Coronavirus: how quickly do COVID-19 symptoms develop and how long do they last?

By now, hopefully everyone knows that the key symptoms of coronavirus includes a fever of about 37.8°C and a new continuous cough. There is however still some confusion about how quickly symptoms develop after exposure to the virus and what you can expect when you become infected.

Definitions of mild, moderate and severe infection tends to vary between countries which makes it impossible to provide 100% accurate predictions of average time to hospital admission, or average time before ICU recovery. The figures in this article are based largely on a report by the World Health Organization of the Chinese experience. Some reflect the experience of other European countries.

Incubation: How long does it take for symptoms to start?

The incubation period of an infection is the time between being exposed to it and developing systems. There are several difficulties with working out the incubation period for coronavirus. Firstly, it is not always possible to know when a person is initially infected, especially if they have received several attacks of the virus.

Also, some countries only test (and confirm) coronavirus in people with severe infection so it’s not known if the incubation period for people with critical/severe/moderate/mild infection is different. It’s also thought that many people are asymptomatic i.e. they do not develop symptoms.

One study has looked at confirmed cases from 50 provinces, regions and countries outside Wuhan, where it was possible to identify a single source of infection.

They found that the median incubation period (half of all cases occur before this time and half after) was 5.1 days and 97.5% of people who develop symptoms will have got them within 11.5 days.

Which symptoms come first?

World Health Organization report based on 56,000 confirmed cases revealed the most common symptoms to be:

Fever (88%).
Dry cough (68%).
Tiredness (38%).
Coughing up sputum (33%).
Shortness of breath (19%).
Aching muscles or joints (15%).
Sore throat (14%).
Headache (14%).
Blocked nose (5%).
Coughing up blood (1%).
Pink/redness of the whites of the eyes (1%).
Up to 1 in 10 people present with diarrhoea and feeling sick 1-2 days before they develop other symptoms.

Other commonly reported symptoms include loss of sense of smell and diarrhoea. There does not appear to be any particular pattern in the order of symptom development. Some people will start with a cough; others will develop fever, with cough arriving only a few days later. Exhaustion and aching all over appear to be common early signs.

How and when do symptoms progress?

If you have a mild version of the disease then your fever is likely to settle within a few days and you are likely to feel much better after one week. 

In people with more severe infection, shortness of breath is likely to become more marked 7-10 days after they develop symptoms.  This occurs because the infection takes hold deep in your lungs, leading to inflammation which prevents efficient transfer of oxygen from your lungs to your bloodstream. Symptoms can develop rapidly (in hours) and worsen in minutes.

At least 4 in 5 people with coronavirus will have mild or moderate disease and will make a full recovery within 2-4 weeks. But even if you are young and healthy – meaning your risk of severe disease is low – it is not non-existent.

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COVID 19: The Facts