With new variants and a changing landscape of vaccination and immunity, what do the symptoms of covid-19—and our understanding of them—now look like? Mun-Keat Looi reports
In the short space of a few years we’ve seen surprising changes in the way covid-19 presents. At the start of the pandemic the first commonly reported symptoms were loss of smell and taste, followed by shortness of breath and a cough, followed by vascular injuries, says David Strain, senior clinical lecturer at the University of Exeter Medical School. “That became the standard that we expected,” he says.
Betty Raman, senior clinical research fellow in the Radcliffe Department of Medicine, University of Oxford, says, “People presenting with the earlier variants would have quite severe cardiorespiratory or mostly respiratory symptoms in the acute phase with other symptoms too, like brain fog. Quite a significant proportion were admitted to hospital with the earlier variants.”
Since then there’s been an evolution of symptom clusters and manifestations across the variants, she says, affected by the evolution of the virus itself but also by vaccines, the vaccine landscape, the use of other treatments, and people getting recurrent infections. This has led to falling hospital admissions and changes in the frequency of each symptom.
Strain says that the loss of sense of smell and taste is nowhere near as prevalent as it used to be. “That really happened at the time of omicron,” he says. “Omicron subvariants BA.1 and BA.2 seemed to migrate from [infecting mainly] lungs and nervous tissue to the upper airways. BA.1 for many people was little more than a severe head cold.”
Raman adds that, while some people still experience brain fog, on a population scale this seems slightly less prevalent with newer variants and vaccines.
Strain estimates that at the start of the pandemic infection …