These are the four strangest symptoms of Covid that could tell you that you are sick

More than two years after the pandemic, hundreds of thousands of Covid cases they continue to be recorded around the world every day.

With the emergence of new variants, Covid symptoms have also evolved. Initially, the UK National Health Service (NHS) considered fever, cough, and loss or change in sense of smell or taste as the main symptoms that could indicate a Covid infection.

Now recently updated NHS guidance also suggests watching out for symptoms including sore throat, stuffy or runny nose, and headache.

But, what about some of the more obscure signs and symptoms? From skin lesions to hearing loss, emerging data is increasingly showing us that Covid symptoms can go beyond what you might expect from a common cold or flu.

Covid-related skin complaints are not uncommon. In fact, a UK study published in 2021 found that one in five patients only had a rash and no other symptoms.

Covid can affect the skin in several ways. Some people may experience a generalized maculopapular rash (flat or raised areas of discolored skin), while others may develop hives (raised areas of itchy skin).

“Covid fingers“, meanwhile, describes red, swollen, or blistering skin lesions on the toes. This symptom is more common in adolescents or young adults with mild or no symptoms.

Most Covid skin lesions they tend to go away after a few days or, in some cases, a few weeks, without the need for any specialized treatment. However, if the skin itches or hurts a lot, you can consult a GP or dermatologist, who can recommend a treatment such as a cream.

During an infection, including Sars-CoV-2 (the virus that causes Covid-19), our bodies naturally try to express that they are under an unusual amount of stress. They can do this in a variety of weird and wonderful ways, including through our fingernails. “Covid Nails” includes changes such as:

  • Beau’s Lines – Horizontal marks that occur at the base of the fingernails or toenails when there is a temporary interruption in nail growth due to physical stress on the body.
  • Mees’ lines: horizontal white lines that appear on the nails, thought to be caused by abnormal protein production in the nail bed.
  • a red crescent pattern that develops at the base of the nails (the mechanism underlying this change is unclear).
The marks left by the coronavirus at the base of the nails.

Data on how many people experience nail covid is limited, but it is estimated that it could be up to 1-2% of covid patients.

Covid nails tend to appear in the days or weeks after Covid infection as they grow. Although they can be painful at first, the vast majority tend to return to normal within a few weeks.

In particular, while these changes may be indicative of Covid, they can also be caused by other causes. For example, Beau’s lines can be secondary to chemotherapy or another infection.

Hair loss is perhaps an underestimated symptom of Covid-19, usually occurring a month or more after acute infection. In a study of nearly 6,000 people who had previously had Covid, hair loss was the most common post-Covid symptom, reported by 48% of participants. It was especially prevalent among people who had severe Covid and white women.

This is believed to be because hair “perceives” stress in the body, leading to excessive fall. In fact, hair loss can also be triggered by other stressful events, such as childbirth. The good news is that over time the hair grows back to normal.

hair loss

As with other viral infections, like the flu and measles, Covid has been found to affect cells in the inner ear, with hearing loss or tinnitus (a constant ringing sensation in the ear) sometimes following infection.

In a review study involving 560 participants, hearing loss occurred in 3.1% of Covid patients, while tinnitus occurred in 4.5%.

In a study of 30 people who had been diagnosed with Covid and 30 who had not (none with pre-existing hearing problems), researchers found that Covid was associated with damage to the inner ear that caused hearing problems at higher frequencies. While for the vast majority of patients this resolves on its own, cases of permanent Covid-related hearing loss have been reported.

We do not understand exactly what causes these symptoms, but we know that the most important role is played by a process called inflammation . Inflammation is our body’s natural defense mechanism against pathogens; SARS-CoV-2 in this case. It involves the production of “cytokines,” proteins that are important in controlling the activity of immune cells.

Photo: AP

Excessive production of these proteins, as part of the inflammation triggered by Covid infection, can cause sensory deficits, which could explain why some people experience hearing loss and tinnitus. It can also disrupt capillary networks, very small blood vessels that supply blood to organs, including the ears, skin, and nails.

The symptoms we have described here are not exclusive to Covid infection. That said, if you notice any of these symptoms, it would be appropriate to consider a Covid test, especially if you are in an area where Covid is circulating.

You can also contact your GP, especially if symptoms worsen or cause you significant discomfort. At the same time, you can be sure that most of these symptoms are likely to improve with time.

*Vassilios Vassiliou
Professor of Cardiac Medicine, University of East Anglia

**Ranu Baral
Visiting Research Fellow (FY2 Academic Foundation Doctor), University of East Anglia

***Vasiliki Tsampasian
SpR and NIHR Cardiology Academic Clinical Fellow, University of East Anglia

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