Covid 19 coronavirus: Unexpected symptoms in some patients

People with Covid-19 are developing lesser-known symptoms than the more recognisable red flags of a cough, fever and sore throat, Australian doctors say.

Hospital rooms are increasingly seeing virus-infected patients presenting with unexpected symptoms such as headache and even conjunctivitis.

And the danger is that because people don't associate conjunctivitis or a headache alone to Covid-19, they're unlikely to be tested.

"Although fever, cough and shortness of breath may be the most common symptoms, if 10 per cent or 15 per cent of patients present with Covid – and we have several thousand cases in Melbourne – there will be presentations with headache and with conjunctivitis," Dr Carmel Crock, the head of emergency at the Victorian Eye and Ear Hospital, told the ABC's 7.30.

The programme reported the hospital's emergency department recently treated two patients with ear-ache and headaches who gave them a "nasty surprise" when they later tested positive for Covid-19.

One person was routinely tested for Covid 19 coronavirus before an operation and was found to be positive. Photo / Tania Whyte, file

"They were seen by our ear, nose and throat doctor, who ruled out an ear cause of the pain and they were then referred to see the eye doctor as well, who tried to rule out eye causes for the headache," Crocks said.

"One of the patients had a preoperative Covid test, which was positive. Then we saw another case about 48 hours later and again that patient, we actually referred for Covid testing and that Covid testing was positive."

ABC medical expert Dr Norman Swan said the danger of the scenario was because the patients didn't meet the testing criteria for Covid-19, "at least one of these patients hung around the emergency department for some time, rather than being isolated".

The eye infection conjunctivitis was also emerging as a more surprising symptom experienced by people with Covid-19.

The World Health Organisation has added it to its list of less common symptoms, along with headache, aches and pains, diarrhoea and skin rash, among others.

"In the international literature, Covid can present with conjunctivitis," Crocks said.

"We have been really particular with our PPE around patients with conjunctivitis in case that's the first presentation of Covid."

Reliance on respiratory symptoms before testing for Covid-19 may be failing to pick up positive cases. Photo / George Novak, file

Victoria's Department of Health and Human Services identifies fever, chills or sweats, cough, sore throat, shortness of breath, runny nose and loss of sense of smell or taste as key Covid-19 symptoms which may prompt testing.

NSW Health also notes the possibility of muscle and joint pain, headache and fatigue.

Swan said relying mainly on respiratory symptoms as possible signals of Covid-19 was "probably a mistake".

He said experiences varied but a recent study found symptoms typically appeared in the following order: fever, cough, sore throat, muscle aches and headaches, and then sometimes nausea, vomiting and diarrhoea. Loss of smell and taste, red eyes and rashes may also develop.

The study by researchers from the University of South California was based on symptoms of more than 55,000 confirmed Covid-19 cases.

'Wouldn't even know she had Covid'

Parents have shared their concerns about the troubling impact of Covid on their children and worries about future implications.

Medical experts have accepted for some time children experience milder Covid-19 symptoms compared to adults but doctors are now seeing that many children have no symptoms, Dr Shidan Tosif, a paediatrician at the Royal Children's Hospital in Melbourne, told 7.30.

"What we're also seeing is that many children are asymptomatic as well," Tosif said.

"What we're seeing is that children who are asymptomatic have lower viral loads, which fits with them being less likely to transmit the virus as well."

Melbourne mum Jessica Foggie told the programme she and her husband caught Covid-19 earlier this month, along with her 4-year-old daughter.

But while Foggie and her husband were bedridden with a nasty dose of the virus, their daughter showed no sign of being ill.

"We were religiously checking temps every day," she said. "No temperature, not even a cough or a sniffle. She's been running around, her usual self.

"She's been asymptomatic the whole time — you wouldn't even know she had Covid if I didn't tell you."

But in some cases, children who do show obvious signs of the virus are suffering from symptoms much later.

New Jersey mum Jennifer Culligan told 7.30 she became sick with Covid-19 along with her two daughters, aged 7 and 3, in early March.

While the girls appeared to recover in about a week, one of her daughters still suffers recurring nosebleeds and nasal congestion, about five months after she was initially diagnosed.

Culligan said she was deeply worried about any lasting psychological and physical impacts on her children, especially as her older daughter prepares to return to school.

"It definitely caused major anxiety for myself," she said. "I think a bit for her sister as well, they share a room. And you're hearing her coughing throughout the night.

"Do [the girls] have antibodies? I haven't had them tested yet. I have them but apparently they only last for so long. Do I want to go through all this again because what if we can get it again?"

Foggie said she was also concerned about any long-term impact of the virus on her daughter.

"As we're learning more about Covid and people are discovering more about how it affects us long term, my main hope is that there's no lasting impacts for her.

"I understand she's had no symptoms now but we don't really know how it works inside the bodies."