We’re not guaranteed for the kids to be safe with this either,” Dearth said.
A recent Centers for Disease Control and Prevention alert came out about Multisystem Inflammatory Syndrome, which is more common in children. Dearth said multiple systems or organs in kids’ bodies can have issues.
A more common issue is cytokine release syndrome, which occurs when the immune system overreacts to the virus. It can happen about a week after feeling under the weather and can lead to organ failure and potentially death, Beeler said. It’s also more common in people with coexisting conditions in their heart, lung or immune system or in people who are 65 and up.
Another possible complication, although rare, is pink eye, faculty member at IU's optometry school Christopher Clark said. This is typically more common in hospitalized patients, and it’s more of a response to everything else going on in the body, Clark said.
“One of the things that’s happening right now with COVID patients is they have low oxygen supply. That can affect the eyes. That can affect the toes. It affects peripheral parts of the body first,” Clark said.
Right now, there still isn't a lot of information about long-term complications from the virus, Beeler said. Dearth said it’s important for people to know and be able to report signs of the virus to their doctor to deal with potential long-term consequences after an infection.