About all

Fatigue runny nose: Covid-19: Runny nose, headache, and fatigue are commonest symptoms of omicron, early data show

by alexxlab

Covid-19: Runny nose, headache, and fatigue are commonest symptoms of omicron, early data show


News

BMJ
2021;
375
doi: https://doi.org/10.1136/bmj.n3103
(Published 16 December 2021)

Cite this as: BMJ 2021;375:n3103

Read our latest coverage of the coronavirus pandemic

  1. Gareth Iacobucci
  1. The BMJ

The UK government has been urged to update its list of symptoms for covid-19, after early data showed that cold-like symptoms were the most commonly reported by people with the new omicron variant.

Data released on 16 December by the Covid Symptoms Study,1 run by the health science company Zoe and King’s College London, show that the top five symptoms reported in the app for omicron infection were runny nose, headache, fatigue (either mild or severe), sneezing, and sore throat. This initial analysis was based on positive cases in London, which was selected because of its higher prevalence of omicron than in other parts of the UK.

The government still lists fever, cough, and loss of sense of smell or taste—which were the most common with the alpha variant—as the covid symptoms to watch out for.

Tim Spector, lead scientist on the Zoe Covid Study app, who has been calling for the list of symptoms to be updated since the emergence of the delta variant,2 said a change was overdue.

“The messaging from the government is just not clear on this,” he said. “I think most people know what cold-like symptoms are. I would probably just add [to the list]: ‘Have you got cold-like symptoms?’ We need to educate people, go back to the basics, and say that if you’ve got cold-like symptoms keep away from people. You shouldn’t be waiting for the three classic symptoms.”

To compare delta and omicron, London data were selected from a week where delta was dominant (a sample of 363 cases from 3-10 October 2021) and compared with the most recent data (847 cases from 3-10 December 2021). This initial analysis found no clear differences between delta and omicron in the early symptoms (three days after testing).

Spector said it was vital that members of the public were aware of the symptoms to look out for, particularly in areas such as London that have very high rates of omicron infection. “If you do have symptoms of a mild or bad cold, it’s highly likely that you’ve got covid if you’re in an area like London at the moment,” he said.

Spector said the UK was now an international exception in not listing cold-like symptoms as likely indicators of covid infection, noting that the US Centers for Disease Control and Prevention, the World Health Organization, and European countries such as Spain and France had all updated their advice.

“The UK is the odd one out,” he said. “They should amend it if the majority are presenting that way.”

The Department of Health and Social Care for England said that the main symptoms listed had been carefully selected to capture the people most likely to have covid-19 while not including a large number of people who did not. A spokesperson said, “Since the start of the pandemic we have acknowledged covid-19 has a much longer list of symptoms than the ones used in the case definition, and experts keep the list of symptoms under review. ”

This article is made freely available for use in accordance with BMJ’s website terms and conditions for the duration of the covid-19 pandemic or until otherwise determined by BMJ. You may use, download and print the article for any lawful, non-commercial purpose (including text and data mining) provided that all copyright notices and trade marks are retained.

https://bmj.com/coronavirus/usage

References

  1. ↵

    Omicron and cold-like symptoms rapidly taking over in London. Zoe Covid Study.16 Dec 2021. https://covid.joinzoe.com/post/omicron-and-cold-like-symptoms-rapidly-taking-over-in-london.

  2. ↵
    1. Mahase E

    . Covid-19: GPs urge government to clear up confusion over symptoms. BMJ2021;373:n1654. doi:10.1136/bmj.n1654 pmid:34183357

Poor sleep and daytime somnolence in allergic rhinitis: significance of nasal congestion

Review

. 2002;1(3):195-200.

doi: 10. 1007/BF03256609.

Sujani Kakumanu 
1
, Casey Glass, Timothy Craig

Affiliations

Affiliation

  • 1 Department of Medicine, Pulmonary, Allergy, Critical Care, Hershey, Pennsylvania 17033, USA.

  • PMID:

    14720057

  • DOI:

    10.1007/BF03256609

Review

Sujani Kakumanu et al.

Am J Respir Med.

2002.

. 2002;1(3):195-200.

doi: 10.1007/BF03256609.

Authors

Sujani Kakumanu 
1
, Casey Glass, Timothy Craig

Affiliation

  • 1 Department of Medicine, Pulmonary, Allergy, Critical Care, Hershey, Pennsylvania 17033, USA.

  • PMID:

    14720057

  • DOI:

    10.1007/BF03256609

Abstract

Patients with allergic rhinitis frequently present with symptoms of nasal congestion, runny nose, sneezing, daytime somnolence and fatigue associated with decreased cognitive performance and impaired quality of life. Recent research has suggested that daytime somnolence in allergic rhinitis can be attributed to chronic inflammation of the nasal mucosa leading to nasal congestion and obstructed nasal passageways resulting in disturbed sleep. Treating daytime somnolence due to allergic rhinitis requires a reduction in obstruction caused by nasal congestion. Currently available therapy for allergic rhinitis includes topical corticosteroids, sedating and nonsedating antihistamines, topical cromolyn sodium (sodium cromoglycate), decongestants, immunotherapy and topical ipratropium bromide. The effectiveness of antihistamines in patients with allergic rhinitis has long been established. However, results of placebo-controlled trials investigating the effects of azelastine on sleep and daytime somnolence have produced conflicting results. Sleep improved with azelastine therapy, but there was a lack of evidence that azelastine significantly affected daytime sleepiness, sleep severity and nasal congestion. Sedating antihistamines exacerbate daytime somnolence and should be avoided in patients with allergic rhinitis. In a separate study, desloratadine failed to benefit sleep, but did not worsen daytime somnolence. Topical nasal cromolyn sodium is inconvenient to use and is unlikely to have a major effect on nasal congestion. Decongestants do decrease nasal congestion but the effect this has on sleep has not been adequately studied. Recent research has shown that topical corticosteroids are an effective treatment for alleviating nasal congestion secondary to allergic rhinitis. However, few studies have assessed the effect of topical corticosteroids on daytime fatigue and sleep. In 20 patients with allergic rhinitis and symptoms of daytime sleepiness, flunisolide significantly improved sleep quality and congestion but daytime sleepiness was not significantly improved. A similar study with fluticasone propionate showed improvement in nasal congestion and sleep but there was no significant change in objective sleep measurements recorded on polysomnography. Further research involving objective measures of sleep quality is necessary to determine the efficacy of medications in the treatment of allergic rhinitis associated with fatigue and daytime somnolence.

Similar articles

  • Effect of topical nasal azelastine on the symptoms of rhinitis, sleep, and daytime somnolence in perennial allergic rhinitis.

    Golden S, Teets SJ, Lehman EB, Mauger EA, Chinchilli V, Berlin JM, Kakumanu S, Lucus T, Craig TJ.

    Golden S, et al.
    Ann Allergy Asthma Immunol. 2000 Jul;85(1):53-7. doi: 10.1016/S1081-1206(10)62434-9.
    Ann Allergy Asthma Immunol. 2000.

    PMID: 10923605

    Clinical Trial.

  • How do topical nasal corticosteroids improve sleep and daytime somnolence in allergic rhinitis?

    Craig TJ, Hanks CD, Fisher LH.

    Craig TJ, et al.
    J Allergy Clin Immunol. 2005 Dec;116(6):1264-6. doi: 10.1016/j.jaci.2005.10.009.
    J Allergy Clin Immunol. 2005.

    PMID: 16337455

    Clinical Trial.

  • The effect of topical nasal fluticasone on objective sleep testing and the symptoms of rhinitis, sleep, and daytime somnolence in perennial allergic rhinitis.

    Craig TJ, Mende C, Hughes K, Kakumanu S, Lehman EB, Chinchilli V.

    Craig TJ, et al.
    Allergy Asthma Proc. 2003 Jan-Feb;24(1):53-8.
    Allergy Asthma Proc. 2003.

    PMID: 12635578

    Clinical Trial.

  • Sleep impairment and daytime sleepiness in patients with allergic rhinitis: the role of congestion and inflammation.

    Thompson A, Sardana N, Craig TJ.

    Thompson A, et al.
    Ann Allergy Asthma Immunol. 2013 Dec;111(6):446-51. doi: 10.1016/j.anai.2013.05.020. Epub 2013 Jun 21.
    Ann Allergy Asthma Immunol. 2013.

    PMID: 24267356

    Review.

  • Pharmacologic approaches to daytime and nighttime symptoms of allergic rhinitis.

    Storms WW.

    Storms WW.
    J Allergy Clin Immunol. 2004 Nov;114(5 Suppl):S146-53. doi: 10.1016/j.jaci.2004.08.045.
    J Allergy Clin Immunol. 2004.

    PMID: 15536446

    Review.

See all similar articles

Cited by

  • Allergic rhinitis and sleep disorders in children – coexistence and reciprocal interactions.

    D’Elia C, Gozal D, Bruni O, Goudouris E, Meira E Cruz M.

    D’Elia C, et al.
    J Pediatr (Rio J). 2022 Sep-Oct;98(5):444-454. doi: 10.1016/j.jped.2021.11.010. Epub 2021 Dec 31.
    J Pediatr (Rio J). 2022.

    PMID: 34979134
    Free PMC article.

    Review.

  • Toxoplasma gondii IgG associations with sleep-wake problems, sleep duration and timing.

    Corona CC, Zhang M, Wadhawan A, Daue ML, Groer MW, Dagdag A, Lowry CA, Hoisington AJ, Ryan KA, Stiller JW, Fuchs D, Mitchell BD, Postolache TT.

    Corona CC, et al.
    Pteridines. 2019 Feb;30(1):1-9. doi: 10.1515/pteridines-2019-0001. Epub 2019 Feb 19.
    Pteridines. 2019.

    PMID: 30918422
    Free PMC article.

  • Allergic Rhinitis in Children: A Randomized Clinical Trial Targeted at Symptoms.

    Mansi N, D’Agostino G, Scirè AS, Morpurgo G, Gregori D, Gulati A, Damiani V.

    Mansi N, et al.
    Indian J Otolaryngol Head Neck Surg. 2014 Dec;66(4):386-93. doi: 10.1007/s12070-014-0708-4. Epub 2014 Feb 11.
    Indian J Otolaryngol Head Neck Surg. 2014.

    PMID: 26396949
    Free PMC article.

  • Bilastine: new insight into antihistamine treatment.

    Ridolo E, Montagni M, Bonzano L, Incorvaia C, Canonica GW.

    Ridolo E, et al.
    Clin Mol Allergy. 2015 Apr 15;13(1):1. doi: 10.1186/s12948-015-0008-x. eCollection 2015.
    Clin Mol Allergy. 2015.

    PMID: 25878559
    Free PMC article.

  • Development of a questionnaire for the assessment of quality of life in korean children with allergic rhinitis.

    Kim JH, Ahn YM, Kim HJ, Lim DH, Son BK, Kang HS, Song YE, Lee HY.

    Kim JH, et al.
    Allergy Asthma Immunol Res. 2014 Nov;6(6):541-7. doi: 10.4168/aair.2014.6.6.541. Epub 2014 Sep 19.
    Allergy Asthma Immunol Res. 2014.

    PMID: 25374754
    Free PMC article.

See all “Cited by” articles

Publication types

MeSH terms

Substances

Fatigue syndrome or common SARS: what can be confused with “omicron”

The symptoms inherent in “omicron”, such as headache and chronic fatigue, may indicate other diseases, immunologists told Gazeta.Ru. In particular, the manifestations of a new strain of coronavirus are similar to influenza or rhinovirus, as well as chronic fatigue syndrome, which many patients suffer in the autumn-winter period.

The first patients infected with the new strain of omicron coronavirus complained of severe fatigue and headaches. Angelique Coetzee, a doctor from the Republic of South Africa, told The Telegraph about this. She was the first to report patients with a new variant of the virus.

According to the specialist, suspicions that the pathogen has mutated again arose due to the increased visits of patients with unusual manifestations of COVID-19. In particular, these were young people complaining of a strong feeling of fatigue and headaches, as well as a six-year-old child with a rapid pulse and a high temperature – while two days later he felt better.

It is noted that none of the patients experienced loss of taste or smell. “Their symptoms were very different from those that I had experienced before, and manifested in a mild form,” she noted.

In total, about two dozen Coetzee patients with symptoms of a new type of infection have tested positive for COVID-19.

“Information about the symptoms of” omicron “appeared for the first time from South Africa, in particular, doctor Coetzee gave an assessment of working with 20 patients. All were young without any serious illnesses and, naturally, they all got sick easily. Based on this, she concluded that the new strain only affects the young and those with symptoms of headache and fatigue. But this is not even a study, but a description of several cases, ”said Nikolai Kryuchkov, candidate of medical sciences, immunologist, in an interview with Gazeta.Ru.

The fact is that weakness and headache are typical symptoms of any type of SARS, they arise due to the production of inflammatory mediators, explained immunologist Maria Polner.

“COVID-19 can affect any organs and systems and lead to an exacerbation of chronic diseases. The new variant of the virus is no exception. Indeed, it is known that there are features of the clinical manifestations of different variants of the virus, but the severity of the course, as well as the consequences of the new version of Omicron, are still being studied, ”she said.

Kryuchkov agreed with her. According to him, any signs of an acute condition – a runny nose, sore throat, headaches, severe fatigue – may indicate both a coronavirus and another infection.

“Based on clinical signs, coronavirus is quite easy to confuse with other SARS. Although it may be SARS, which this season will be much more than last. Rhinovirus, influenza and adenovirus – all these symptoms will be, ”he added.

Headache and severe fatigue are also indicative of chronic fatigue syndrome, which many people suffer from when cold weather sets in, explained Irina Ivanova, general practitioner.

“In conditions of late autumn and early winter with extremely low levels of insolation, it will be very difficult to suspect infection with a new strain of coronavirus. For young, working and studying people at this time of the year, chronic fatigue syndrome is very typical. And they are trying to present this complaint to us as characteristic of a new mutation, ”the specialist emphasized.

It is already known that Omicron, like Delta, is highly contagious due to the fact that most of its mutations are in the spike protein (S-protein).

“In addition, there are big concerns that it can bypass both the antibodies formed as a result of vaccination and the antibodies that form after the illness. That is, it is quite possible to get coronavirus of different genetic variants twice in a row. Of course, a lot depends on the amount of ready-made antibodies at the time of infection, as well as on the number of viral units that have entered,” Polner said.

In this regard, the assertion that only young people aged 20-30 years are subject to the “omicron”, as South African scientists previously stated, is not tenable.

“In those countries where the population is older, the average age is higher, where there are many elderly, unlike South Africa, the new strain of coronavirus will behave, I think, like the “delta,” Kryuchkov said.

According to the immunologist, “omicron” appeared as a result of a spontaneous mutation of the coronavirus in a human body with an advanced form of immunodeficiency.

“There was a bit of a glitch, because in fact, in an immunodeficient untreated patient with HIV infection, this virus mutated for several months and grew to an “omicron”. Moreover, apparently, the patient was close to AIDS – he contracted the coronavirus, and maybe two strains at once. Therefore, this strain is unusual and very different from the delta. This conclusion can be drawn due to the fact that there are no intermediate links in the development of a new strain. That is, where did it come from in the population,” Kryuchkov concluded.

Fatigue, runny nose and headache are called early symptoms of “omicron”

Fatigue, runny nose and headache are called early symptoms of “omicron”

A sore throat, runny nose, fatigue and headache may be early signs of infection with the omicron strain of coronavirus. You should also pay attention to body aches, sneezing and night sweats.

This was stated by scientists from the UK, US and South Africa, writes the British newspaper Express. The conclusions of the doctors in an interview with RBC were confirmed by the director of the Center for the Global Virological Network Konstantin Chumakov. He noted that the incubation period of the virus has been markedly reduced. A person gets sick very quickly – 2-3 days after infection. The symptoms of the omicron strain are very difficult to distinguish from the common cold.

Previously, the St. Petersburg TV channel reported that more than two hundred cases of the VA.2 subspecies were detected in Russia – more contagious than the original version. The fact that a new version of Omicron has come to Russia was announced on February 2 by the head of Rospotrebnadzor Anna Popova.

Photo: St. Petersburg TV channel

Reportage
More

“Talent and provocation are in trend”: international fashion competition Graduate fashion-2023 was held in St. Petersburg

Graduates of the leading St. Petersburg design schools today presented their collections at the Graduate fashion-2023 international competition. The show was held in the format of a defile, installation and video presentation. Fashion industry experts evaluated the work of graduates of the Stieglitz Academy and the University of Industrial Technology and Design. A fashionable verdict was to be passed on 25 unique and striking collections.

July 3 23:15

Sleepless St. Petersburg: why night excursions in the city are more expensive, but more popular than daytime ones

Since the beginning of 2023, more than 4 million tourists have visited St. Petersburg. The figure is 10 percent higher than last year. According to the government, the peak season is during the white nights. Experts assure that sunset tours are more popular than day trips.

July 3 20:16

Students from seven regions of Russia will help passengers at Pulkovo

In addition to the construction, this year student groups went to work in Pulkovo. The main task is to help cope with the increased flow of passengers.