Worldwide Comparison of Symptoms and Symptomatic Treatment Recommendations in Mild COVID-19:

Abstract

Background: Coronavirus disease 2019 (COVID-19) has rapidly become a common illness, affecting over 1% of the global population in 2020. Although some patients are severely affected and may have life-threatening complications, most SARS-CoV-2 infections cause mild disease. Yet, symptoms can entail considerable suffering. This is the first worldwide systematic review comparing COVID-19 symptoms and symptomatic treatment recommendations from the literature and health authorities, with a focus on self-care medication in mild disease. Methods: To systematically compare symptoms and symptomatic treatment recommendations in mild COVID-19 from the scientific literature and by health authorities worldwide, we have performed systematic literature searches for COVID-19 and symptoms, limited to mild disease or self-reported symptoms and patients staying home. Web sites of the major national health authorities from Africa, America, Asia, Europe, Middle East, and Oceania were searched for patient recommendations. Results: Symptoms of COVID-19 are multifarious, touching practically all organ systems. Except for the neurological symptoms (e.g. anosmia and ageusia), the most common complaints of mild disease (e.g. fever, cough, rhinitis, sore throat, headache, myalgia, and diarrhea) are amenable to self-care medication. From the health authorities of 30 countries across all global regions, 29 recommendations were reviewed. Practically all the authorities mention fever and cough, while other symptoms, in particular neurological and gastrointestinal manifestations, are not listed consistently. Only four of the 29 institutions provide patients with specific recommendations for symptomatic treatment, whereas two advise explicitly against any symptomatic therapy. Conclusions: More complete and up-to-date descriptions of anticipated COVID-19 symptoms could help direct more patients to testing, isolation, and appropriate care. For most COVID‑19 patients, symptomatic treatments should be the therapeutic mainstay. However, advice from the health authorities on the self-care treatment of COVID-19 symptoms is scarce. This may deprive patients of necessary and effective treatments and turn them toward less reliable sources and potentially harmful remedies.