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

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


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.



  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.

    1. Mahase E

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

Cold or Flu? | Patient Education

Colds and flu are both highly contagious and, in the initial stages, a bad cold and a mild case of the flu might seem alike. Unlike a cold, though, the flu is a serious illness that can have life-threatening complications. Here is a comparison of cold and flu symptoms.


  • With a cold – Fever is rare in adults and older children, but babies and small children may have a fever as high as 102 degrees Fahrenheit.
  • With the flu – Fever is often a symptom of the flu and is usually around 102 degrees Fahrenheit, but can go as high as 104 degrees. Fever with the flu usually lasts three to four days.


  • With a cold – Headaches are rare.
  • With the flu – Headaches are common, can come on suddenly and may be rather severe.

Muscle aches

  • With a cold – Muscle aches are usually mild.
  • With the flu –  Muscle aches are common and often severe.

Feeling tired and weak

  • With a cold – You may be tired and weak, but this feeling is typically mild and never turns into extreme exhaustion.
  • With the flu – It’s extremely common to feel tired and weak for two weeks or longer. You may also have extreme exhaustion that comes on suddenly.

Runny nose, sore throat and sneezing

  • With a cold – It’s common to have a runny nose, a sore throat and sneezing.
  • With the flu – You may have a runny nose, a sore throat and sneezing.


  • With a cold – A mild hacking cough is common.
  • With the flu – Coughing is common and can become severe.

This information was adapted from the U.S. Centers for Disease Control and Prevention (CDC) website. For more information, visit the CDC’s flu page.

UCSF Health medical specialists have reviewed this information. It is for educational purposes only and is not intended to replace the advice of your doctor or other health care provider. We encourage you to discuss any questions or concerns you may have with your provider.

Recommended reading

Can You Tell If It’s the Flu or COVID-19?

UCSF experts help explain the differences between flu and COVID-19, when to get a test, and why you shouldn’t try to diagnose yourself.

Facts About the Flu

Find facts about influenza, aka “the flu,” including, prevention, signs and symptoms, transmission, diagnosis, treatment and complications. Learn more here.

When to Call Your Doctor About the Flu

If you are at special risk of flu complications, contact your doctor as soon as your symptoms begin. Learn more here.

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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


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