Talk:Symptoms of COVID-19

This article was the subject of a Wiki Education Foundation-supported course assignment, between 10 January 2022 and 22 April 2022. Further details are available on the course page. Student editor(s): JDouglass23 (article contribs).

Symptom image misleading?

Source linked for the symptoms and percentages shown fails verification

The image shown reports symptom percentages that are not supported by the linked source. This can be very misleading and should be removed. For example 83%+ for fever is not supported/contradicted by other sources such as the ECDC that reports 45.4% [1]. Percentages should probably be avoided or corrected with more solid sourcing. -- {{u|Gtoffoletto}}  ^talk 13:02, 29 December 2020 (UTC)

Pinging the author Mikael Häggström (talk · contribs). Could we fix this? Could you remove the percentages or base them on a more solid source? Maybe the [2] EUCDC source reported above could serve as a solid basis. -- {{u|Gtoffoletto}}  ^talk 18:52, 12 January 2021 (UTC)

Given that it's an SVG, it's not too hard to change it ourselves, if we can get up-to-date references on the percentages. John P. Sadowski (NIOSH) (talk) 05:36, 13 January 2021 (UTC)

@John P. Sadowski (NIOSH): I would start by removing the percentages as they are wrong and we can then try to determine a better source. The best I've found so far is the ECDC linked above. I'm not sure how to proceed with the removal on commons as the image is translated in many different languages. I am concerned this image is misleading people dangerously e.g. "I don't have fever so it can't be COVID". The image states 83%-99% have fever but this is false. Less than half do! -- {{u|Gtoffoletto}}  ^talk 11:50, 13 January 2021 (UTC)

Gtoffoletto, I updated the image to not include percentages, as requested. Pretty easy to do in an open source vector image program like Inkscape. Hope it helps. –Novem Linguae (talk) 19:27, 15 January 2021 (UTC)

Novem_Linguae thanks! Will reintroduce into the article. -- {{u|Gtoffoletto}}  ^talk 23:26, 15 January 2021 (UTC)

Is there information on asymptomatic carriers? Jackieneumann (talk) 01:56, 24 February 2021 (UTC)

A request to independent Wikipedia editors to resolve a controversy on an editing supported by reference

Recently me and Gtoffoletto started a discussion at his talk page about a minor editing of the Wikipedia Symptoms of COVID-19 article I performed and the reference to the scientific journal supporting this editing. Gtoffoletto undid my minor editing, while I propose substantial arguments about its appropriateness. Over several rounds of the discussion it become clear we have very opposite points of view on this topic. I think we need the independent judgement to define whether my minor editing should be returned back, and make the current section at this talk page to know the opinion of other Wikipedia editors.

I proposed this editing based on several reasons:

• the importance of the fact that in 5-10% of SARS-CoV2 infected persons the onset of symptoms (i.e. duration of the incubation period) could occur after the 14 days. This has important implications to the public health and individual decision making;
• the manuscript indicating this has been published in the respectable scientific journal "Travel Medicine and Infectious Disease" with the impact factor 4.6;
• the manuscript has been peer-reviewed that guarantee its quality and independent evaluation by other scientists;
• the manuscript represents the findings from six different studies;
• in the emerging field of information about COVID is not always possible to wait many years until more evidence will be summarized in a meta-analysis or a guideline. And sometimes important and reliable information about such emerging topics could be inserted in the Wikipedia based on other publication types listed in the WP:MEDASSESS hierarchy of medical data sources.

Gtoffoletto undid the minor editing I've performed based on this manucript ((particularly this revision) and indicated "source is not WP:MEDRS compliant"), and continue to propose different arguments against it. It seems very strange that in every step of our discussion he propose somewhat different arguments. First he suggested that Wikipedia doesn't use peer-reviewed papers (primary sources) directly but try to only rely on reviews and other secondary or tertiary sources. When I indicated that the manuscript summarises 6 data sources and is not an original study with the primary data analysis, he proposed this reference does not qualify as a strong WP:MEDRS source because it is a letter to the editor. When I indicated that according to the journal information this manuscript has been peer-reviewed and even revised according to the reviewers' suggestions, and the same Wikipedia article contains a dozen of references representing short commentaries in the "News" section of scientific journals (for example the reference 8 with the doi:10.1038/d41586-020-03141-3), he proposed to me to edit the existing Wikipedia article and remove from it other references and data supported by not-meta-analyses and not-guidelines publications.

I have no idea why, but it seems he is trying to apply different rules to the same type of evidence: keep one not-meta-analyses and remove another not-meta-analyses, and he has no discomfort that other not-meta-analyses used as references at this page but persisting each time with new arguments that the not-meta-analysis reference I proposed sould be abandoned. I think it is not appropriate to apply such double-truth logic.

As a summary, taking into account the emerging nature of the topic and the reliable data source from high-impact scientific journal, I believe it is fine to add this important information to the Wikipedia article supported by the given reference. Because Gtoffoletto and me could not achieve agreement, I am asking other Wikipedia editors to define whether my minor editing supported by the reference form the scentific journal should be returned back. Thanks in advance for helping to resolve this issue.Borisbikbov (talk) 21:29, 24 February 2021 (UTC)

It would have been good to be transparent that you appear to be the author of the manuscript you cited. This kind of transparency helps to ensure you don't violate policies on conflicts of interest: WP:COI and WP:MEDCOI. I'd suggest you refrain from directly editing the article page further for this reason.

Addressing WP:MEDRS, you're correct that if this is in fact a peer-reviewed secondary source, that's generally the baseline threshold for inclusion. There are a few other details to consider. One is whether this is indicative of scientific consensus or not. Given that this paper is seeking to update consensus, it should be phrased as such. Although significant-minority views are welcome in Wikipedia, such views must be presented in the context of their acceptance by experts in the field. I think this would be the most likely way to include this currently; presenting the 14-day as the consensus, with this manuscript as the dissenting view. The second, less serious concern, is that half of the studies cited in your manuscript are preprints. A secondary source made of unreviewed secondary sources doesn't make those unreviewed studies acceptable, so your manuscript would be of better use on Wikipedia if it referred only to the reviewed studies. On a quick look at the three peer reviewed sources, I'm not entirely convinced of their veracity (for instance, figure S2 here has a significant range of uncertainty, and the paper itself only uses that to estimate 95% of infected develop symptoms in 14 days). Not necessarily a deal breaker, it's just not clear cut and easy to argue for inclusion as a slam dunk source. Bakkster Man (talk) 22:34, 24 February 2021 (UTC)

Dear Bakkster Man, you are correct that I co-authored this manuscript, I just didn't know that mentioning co-authored manuscripts need some special approach, but have valued first of all its peer-review nature and the confidence of journal with high impact factor. Now the rule is clear, I will not directly editing the article page regarding the findings from this particular reference.

However, I would like to point that there are more evidence on the fact that in substantial number of persons the incubation period could exceed 14-days threshold that is currently widely accepted. If you are interested, I could share these additional references in this talk. But they represent primary analyses and original articles in peer-reviewed journals.

I also would like to point that from February to June 2020 the WHO did not recommend mask usage due to the "lack of evidence", and has changed its position about mask use after the publication of meta-analysis summarizing the publications about mask use effect. Thus, even WHO guidelines could be not perfect. I wonder what would would be your position and the Wikipedia content about mask use from February to June?

The topic of incubation period has much less attention in the research and health policy agenda, even the appropriate management of persons during incubation period is crucial in stopping the pandemic. I think the encyclopaedia should present wide view on the topic, even if there is some controversy between widely accepted approaches and the emerging scientific evidence. Decide you how to proceed. Borisbikbov (talk) 10:35, 25 February 2021 (UTC)

I appreciate your abiding by the COI rules. Please note, I'm not saying your manuscript can't be included (I think it probably should), just that it needs to come with the caveat that it's not the prevailing consensus (yet). Along with my own reading of the reasons why Gtoffoletto might have reasonably disagreed with the quality of the paper as it concerns WP:MEDRS. I'm hoping we'll get more input on this; I don't want the inclusion of the 3 preprints to disqualify an otherwise worthwhile paper, but I think it will probably change how much weight we're able to give the conclusions of your manuscript in this article (5-7.7% over 14 days, not the 9.5% from the preprint for instance). And, as you mention, if more data bears out these findings, the wording in the article will continue to get stronger, up until we get CDC/WHO or another major body adopting the longer timeframe as a standard. Bakkster Man (talk) 15:02, 25 February 2021 (UTC)

I would not be opposed to including this in the article by treating it clearly as a minority view. I only just realised that Borisbikbov opened several discussion in different pages. This is not a great idea if we want to centralise discussion on this topic. It is better to keep the discussion in one single talk page. -- {{u|Gtoffoletto}}  ^talk 15:13, 25 February 2021 (UTC)

Agreed on the preference for a single discussion location, with shorter comments pointing other talk pages there. I added a sentence to the body of the initial symptoms section, rather than in the lede. Please take a look. Bakkster Man (talk) 15:39, 25 February 2021 (UTC)

Tagging Ozzie10aaaa as the other editor with a comment, to concentrate the conversation in one spot. Bakkster Man (talk) 20:44, 25 February 2021 (UTC)

Im glad you called/pinged, as I had just 1.[3] and 2. no it does not meet the "bar" that should be set for this article...lets remember last year it(COVID-19 pandemic and its related articles) were the most read[4](and that may continue as no one really knows if the variants may prolong the pandemic). To be brief please follow WP MEDRS Wikipedia:Identifying_reliable_sources_(medicine), thank you--Ozzie10aaaa (talk) 21:02, 25 February 2021 (UTC)

Thanks for considering all arguments and thank you for the critical evaluation of the manuscript content, I am glad you find the data useful. As for the other references supporting that the incubation period could exceed 14 days, they are the original articles with the primary analysis of data, and their main topic of interest is not the incubation period itself but the comprehensive description of the outbreak in general. For example, the article from Korea (published already after the revision of the manuscript I co-authored) evaluated the outbreak related to the fitness center with 116 confirmed cases and 1,687 traced contacts. Among other findings the authors estimated serial intervals and concluded "The median incubation period is estimated between 4 and 9 days, and the maximum of the estimates of shortest and longest were 20 and 22 days, respectively (Fig. 1)", and if you will look at the Fig. 1 in their article you could see that the proportion of patients with longer than 14 days incubation period is substantial. However, the authors didn't report the exact numbers. There is urgent need to analyze the data about the incubation period, but it is not among the priorities in majority of research groups working with the COVID data. Borisbikbov (talk) 21:22, 25 February 2021 (UTC)

Fever

We state that "Fever is the most common symptom of COVID-19.[2] The fever may be high or low. Most people with COVID-19 develop a fever at some point.[2]" The source is https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7310678 which is based on studies made in April of 2020. It states that We confirm that fever and cough are the most prevalent symptoms of adults infected by SARS-CoV-2. However, there is a large proportion of infected adults which symptoms-alone do not identify. and The most prevalent symptoms were fever (78% [95% CI 75%-81%]; 138 studies, 21,701 patients; I2 94%) however the ECDC source in the article reports a much lower incidence of fever and states that 2 out of 3 identified "clusters of patients" do not develop fever at all. I will edit the article to make it less misleading. -- {{u|Gtoffoletto}}  ^talk 15:28, 25 February 2021 (UTC)

Death listed as a "complication"

Is this a correct use of terminology? · · · Peter Southwood ^(talk): 06:02, 4 March 2021 (UTC)

The second paragraph of the introduction includes this sentence:

These asymptomatic carriers tend not to get tested and can spread the disease.

This has two problems in my view. First, the claim of “tend not to get tested” is not supported in the statement. I believe it is probably true but wouldn’t we want a cite before making a claim like this?

Second, the construction of the sentence suggests that only asymptomatic carriers spread the disease or that they have a higher transmission rate than symptomatic carriers which is not true on its face — it’s only true if the symptomatic carrier takes measures to prevent spread (e.g. quarantining), something that is known to not always occur.

Outdated information

Some of the figures cited in the systemic symptoms section date to research published in June 2020. If I recall correctly most research that early only accounted for Chinese cases, which, if correct, would mean that we are using information on symptoms that is biased towards the Chinese case on the early months. Let's find a more recent reference which accounts for cases in United States, UK, Italy, as well as China. Forich (talk) 04:16, 29 December 2021 (UTC)

Wiki Education assignment: Technical and Scientific Communication

This article was the subject of a Wiki Education Foundation-supported course assignment, between 22 August 2022 and 9 December 2022. Further details are available on the course page. Student editor(s): Mcollins4 (article contribs).

I added more information to the "Longer-term effects" section of this article. I provided a definition for long COVID, long-term symptoms, and potential treatment options.

— Assignment last updated by Mcollins4 (talk) 01:16, 21 September 2022 (UTC)

"Other" section

The structure of this section seems off. It seems to be repeating the same information just spaced out to make the section look longer. A specific example that had weird phrasing is the first sentence. "Other symptoms are less common among people with COVID-19." I feel as though this could combined with the next sentence and it would flow a lot easier. Mcollins4 (talk) 00:22, 5 October 2022 (UTC)

Loss of smell section outdated

The main references used for this subsection are all from 2020. I propose we replace all Aygnes et al (2020) references for more updated reviews. Forich (talk) 14:24, 5 April 2023 (UTC)