This Is Now the Most Common Non-Respiratory COVID Symptom

COVID-19 can easily be mistaken for a cold, the flu, or pneumonia because these illnesses often share common symptoms like coughing. However, the virus affects other parts of the body as well, not just the lungs and respiratory tract. 

New research that looked at medical records from over 63,000 patients shows that fever is the most common non-respiratory symptom of COVID-19 across all variants of the virus, regardless of a person’s vaccination status. However, the findings also suggested that being fully vaccinated was associated with a lower frequency of non-respiratory COVID features.

Shannon Cotton, RN, a study author and a clinical nurse at UC San Diego Health, told Verywell that she felt it was important to look into these non-respiratory (extrapulmonary) features of COVID to encourage the public to get fully vaccinated.

“Whether you believe COVID enters all organ systems or the extrapulmonary features are due to the intrinsic immune system, our research shows that full vaccination decreases features and mortality,” Cotton said.

Who Is Most Likely to Have Non-Respiratory COVID Symptoms?

According to the research, which was presented at the recent ATS 2023 International Conference, the risk of developing non-respiratory COVID symptoms across all variants was higher among people who were not fully vaccinated. Heart-related features, in particular, were higher among non-fully vaccinated people when the Omicron variant was dominant.

Cotton said that a fast heart rate (tachycardia) was a particularly prominent extrapulmonary feature of Omicron.

In general, Cotton said that the benefits of vaccination are clear in the data, which shows that fully vaccinated people are less likely to have non-respiratory COVID features. The same might be true for respiratory symptoms; a recent preprint study that has not been peer-reviewed suggested that being fully vaccinated resulted in fewer respiratory features and higher odds of survival for people who do get COVID.

Why Does COVID Cause a Fever?

“Symptoms for every infectious disease are the result of both the infecting pathogen and the host immune response,” Amesh Adalja, MD, an infectious disease expert and senior scholar at the Johns Hopkins Center for Health Security, told Verywell.

In other words, fever and respiratory symptoms when you’re infected with COVID are your body’s reaction to the infection. However, Adalja said that “vaccination, by priming the host immune response, can change the trajectory of symptoms.”

According to Adalja, the most common COVID symptom overall is what providers call “malaise”—which means that you’re just not feeling well.

While fever is the most common non-respiratory symptom of COVID, you can’t safely assume that you do not have the virus just because you’re not running a temperature. If you think that you have COVID or you were recently exposed to someone with it, get tested.

How Long Does a COVID Fever Last?

Adalja said that a fever caused by COVID comes on after malaise and respiratory symptoms, and may last for a few days.

You can end isolation if your symptoms are getting better and you’ve been fever-free for 24 hours without using any fever-reducing medication (like acetaminophen or ibuprofen).

According to Adalja, it’s important to make sure that you have not had a fever for about a day before interacting with others. That’s because a fever may represent a surrogate symptom for ongoing viral replication—which means you could still be contagious.

There’s evidence to back up that idea: A 2021 study found that the elevated temperatures associated with COVID help inhibit viral replication in respiratory tissues.

“Although COVID-19 is primarily a respiratory illness, it is a disease that has systemic manifestations that move beyond the respiratory system,” Adalja said.

The information in this article is current as of the date listed, which means newer information may be available when you read this. For the most recent updates on COVID-19, visit our coronavirus news page.