By Sfoorti Mishra

New Delhi, Apr 30 (IANS): The initial symptoms of novel coronavirus disease were identified as Influenza like and respiratory problems till now, but recently the Centre for Disease Control and Prevention, the US agency charged with tracking and investigating public health trends, has come up with new symptoms of novel coronavirus.

These new symptoms include symptoms like chills, repeated shaking with chills, headache, muscle pain, loss of taste and smell.

Some experts say the new symptoms have been observed in Indian patients too while others have maintained that no such study in India has been published yet and it requires more evidence and data for this conclusion.

Speaking to IANS, Senior Resident of Infectious Diseases department of All India Institute of Medical Sciences, New Delhi, Dr Soumyadip Chatterji said, "Yes, we are getting patients with these complaints."

Dr Cahtterji explained that people having complaints of loss of smell feel very irritated. "Anosmia is very irritating for patients. Anosmia is loss of smell."

Dr Chatterji, who is currently posted at AIIMS dedicated COVID centre in Jhajjar, Haryana, told IANS that such symptoms in Indian COVID patients were visible since the end of March. "As the number of patients increased here in India, we found these symptoms in Indian patients too. I recently encountered an aged diabetic who was unable to take food as he had loss of taste and smell," said Dr Chatterji.

The doctor said that Chills, muscle pains were known symptoms from early Chinese reports too. Anosmia cropped up in reports towards the end of March and early April. There were reports from the United States of patients having what looks like frostbite or is called COVID toe these days. However in India the thickness of blood has been noticed in many patients.

Talking about painful sores or 'COVID toe' symptoms, Dr Cahtterji said that he did not come across any such patient as of now at the COVID centre he is currently posted at. "I have not seen any symptom like this yet, but I have read in reports about it," said Dr Chatterji, adding "Skin rashes in viral infections are not new. They are common and this particular manifestation has not yet been proven to be covid manifestation but its association has been noticed."

The reason behind this symptom, Dr Chatterji said, may be due to vessel inflammation as a part of immunological response or due to micro clots. However he said nothing is clear yet. "We have to keep in mind that micro clots are menace in COVID and thus we use anti-clotting drugs. But cause of this awaits confirmation," he said.

He also said in any kind of viral infections, skin lesions may range from reddish patches called Erythematous maculopapular lesions to Petechiae, meaning bleeding spots to over clots in skin or even this kind of what these days is called 'COVID toe' on internet.

"However I would like to call it another skin manifestation during a viral disease."

Another doctor, Dr Bisakh Bhattacharya, a Senior Resident of Infectious Diseases Department at the AIIMS, currently posted at National cancer institute (NCI) Jhajjar which is a dedicated COVID centre of AIIMS, told IANS that if these atypical symptoms are shown in the patients and the person is from any containment zone, he needs to be tested for COVID-19 too.

Dr Bisakh said, "many patients come with the complaint of severe headache and sometimes they do not show typical symptoms of COVID like cold and cough. Even if a patient is complaining these symptoms sans typical symptoms of the novel coronavirus and he is coming from hotspot areas, that person needs to be tested for COVID-19."

He also added that however it was too early to reach to that conclusion as the knowledge about this disease is very dynamic and adding new aspects frequently. "We need more data to make such decisions and there is not any advisory from the government regarding it," said Dr Bisakh.

Another doctor, Dr Gaurav Gupta of medicine department at the AIIMS in Delhi said, "COVID-19 is a viral illness and the symptoms can range from very mild to severe. These are very similar to other respiratory illnesses, such as influenza. Some people may have only a few symptoms, and some people may have no symptoms at all. People who are older or who have existing chronic medical conditions, such as heart disease, lung disease, diabetes, severe obesity, chronic kidney or liver disease, or who have compromised immune systems may not present with classical symptoms."

Talking about the new symptoms of coronavirus, Dr Gupta said, "In India, no such study has been published regarding this as of now. However, to suspect, we add these symptoms to the list with classical symptoms such as fever, sore throat and cough. Patients of older age group may have atypical symptoms."