Are COVID-19 symptoms still the same? What to know about this winter’s JN.1 wave

Reports of respiratory illnesses have now reached “high” or “very high” levels across at least 16 state or metropolitan health departments, the Centers for Disease Control and Prevention saidas trends to COVID-19 and influenza have accelerated in many parts of the country. And while a rapidly growing new COVID variant called JN.1 estimated to be the driving force behind much of the current winter wave of infections, officials say so far there has been no sign of new or unusual symptoms caused by the virus.

Here’s the latest on what we know about this winter’s wave so far.

Are COVID-19 symptoms still the same?

Experts warn that teasing out subtle changes in symptoms caused by different COVID-19 variants has proven difficult, given the now wide range of antibodies that people have from either vaccinations, previous infections with different variants, or both .

“The types of symptoms and how severe they are usually depend more on a person’s immunity and general health rather than which strain is causing the infection,” CDC said in a December 8 report discussing the JN.1 strain.

New study data from the UK health authorities where COVID-19 and influenza trends is also increasing, suggests that common symptoms reported from this winter’s bout of respiratory infections among all residents surveyed include:

  • Runny nose (31.1%)
  • Cough (22.9%)
  • Headache (20.1%)
  • Weakness or fatigue (19.6%)
  • Muscle pain (15.8%)
  • Sore throat (13.2%)
  • Difficulty sleeping (10.8%)
  • Worry or anxiety (10.5%)

How these symptoms differ depending on whether people specifically test positive for COVID-19 versus other infections is not yet clear, although the UK’s Health Security Agency’s Jonathon Mellor said on Thursday that the more detailed analyzes could come as their sample size grows.

Research from last winter, co-authored by UK health authorities, found that symptoms were similar for COVID-19 and other bacteria that often cause respiratory illnesses in winter.

“Cough, sore throat, sneezing, fatigue and headache were all among the most commonly reported symptoms for each of the three infections, suggesting that distinguishing between SARS-CoV-2, influenza and RSV based on symptoms alone,” they wrote. in a preprint that has not been peer-reviewed, released in October.

It’s also in line with other research from previous waves of COVID-19.

Research through 2022 from the CDC’s Nationwide Household Transmission Survey, released as a May preprint, which has also not yet been peer-reviewed, commonly reported symptoms among household contacts infected with the BA.5 variant were:

  • Any symptom (77%)
  • Cough (63%)
  • Fever (48%)
  • Shortness of breath (22%)
  • Change in taste or smell (20%)

The prevalence of most COVID symptoms was not far from those reported before even the Delta variant emerged in late 2020.

The exception to this is reports of change in taste or smell, which dropped from 42% early in the pandemic. Unlike many other COVID-19 symptoms, researchers around the world have confirmed one sharp drop in reports of loss of taste or smell — a symptom that was much more common when COVID first swept the globe.

Faster incubation time?

Other subtle changes that scientists have traced to the virus are a gradual decrease in the “incubation period,” or the time it takes for people to get sick after being exposed to COVID-19.

Research published by the CDC from authors i Japan and Singapore earlier this year found this time possibly shortened to as little as 2 to 3 days on average.

Long COVID rates and symptoms

Data suggests long COVID rates may have decreased since the beginning of the pandemic. The exact definitions vary, but the CDC generally considers long or “post-COVID” conditions must be symptoms that persist or appear at least four weeks after otherwise recovering from the virus.

“Approximately 1 in 10 adults with prior COVID-19 experienced prolonged COVID-19 at the end of the study period, underscoring the continued importance of COVID-19 prevention actions, including vaccination,” a CDC examination of Census Bureau survey data said in August, noting that its prevalence among people who said they previously caught COVID-19 has not changed since January 2023.

In a separate CDC analysis of the same ongoing study, 4.6% of US adults reported in October that they had limitations in their activities due to long-term symptoms of the virus, down from 5.7% at the same time in 2022.

Another study, published in the medical journal YAMA in May, identified 12 symptoms most commonly associated with prolonged COVID:

  • post-exertional malaise (incapacitating fatigue that gets worse after physical or mental activity)
  • fatigue
  • brain fog
  • dizziness
  • gastrointestinal symptoms
  • heartbeat
  • problems with sexual desire or capacity
  • loss of smell or taste
  • thirst
  • chronic cough
  • chest pain
  • abnormal movements

Other symptoms were reported by a smaller number of patients, with the study noting 37 symptoms that were more common in those who had had a COVID infection at 6 months than in people who had not been infected.

Have the recommendations for COVID-19 testing changed?

Guidance from US authorities regarding testing and treatment remains largely unchanged for this winter.

For most COVID-19 home tests, such as for free rapid antigen kits that every American household can request from the Biden administration this winter, the FDA’s guidance is unchanged since last winter.

If you first get a negative result from the antigen test but have symptoms or think you have been exposed to the virus, the FDA will say you should wipe your nose “again 48 hours after.”

That was the result of studies that the FDA and the National Institutes of Health supported earlier during the pandemic found the probability of false negative results from antigen tests was reduced after repeated tests.

These recommendations only apply to antigen testlike the CDC say “are generally less susceptible” to picking up infections.

Home molecular tests for COVID-19, like the Lucira kit from Pfizer, which was the first in February green light by the FDA to also test for influenza, has provided more accurate results. Among positive COVID-19 samples, 88.3% were correctly seen in studies of the test.

Another method that some have floated to try to improve the accuracy of COVID testing has also been to inoculate inside the throat or mouth, similar to what is done for some tests in many countries overseas. So far, that approach has not been approved by the FDA for use in home tests, partially over security concernsthough the agency now says it is “open” to considering it.

“While there are currently no FDA-approved COVID-19 tests for throat self-collection, the FDA is open to reviewing testing with new sample types,” James McKinney, an FDA spokesman, told CBS News in a statement.

A study published this month from Denmark found combining self-collected nasal and throat swabs increased the sensitivity of tests by 15.5 percentage points.

“As with all devices, the FDA will evaluate them for both safety and effectiveness, including considering any safety concerns regarding self-collection of throat swabs. Self-collection of throat swabs is more complicated than nasal swabs — and if done incorrectly, could potentially cause patient harm,” said McKinney.

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