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Official list of Covid symptoms is 'dodgy and inadequate': Top scientific adviser calls for list to be expanded to include tiredness, breathlessness and loss of appetite

The official list of COVID symptoms has been branded 'dodgy' and 'inadequate' by a top scientific advisor. Dr Nick Summe...

The official list of COVID symptoms has been branded 'dodgy' and 'inadequate' by a top scientific advisor.
Dr Nick Summerton called for tiredness, breathlessness and loss of appetite to be included in key symptom list.
Currently the NHS only notes a persistent cough and fever as the main signs, and says these are the only symptoms to warrant calling 111.
But the World Health Organization lists 13 symptoms, and the CDC bumped its up to nine last week.
Both acknowledge muscle pain, loss of taste and smell and headaches as typical signs of SARS-CoV-2 infection. 
By leaving out symptoms, Dr Summerton said the virus could fuel further spread of the virus in Britain.
There are now more than 180,000 cases in the UK - but there are potentially millions that have gone unnoticed. Deaths are nearing 29,000. 
Currently the NHS only notes a persistent cough and fever as the main signs, and says these are the only symptoms to warrant calling 111
Currently the NHS only notes a persistent cough and fever as the main signs, and says these are the only symptoms to warrant calling 111
Dr Summerton, leading primary care diagnostics expert with a doctorate from Oxford University, has acted as an adviser to the Government during the pandemic.
He said he has urgently called for urgent research to be conducted to detect the most common symptoms of the virus.
'These two basic symptoms aren't good enough,' Dr Summerton told The Sunday Times
'We need to consider what the broader group of symptoms are and the combinations of symptoms patients have. Time is not on our side and we must get this right.
'We've got people who are wandering around with the coronavirus and that's the concern. Those missed cases will just spread around the community. That's why I believe these two symptoms are a dodgy foundation.
'If we haven't got this bit right, we're never going to get a grip on the epidemic. If you don't get the case definition right, you don't know who you're fighting.'
Dr Summerton claims to have broached the subject with government officials on multiple occasions, but his worries had fallen on deaf ears.
Three times this has been with Professor John Newton, the UK's national testing co-ordinator from Public Health England.  But he had not received any response.
The public health physician said the public may be reassured they don't have the coronavirus if they look at the NHS website, therefore unwillingly go around spreading it to others. 
Dr Summerton fears the UK will fail to get 'a grip on the epidemic' by ignoring the presence of symptoms which may have previously been seen as uncommon.
Research has pointed towards an array of symptoms SARS-CoV-2 can cause beyond the typical cough and fever. Sometimes these depend on the severity of disease.
More than a month ago, on March 31, King's College London researchers said almost 60 per cent of coronavirus patients experienced a loss of taste and smell. 
They collected data of more than 1.5million Britons who downloaded the Covid Symptom Tracker App. 
Some 59 per cent of those who reported their health by March 29 and tested positive reported a loss of smell and taste, compared with 18 per cent of those who tested negative.
But the Government discarded loss of smell and taste - which Health Secretary Matt Hancock said he suffered with during his illness - as 'anecdotal evidence' on April 3.
Loss of taste or smell as well as chills, repeated shaking with chills, muscle pain, headache and sore throat were recently added to CDC's list of symptoms.
Health officials made the changes after pressure from physicians. It also conducted its own research on thousands of patients in the US - where cases have reached 1.1million and deaths 67,000.
Data has highlighted the main symptoms in hospitalised American adults - including muscle pain in 61 per cent of cases and a headache in 58 per cent.
But its Coronavirus Disease 2019 in Children report on April 6, formed part of the Morbidity and Mortality Weekly Report, showed symptoms are less obvious in children. 
Compared with adults, children are less likely to have the tell-tale symptoms and may not show any signs of the virus at all. Pictured: Around 73 per cent of US children have a fever, cough or shortness of breath, compared with 93 per cent of adults
Compared with adults, children are less likely to have the tell-tale symptoms and may not show any signs of the virus at all. Pictured: Around 73 per cent of US children have a fever, cough or shortness of breath, compared with 93 per cent of adults
Headaches, listed by the CDC, were flagged as a potential sign by Chinese researchers in mid-April after a study of 214 patients.  
Neurologic symptoms were seen in 36.4 per cent of patients and were more common in patients with severe infection - based on their respiratory symptoms.

The researchers said 13 per cent reported a headache, 17 per cent dizziness, 19 per cent nerve pain and 19 per cent muscle inflammation. 
Patients whose condition became severe went on to develop more intense neurological problems, including confusion, seizure and stroke, according to the paper published in the medical journal JAMA Neurology
In a similar vein, the WHO has 'loss of speech or movement' under serious symptoms.
The board has the most expansive list of coronavirus symptoms which it says can appear up to 14 days after infection. 
It says tiredness is one of the most common symptoms, alongside fever and a dry cough. Some people with the infection report feeling constantly tired or wiped out.
The WHO also warns that 'around one out of every five people who gets COVID-19 becomes seriously ill and develops difficulty breathing' - another symptom the NHS has not recorded.
A rash on the skin or discolouration of the fingers or toes have also been listed by the WHO - bizarre signs that have come to light in recent weeks.
Dermatologists in Spain have warned of at least five different skin conditions they believe are related to the virus, including small blisters over the torso and a nettle-like rash.
They studied 375 patients with suspected or confirmed mild COVID-19 before the lockdown came into force, finding half had a rash with raised or flat bumps. 
It followed 'numerous' reports across Europe of bruising and lesions on the feet - either purple chickenpox or chilblain-like marks - on COVID-19 patients. 
Experts warn the mysterious symptom has primarily been spotted in children and teenagers.
But skin manifestations potentially caused by the virus were seen in one in five patients in an Italian hospital.

WHAT SYMPTOMS DO HEALTH OFFICIALS LIST? CDC'S PREVIOUS AND CURRENT LIST OF CORONAVIRUS SYMPTOMS 

NHS 
The NHS lists the following as the main symptoms of the coronavirus:
  •  a high temperature – this means you feel hot to touch on your chest or back (you do not need to measure your temperature)
  • a new, continuous cough – this means coughing a lot for more than an hour, or 3 or more coughing episodes in 24 hours (if you usually have a cough, it may be worse than usual)   
It also says to use the NHS 111 service if you have those symptoms
The Centres for Disease Control and Prevention (CDC) 
Until recently, the CDC only listed three symptoms of coronavirus on its website:
  • Fever 
  • Cough
  • Shortness of breath 
Last week, the CDC expanded its list to include the following signs:
  • Chills
  • Repeated shaking with chills
  • Muscle pain
  • Headache
  • Sore throat
  • New loss of taste or smell 
The World Health Organization
Most common symptoms:
  • Fever  
  • Dry cough
  • Tiredness
Less common symptoms:
  • Aches and pains
  • Sore throat
  • Diarrhoea
  • Conjunctivitis
  • Headache 
  • Loss of taste or smell
  • A rash on skin, or discolouration of fingers or toe 
Serious symptoms:
  • Difficulty breathing or shortness of breath
  • Chest pain or pressure
  • Loss of speech or movement 

HEADACHES AND DIZZINESS A SIGN OF COVID-19 

More than a third of coronavirus patients develop neurological symptoms including headaches and dizziness, a study in China suggests.
Researchers analysed 214 patients hospitalised in Wuhan who tested positive for COVID-19. Most (60 per cent) were not seriously ill. 
Neurologic symptoms were seen in 36.4 per cent of patients and were more common in patients with severe infection - based on their respiratory symptoms.
The researchers said 13 per cent reported a headache, 17 per cent dizziness, 19 per cent nerve pain and 19 per cent muscle inflammation. 
Patients whose condition became severe went on to develop more intense neurological problems, including confusion, seizure and stroke.
All neurologic manifestations were reviewed and confirmed by two trained neurologists, the team wrote in their paper, published in the medical journal JAMA Neurology.
They explained that the neurological symptoms may be due to the way in which the virus attaches to cells in the body.
In January 2020, a receptor called ACE2 was identified as the 'door' into cells. The receptor is found in multiple human organs, 'including nervous system and skeletal muscles'.  

WHAT ARE THE COMMON AND 'ATYPICAL' SYMPTOMS OF COVID-19? 

The NHS website states that the symptoms of COVID-19 are:
  • A high temperature
  • A new, continuous cough
The World Health Organisation says other indicators include fatigue, aches and pains, a blocked nose, sore throat and diarrhoea. 
As the coronavirus infects millions globally, anecdotal and scientific studies have spotted some other 'atypical' symptoms:
Headaches and dizziness
A study in China found that 13 per cent of 214 patients hospitalised with COVID-19 had headaches, and 17 per cent reported dizziness. Overall more than a third reported neurological symptoms. 
The team explained the symptoms may be due to the way in which the virus attaches to cells in the body - through ACE2 receptors found in human organs and tissues within the nervous system. 
Loss of taste and smell
Data gathered by ENT UK, which represents ear, nose and throat specialists, suggests an inability to smell — and often taste — may be the very first symptom and can start within hours.
Those with the symptom are thought to be mostly healthy young adults whose immune systems react sufficiently to the virus to contain it within the nose, preventing it spreading to the lungs, where it can cause potentially fatal pneumonia.
Testicular pain
In February, scientists in China claimed the virus could attack the male reproductive organs - but there is not enough robust research to prove it.
The virus binds to the ACE2 receptors on cells which are found in abundance in the testes, and could lead to 'tissue damage', the team speculated in their paper, which has not been peer-reviewed.
A 42-year-old man from America tested positive for the coronavirus after going to hospital with testicular pain, even though there were no signs of abnormalities.
Skin changes
Dermatologists in Spain warned of five skin conditions that may be symptoms of the killer infection after studying 375 patients. Their paper was published in the British Journal of Dermatology
The most common was a rash made of small red marks, either flat or raised, affecting almost half of patients. Sometimes they were scaly. 
Following behind chilblain-like lesions on the hands and feet, seen in mostly young patients, and itchy wheals which are seen in more severe cases. Both affected a fifth of patients. 
Small itchy blisters, sometimes filled with blood, appeared on the trunk of some patients, while a blotchy red pattern linked to an impairment in blood circulation was most commonly seen in the elderly.  
A study of 88 coronavirus patients at Alessandro Manzoni Hospital in Lecco, northern Italy, found one in five complained of skin manifestations.
They had not taken any medications or drugs in the preceding 15 days, which could have caused a skin reaction. 
'Numerous cases' of chickenpox-like marks on the feet have been reported in Spain, Italy and France, mostly in children.  
The phenomenon is not well researched. But one theory is that skin eruptions are caused by the closure of tiny blood vessels, which might be induced by the nervous system in response to the virus.

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