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Coronavirus update: The symptoms of COVID-19 that can appear before a cough and fever

Coronavirus may begin with neurological problems, a new study has found. Researchers have said headaches, dizziness, strokes, weakness, decreased alertness or other neurological symptoms can appear before the more commonly known symptoms of COVID-19 (also known as SARS-COV-2).


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Neurological symptoms can also include loss of taste and smell, seizures, muscle pain and difficulty concentrating.

The findings, published in the Annals of Neurology, illustrate the virus is far more than a respiratory infection and rather one that poses “a global threat” to the whole nervous system.

Lead study author Igor Koralnik, professor of neurology at Northwestern University Feinberg School of Medicine, said: “It’s important for the general public and physicians to be aware of this, because a SARS-CoV-2 infection may present with neurological symptoms initially, before any fever, cough or respiratory problems occur.”

As part of the study, Koralnik’s team looked at 19 COVID-19 patients hospitalised at Northwestern Medicine to see how often neurological complications appeared.

Koralnik said: “This understanding is key to direct appropriate clinical management and treatment.”

He added the virus can affect the whole nervous system – the brain, spinal cord, nerves and muscles.

COVID-19 can also affect the lungs, kidneys heart and brain.

Also, the reaction of the immune system to the virus can cause inflammation that can damage the brain and nerves.

At this point, little is known about the long-term effects of the virus, but the researchers insured to follow patients with neurological problems to see how they’re affected over time.

Other studies have also found the cognitive effects of the virus.

One study suggested as many as 65 percent of COVID-19 patients experience delirium, vivid hallucinations, disorientation, irritability, and a range of other cognitive changes. 

Other symptoms of coronavirus

The World Health Organization’s (WHO) list of coronavirus symptoms is more extensive than the one listed by the NHS.


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WHO lists the most common symptoms as:

  • Fever
  • Dry cough
  • Tiredness

Les common symptoms include:

  • Aches and pains
  • Sore throat
  • Diarrhoea
  • Conjunctivitis
  • Headache
  • Loss of taste or smell
  • A rash on skin, or discolouration of fingers or toes

Serious symptoms include:

  • Difficulty breathing or shortness of breath
  • Chest pain or pressure
  • Loss of speech or movement

What to do if you think you have symptoms

The NHS advises if you experience a high temperature, a new, continuous cough or a loss or change to your sense of smell or taste, to use the 111 online coronavirus service. 

If your symptoms are mild you must not to leave your home. This is called self-isolation.

The health body adds: “Anyone with symptoms must self-isolate for 7 days from when their symptoms started.

“Anyone you live with (or anyone in your support bubble) who does not have symptoms must self-isolate for 14 days from when the first person started having symptoms.”

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