Strain says that with the BA.2 subvariant the vascular component meant that a key symptom most people presented with was fatigue, not getting enough sleep, or “non-restorative sleep-basically, they would be waking up and feeling exhausted as if they hadn’t rested, as if they hadn’t slept at all.” 5 Night sweats and insomnia are also symptoms that have cropped up more commonly in the recent BA.5 era. 4 Tim Spector, lead investigator at ZOE, has said that fatigue in the morning, even after a good night’s sleep, and a sore throat could now be considered to be signs of infection. 3ĭata from ZOE indicate that subvariants BA.4 and BA.5 are more likely to cause sore throats and a hoarse voice. When the alpha variant arrived, a small study in Italy reported that it was associated with greater risk of muscle pain, insomnia, brain fog, anxiety, and depression, 2 while data from the ZOE symptom tracker app indicated that runny noses had become more common during the delta wave. He notes that many of these are not specific to covid-19 and could also be a manifestation of other viral illnesses.Īre particular symptoms associated with particular variants? Strain says that we now see mostly upper respiratory symptoms, fever, myalgia, fatigue, sneezing, sore throat, and cough. With vaccination, immunity from prior infection, and the evolution of omicron to cause overall less intense acute infection, the presentation of symptoms has evolved. “Very, very few people get onto that final stage.” “Thankfully, ARDS has almost completely disappeared now that we’ve got vaccination,” he says.
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Strain estimates that at the start of the pandemic infection resulted in vascular damage in around 15-20% of patients-“for some this was simple ‘covid toes,’ but for others it was pulmonary emboli and acute kidney injury”-while a smaller proportion went on to experience a full cytokine storm and acute respiratory distress syndrome (ARDS). Raman adds that, while some people still experience brain fog, on a population scale this seems slightly less prevalent with newer variants and vaccines. BA.1 for many people was little more than a severe head cold.” “Omicron subvariants BA.1 and BA.2 seemed to migrate from lungs and nervous tissue to the upper airways. “That really happened at the time of omicron,” he says. Strain says that the loss of sense of smell and taste is nowhere near as prevalent as it used to be.
This has led to falling hospital admissions and changes in the frequency of each symptom. 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. Quite a significant proportion were admitted to hospital with the earlier variants.” “That became the standard that we expected,” he says.īetty 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. 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. In the short space of a few years we’ve seen surprising changes in the way covid-19 presents. How have covid symptoms changed since the start of the pandemic?
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