Some of the more well-known and commons signs of Covid-19 can be just as dangerous.
An inability to take a deep breath: Shortness of breath is not usually an early symptom of Covid-19, but it is the most serious. It can occur on its own, without a cough. If your chest becomes tight or you begin to feel as if you cannot breathe deeply enough to fill your lungs with air, that's a sign to immediately call your doctor or a local urgent care, experts say.
"If the shortness of breath is severe enough, you should call 911," said American Medical Association president Dr. Patrice Harris.
Get medical attention immediately, the CDC says, if you experience a "persistent pain or pressure in the chest," or have "bluish lips or face," a possible sign of a lack of oxygen.
A rising temperature: Fever is a key sign of Covid-19. But don't fixate on a number on the thermometer. Many people have a core body temperature that is above or below the typical 98.6 degrees Fahrenheit (37 degrees Celsius).
CNN anchor Chris Cuomo, who battled the virus in late March and early April from his home in New York, is one of those people.
"I run a little cool. My normal temperature is 97.6, not 98.6. So, even when I'm at 99 that would not be a big deal for most people. But, for me, I'm already warm," Cuomo told CNN Chief Medical Correspondent Dr. Sanjay Gupta in a CNN Town Hall.
Most children and adults, however, will not be considered feverish until their temperature reaches 100 degrees Fahrenheit (37.7 degrees Celsius).
"There are many misconceptions about fever," said Dr. John Williams, chief of the division of pediatric infectious diseases at the University of Pittsburgh Medical Center Children's Hospital of Pittsburgh.
"We all actually go up and down quite a bit during the day as much as half of a degree or a degree," Williams said, adding that for most people "99.0 degrees or 99.5 degrees Fahrenheit is not a fever."
Don't rely on a temperature taken in the morning, Schaffner advised, because temperature varies during the day. Instead, take your temperature in the late afternoon and early evening.
"One of the most common presentations of fever is that your temperature goes up in the late afternoon and early evening. It's a common way that viruses produce fever."
A debilitating cough: Coughing is another common symptom, but it's not just any cough, Schaffner said. The cough is bothersome, one that you feel deep in your chest.
"It's not a tickle in your throat. You're not just clearing your throat. It's not just irritated," Schaffner explained. "It's coming from your breastbone or sternum, and you can tell that your bronchial tubes are inflamed or irritated."
Around 60% of the people infected with Covid-19 experienced a dry, peristent cough, likely from irritated lung tissue, according to studies from China. As the disease worsens, the lungs begin to fill with fluid, which might change the nature of the cough.
A report put out by the World Health Organization in February found over 33% of 55,924 people with laboratory-confirmed cases of Covid-19 coughed up sputum, a thick mucus sometimes called phlegm, from their lungs, which is also characteristic of the common cold or flu.
Chills and body aches: "The beast comes out at night," said Cuomo, referencing the chills, body aches and high fever that visited him on April 1.
'It was like somebody was beating me like a piñata. And I was shivering so much that ... I chipped my tooth. They call them the rigors," he said from his basement, where he was quarantined from the rest of his family until April 20.
"I was hallucinating. My dad was talking to me. I was seeing people from college, people I haven't seen in forever, it was freaky," Cuomo said.
Not everyone will have such a severe reaction, experts say. Some may have no chills or body aches at all. Others may experience milder flu-like chills, fatigue and achy joints and muscles.
Of course that makes it difficult to know if you have the flu or have been exposed to the novel coronavirus. One possible sign that you might have Covid-19 is if your symptoms don't improve after a week or so but actually worsen.
Overwhelming exhaustion: For some people, extreme fatigue can be an early sign of the novel coronavirus. The WHO report found nearly 40% of the nearly 6,000 people with laboratory-confirmed cases experienced fatigue.
Just a few days into his quarantine, Cuomo was already drained by the fevers and body aches the disease brings.
"I'm so lethargic that I can stare outside, and, like, an hour-and-a-half goes by," Cuomo told Gupta on Anderson Cooper 360. "I think I took a 10-minute nap, and it was three and a half hours."
Fatigue may continue long after the virus is gone. Anecdotal reports from people who have recovered from Covid-19 have said exhaustion and lack of energy continue well past the standard recovery period of a few weeks. Some continue to experience fatigue and other symptoms for months. As more cases of lengthy illness appear, these unlucky victims of the virus are now being described as "long-timers."
Diarrhea and nausea: At first science didn't think gastric issues that often come with the flu applied to Covid-19. After all, this is a respiratory disease. But as more research rolled in and the virus was found in stool samples, that opinion quickly changed.
"In a study out of China where they looked at some of the earliest patients, some 200 patients, they found that digestive or stomach GI (gastrointestinal) symptoms were actually there in about half the patients," Gupta said on CNN's "New Day" news program.
Researchers have now found that SARS-CoV-2 can infect cells in the intestine and multiply there. That's likely because, like the lungs, the intestinal lining is loaded with ACE2 receptors, the sweet spot where the spokes of the SARS-CoV-2 virus attach and enter the body's cells.
Sore throat, headache and nasal congestion: The early WHO report also found nearly 14% of the almost 6,000 cases of Covid-19 in China had symptoms of headache and sore throat, while almost 5% had nasal congestion.
Today, science recognizes those very common signs of both the common cold and flu as more frequent in Covid-19 than previously thought. The CDC added both sore throat and headache to its most recent update of common Covid-19 symptoms on the recommendation of the Council of State and Territorial Epidemiologists, who advise the agency.
While cough, shortness of breath or difficulty breathing are key red flags of Covid-19, the council recommended headache and sore throat fall into a second tier of symptoms that may trigger doctors to consider testing for Covid-19.
That tier kicks in when patients present with two of the following clinical signs: Chills or shivers, fever, muscle pain, headache, sore throat or new loss of taste and smell. If there is no other more appropriate diagnosis, the guidelines say doctors should report those patients as potentially infected with Covid-19.
Who is most at risk?
Everyone — every man, woman and child in the world — is equally at risk of being infected with Covid-19. How the disease will then impact you or your loved one depends on many variables, including some that science does not yet understand.
Why do some people — even the elderly — have few or no obvious symptoms? Why do others — despite being young and healthy — quickly collapse, go into a cytokine storm and die? Why do a rare subset of children who have recovered from Covid-19 present weeks later with a deadly toxic shock-like illness called "pediatric multisystem inflammatory syndrome"?
No one yet knows.
Age appears to play a role — most children and young adults appear to weather the virus more successfully, but not all. Older adults appear to be the most fragile, but that's likely due to their weaker immune systems and chronic conditions.
One thing is very clear: The highest risk of severe illness and death is for anyone with an underlying health condition. The list includes diabetes, chronic lung disease or asthma, cardiovascular disease, cancer (or are undergoing chemotherapy), organ transplants, sickle cell anemia, kidney disease with dialysis, poorly controlled HIV infection, any autoimmune disorder or a body mass index (BMI) over 30 (obese).
To put that in context: More than 40% of the American population have a BMI of over 30 and are considered obese, while an estimated 60% of American adults have at least one chronic medical condition, according to the CDC.
"Older patients and individuals who have underlying medical conditions or are immunocompromised should contact their physician early in the course of even mild illness," the CDC advises.
To be clear, you are at higher risk — even if you are young — if you have underlying health issues.
Pregnancy is also a risky time, science has discovered. Early in the pandemic, the CDC didn't think Covid-19 would raise the risk for either expecting mother, fetus or newborn.
But the agency added pregnancy to its list of top risk factors, after a study found pregnant women who get infected are more likely to be hospitalized, admitted to an intensive care unit and put on a ventilator.
"Pregnant women were 50% more likely to be admitted to the intensive care unit and 70% more likely to receive mechanical ventilation," said Dr. Sara Oliver of the CDC's National Center for Immunization and Respiratory Diseases in late June.
How to be evaluated
Think you might have signs of the novel coronavirus? With the explosion of cases this summer across the United States, many hospitals are again bursting at the seams. Unless you are experiencing emergency signs of Covid-19, which include trouble breathing, persistent chest pain or pressure, new confusion, an inability to wake or stay awake or a bluish tinge to lips or face, you should call your health provider first. If you do have any alarming symptoms, call 911.
"If you have insurance and you're looking for a provider or someone to call or connect with, there's always a number on the back of your insurance card; or if you go online, there is information for patients," said the AMA's Harris.
"If you don't have insurance, you can start with the state health department or the local community health centers, those are officially known as federally qualified health centers," Harris advised, adding that some states have a 1-800 hotline number to call.
"If there is a testing and assessment center near you, you can go there directly," said Vanderbilt's Schaffner. "It's always good to notify them that you're coming. Otherwise, you need to call your healthcare provider and they will direct you what to do."
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