Ignored potential Covid symptoms means ‘millions of cases’ go unconfirmed

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Up to one third of all coronavirus cases in the UK may have been missed due to the fact booking a test via the NHS requires the person to have one of the three "classic" symptoms of the virus.

These symptoms are a new, persistent cough, a high temperature/fever or a loss of smell or taste – without showing signs of any of these three side-effects you do not qualify as eligible for a test.

Researchers at King's College London have said said that by extending the list of symptoms to include fatigue, sore throat, headache and diarrhoea would aid in identifying millions of cases that would otherwise have gone undetected and potentially led to a further spread of the virus.

Published in the Journal of Infection, the findings are based on data from 122,000 UK adult users of the Zoe Covid Symptom Study app who all had PCR swab tests.

The lead scientist behind the Zoe Covid app, Professor Tim Spector has expressed how it has been known among medical experts for a while that there were more than just the three main symptoms, he said: "We've known since the beginning that just focusing testing on the classic triad of cough, fever and anosmia misses a significant proportion of positive cases.

"We identified anosmia as a symptom back in May and our work led to the Government adding it to the list; it is now clear that we need to add more.

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"By inviting any users who log any new symptoms to get a test, we confirmed that there are many more symptoms of Covid-19.

"This is especially important with new variants that may cause different symptoms.

"For us, the message for the public is clear: if you're feeling newly unwell, it could be Covid and you should get a test."

Kings College London joined forces with the Coalition for Epidemic Preparedness Innovations to study the data provided by 122,000 Zoe Covid app users – of which 1,202 returned a positive PCR test within the first 7 days of symptoms beginning to show.

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The study identified that exclusively testing people who were only showing signs of the three main symptoms would have identified just 69% of symptomatic cases.

The researchers claimed that by adding fatigue, sore throat, headache and diarrhoea to the list of recognised symptoms could spot 96% of symptomatic cases if tested within the first three days of illness.

Surprisingly, the study also found that 31% of people who contract the disease do not show any of the classic symptoms during the early stages of the virus, when it is at its most infectious.

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Dr Jakob Cramer, head of clinical development at the Coalition for Epidemic Preparedness Innovations, said: "Accurate diagnosis of Covid-19 cases is crucial when assessing the efficacy of Covid-19 vaccine candidates in large-scale studies, especially since the signs and symptoms associated with the disease are extensive and overlap with other common viral infections.

"The findings of this study provide important insights that will help optimise the choice of triggering symptoms for diagnostic work-up in Covid-19 vaccine-efficacy trials.

"We hope the findings of this study will not only aid Cepi's Covid-19 vaccine development partners but also the wider R&D community."

  • NHS
  • Coronavirus

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