Roundup: Likely Order of COVID Symptoms; Update on Lasting Immunity; and Salmonella Outbreak Grows

New Study Pinpoints Likely Order of COVID-19’s Symptoms

Researchers say there is a likely order in which COVID-19 symptoms first appear. They are fever, cough and muscle pain, then nausea and/or vomiting, and then diarrhea.

According to the study from the University of Southern California (USC) , published in the medical journal Frontier Public Health, determining the probable order of COVID-19 symptoms can help doctors plan treatments. Fever and cough are common symptoms associated with other respiratory illnesses. But the timing and symptoms in the upper and lower gastrointestinal tract set COVID-19 apart, researchers said.

“This order is especially important to know when we have overlapping cycles of illnesses like the flu that coincide with infections of COVID-19,” said Peter Kuhn, professor of medicine, biomedical engineering, and aerospace and mechanical engineering at the USC Dornsife College of Letters, Arts and Sciences. “Doctors can determine what steps to take to care for the patient, and they may prevent the patient’s condition from worsening.”

The USC team based their “order of symptoms” on rates of “symptom incidence” of more than 55,000 confirmed coronavirus cases in China — collected Feb. 16-24 by the World Health Organization. They also reviewed a separate dataset of nearly 1,100 cases collected Dec. 11-Jan. 29 medical administrators through the National Health Commission of China.

“The upper GI tract (i.e., nausea/vomiting) seems to be affected before the lower GI tract (i.e., diarrhea) in COVID-19, which is the opposite from MERS (Middle East respiratory syndrome) and SARS (severe acute respiratory syndrome),” the scientists wrote.

More Studies Indicate Lasting COVID-19 Immunity, Even After Mild Cases

Researchers are seeing encouraging signs that points to lasting COVID-19 immunity, even in patients who have experienced mild symptoms, according new studies and media reports.

However, much is still uncertain, including how long immunity lasts. For now, scientists say immunity could be present for months after coronavirus infections have resolved. Infectious disease experts are being cautiously optimistic about this data.

These immunity studies also indicate that a vaccine could protect people for more than just a short period of time. “The hopes that I’ve had appear to be realized with these early studies,” said Ian Lipkin, M.D., director of the Center for Infection and Immunity at Columbia University Mailman School of Public Health, told CNN.

One of the recent studies finds that T cells appear to be activated by COVID-19. T cells are essential components of the body’s immune system. They attack cells infected by a virus.

A separate study that reviewed donor blood samples found that between 20 percent to 50 percent of people in some regions of the U.S., may have T cells that recognize COVID-19, even if that person has never been infected with the coronavirus.

CDC: Salmonella Outbreak of Recalled Onions Spreads to 47 States

A salmonella outbreak nationwide linked to recalled onions has spread to 47 states, with increased cases and even hospitalizations, according to the U.S. Centers for Disease Control and Prevention (CDC).

Check your home for recalled onions and recalled foods from Thomson International, Inc. and other companies, including Food Lion, Giant Eagle, Kroger, Publix, Ralph’s, Trader Joe’s, and Walmart onions — and throw them out, says the CDC.

“If you can’t tell where your onions are from, don’t eat them. Throw them away,” states the CDC.

In the CDC’s update this week, the number of reported cases of salmonella had grown to 869 cases, with 116 hospitalizations in 47 states (only Oklahoma, Louisiana, and Vermont have not had cases). No deaths have been reported.

The U.S. Food & Drug Administration said it is examing samples from Thomson International of Bakersfield, California, which has recalled all red, white, yellow and sweet yellow onions shipped to all 50 states and the District of Columbia from May 1 to Aug. 1.

The initial onion recall targeted wholesalers, restaurants, and retail stores nationwide under brand names such as Thomson Premium, TLC Thomson International, Kroger, Food Lion, and Onions 52.