Is it COVID-19 or just a cold? Clues and warning signals

Is it COVID-19 or just a cold? Clues and warning signals

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Detect Coronavirus Infections and Act Correctly

The course of the disease of the disease COVID-19 caused by the coronavirus SARS-CoV-2 differs greatly from person to person. Some people hardly notice at all, others experience flu-like symptoms and some develop life-threatening courses. Experts summarize how to recognize the disease and when to react.

Just a little cold? Nothing tastes better? No more air to breathe? Infection with the new corona virus is not the same for everyone. The majority of those infected feel little or nothing. Other sufferers die. The course of the disease in the new corona virus varies considerably. About clues and warning signals.

The clinical picture COVID-19 varies widely

For some it feels like a cold, for others it can be life-threatening or even fatal. General statements about the typical course of the disease are not possible, explains the Robert Koch Institute (RKI) in Berlin.

Every second infected person goes unnoticed

RKI boss Lothar Wieler recently said that about half of the people who were infected would not notice it at all: “We don't see them at all.” Data on the complaints of the infected people that have been identified are now available from several countries and increasingly also from Germany in front. Some of those affected also report themselves how they are doing with Sars-CoV-2 - an overview of the characteristics.

Mild courses without hospitalization

According to the RKI, four out of five of those infected who notice something have a mild course. Cough (54 percent) and fever (40 percent) were among the most common symptoms according to data from more than 22,000 people in Germany, as Wieler explains.

"It is rumored that a Sars-CoV-2 infection definitely does not cause a runny nose," adds Martin Witzenrath from the Clinic for Infectious Diseases and Pneumology at Charité Berlin, where, according to him, more than 20 patients with varying degrees of severity are currently being treated .

The FDP politician Alexander Graf Lambsdorff told the Heidelberg “Rhein-Neckar-Zeitung” that the illness was wavy for him. He had had a runny nose for some time, and then there was a cough. He described the symptoms as “less spectacular”.

Reports from the Heinsberg risk area

Teams around Bonn virologist Hendrik Streeck asked how 100 people in the particularly affected district of Heinsberg in North Rhine-Westphalia fared in domestic isolation: “The most frequently described symptom was dry cough with 70 percent, before the loss of taste and taste Sense of smell at 68 percent and fatigue at 68 percent, ”he says. Many sufferers also reported a runny nose, headache, muscle and sore throat and fever. "Some were pretty knocked out," says the scientist. Diarrhea was also not uncommon, says Streeck.

After two weeks, the spook is mostly over

According to data from the World Health Organization (WHO), mild illnesses take an average of two weeks. According to previous experience, the disease begins with sore throat or pain and often fever, says Streeck. And with that, like many colds. Are there any signs that can be used to clearly differentiate Covid-19? “The only thing that doesn't cause flu is this loss of taste and smell,” says Streeck. Otherwise apply to mild courses: "It is like a flu infection. Those affected would not have noticed the Sars-CoV-2 infection at all. "

Food tastes metallic or bitter

Chief physician Clemens Wendtner from the Clinic for Infectious Diseases at Munich Clinic Schwabing, who treated the first infected people in Germany at the end of January, also reports that, for example, sick people could not smell and taste good for a few days and the taste of food - although their preferred dish - was considered felt metallic or bitter. According to Wendtner, the impairment can occur right at the beginning and be a first indication of an illness. Sars has also assumed that the virus also affects olfactory receptors in the nose.

Severe courses with hospital treatment

It is not yet known how many people in Germany are or were in hospital because of Covid-19. With almost 56,000 cases recorded in China, 14 percent were difficult. In six percent the course was critical to life-threatening, for example due to lung failure. According to the WHO, severe courses can last between three and six weeks on average.

According to previous experience, it takes four to eight days for patients with symptoms of the upper respiratory tract to decide whether the disease also affects the lower respiratory tract, says Witzenrath from the Charité. But there are also patients who get pneumonia directly without first affecting the upper respiratory tract. Inflamed lung tissue means that oxygen intake no longer works as well.

In the event of breathlessness, medical attention should be sought immediately

Italian doctors described that there are some patients in the severely affected country who go to a clinic too late. RKI boss Wieler said on Wednesday that if one feels increasing shortness of breath, it is important to consult a doctor.

COVID-19 differs from other pneumonia

The clinical picture in Covid-19 differs significantly from the previously known pneumonia, says Witzenrath. “The special thing about it is that some of the patients have a little shortness of breath, not dramatically. Then you look at the lungs in the CT and it looks really bad. It's something we haven't seen before. ”For example, more than half of the lungs could be damaged by the virus. The course could then deteriorate rapidly.

Act immediately on alarm signals

The doctor calls alarm signals: “If you go up a flight of stairs that you would otherwise be able to cope with easily, and realize after half that you are clearly not getting any air, that should make you think. Especially when you are older and have previous illnesses. ”Relatives could keep an eye on the respiratory rate of the sick: While the patient is lying in front of the television, for example, one can observe - best of all unnoticed by this - how often the chest rises. "If the number at rest is over 20 or 22 per minute, that's definitely a warning signal."

What happens in the hospital?

Some Covid 19 patients could initially be treated in normal wards, says Witzenrath. "For example, people who get some oxygen to support them through a small plastic tube under the nose, and patients whose pre-existing condition worsens under pneumonia," explains the doctor.

If patients need even more oxygen, a specific oxygen therapy (high flow) is also used in intensive care units. If this is no longer sufficient, ventilation through a tube in the trachea is necessary, and patients are put in a coma. "However, complications can arise with the duration of the intubation," says Witzenrath. According to previous data, it is assumed that sufferers in intensive care units must be ventilated on average for 17 days. "It's a very, very long time."

According to experts, it is so far difficult to say how high the proportion of those affected who need ventilation is, partly because of the number of undetected infections. The RKI calls for China: two to six percent. (vb; source: Gisela Gross, dpa)

Author and source information

This text corresponds to the specifications of the medical literature, medical guidelines and current studies and has been checked by medical doctors.

Graduate editor (FH) Volker Blasek


  • European authority ECDC on Covid-19 (access: 26.03.2020),
  • World Health Organization WHO on Covid-19 (accessed: March 26, 2020),
  • RKI: Answers to frequently asked questions about the SARS-CoV-2 coronavirus (accessed: March 26, 2020),
  • RKI: How can you protect yourself and your fellow human beings from infection? (Retrieved: 26.03.2020),
  • Federal Ministry of Health: Up-to-date information on the coronavirus (accessed: March 26, 2020),

Video: Monday Media Briefing on COVID-19 (January 2023).