Covid-19 Timeline: How Long It Lasts & What Symptoms To Expect

A coronavirus strain called Severe Acute Respiratory Syndrome Coronavirus 2, or SARS-CoV-2, is behind the Covid-19 pandemic. The virus first emerged in Wuhan, China, in late 2019 and quickly spread across the world.

Over the intervening two years, tremendous research has gone into understanding how the virus works and what symptoms to expect once infected. However, multiple mutations have given rise to new variants, with the latest, Omicron, having symptoms that differ from previous variants.

Nevertheless, the Covid-19 infection timeline has remained the same, making it possible to get a test, track symptoms, understand each stage of the timeline, and determine whether to seek treatment.

Covid-19 infection, symptoms, and recovery timeline

Anyone can get Covid-19. As a flu-like virus, transmission occurs when the virus jumps from one person to another through saliva, mucus, or airborne droplets. When an infected individual sneezes, coughs, or touches high-touch surfaces after sneezing or coughing into their hands, other people may be exposed to the virus and can easily catch it.

Although initial strains of the virus were not as highly transmissible as current variants, they spread faster because few people understood how it was circulating or how to slow down the spread (or flatten the curve). The current variant, Omicron, is highly transmissible even among people who wear masks and are vaccinated, making it one of the fastest-spreading variants currently identified.

Within the Covid-19 infection timeline, symptoms might appear earlier for Omicron infections while they might be delayed for Delta variants. Keep in mind that the Covid-19 timeline does not always follow the same path, with some people getting severely ill within a few days and others remaining asymptomatic (with no symptoms) for the duration of the illness.

The best way to protect yourself and your loved ones if exposed is to get an early test and seek medical care if your symptoms become progressively worse.

Exposure – Day T-5

Exposure to the Covid-19 virus can happen in multiple ways. Since anyone recently infected is a carrier capable of infecting others, any contact with such individuals constitutes exposure and can lead to infection.

Even if an individual has no symptoms, it is possible that their infection might not have kicked in yet or they are recovering, which still does not rule out the possibility that they can infect others. If you suspect you have been exposed, the best course of action is to get a Covid-19 test as soon as possible. In some cases, you might contract the virus and then expose others unknowingly.

From a symptomatic perspective, there are usually no immediate symptoms immediately after exposure, so it is impossible to tell whether you have been infected or not without getting a test. The scientific reason behind this is that the virus needs time to multiply before your body even notices it or mounts an immune response. This incubation period can take anything from a day to a week.

Infection – Day 1-5

If infected, you are now in the incubation period, which can last for between a day and 14 days. During incubation, the virus enters healthy cells and uses cell resources to ‘manufacture’ or replicate new copies of itself. Since this happens within the cell, the immune response remains unaware of the infection.

After each replication cycle, these new copies exit the infected cell, latch onto nearby healthy cells, and continue the replication process. This process happens exponentially, with the virus able to manufacture tens of millions of copies of itself within hours. Once the rate of viral replication reaches high enough levels, the body starts to take notice and engages the immune system to investigate the infection.

By this point, some people will develop rapidly escalating symptoms. Still, most people will experience few if any symptoms, although they can still infect others because the viral load has risen significantly.

Early symptoms – Day 5 to 14

Covid-19 early symptoms start to take hold once the body releases cytokines as part of the immune response.

According to the CDC, some of the symptoms that may occur at this early stage include:

• Fever of 100.5 F (38 C) or higher
• Dry cough
• Fatigue
• Muscle or body aches
• Headache
• New loss of taste or smell
• Sore throat
• Congestion or runny nose
• Nausea or vomiting
• Diarrhea

The CDC notes that this is not an exhaustive list of symptoms and that not everyone will experience the same set of symptoms from the list.

As such, symptom prevalence rates will vary across the population, as one study found:

If you have been infected, by the end of week two (14 days) at most, you will experience some of these symptoms, although they might not be as severe and might signal the peak of the infection for most people.

However, another level of illness can occur for others, which might require hospitalization.

Severe symptoms and hospitalization – Day 14 to 21

According to the CDC, older adults and people with severe underlying medical conditions like heart or lung disease or diabetes seem to be at higher risk of developing more serious complications from Covid-19 illness.

In most instances, the primary signs that indicate the illness is getting worse include:

• Shortness of breath or difficulty breathing
• Severe pneumonia
• A significant drop in blood oxygen levels

At this point, symptoms are severe enough to warrant hospitalization but not yet severe enough to require supplemental oxygen.
Therapeutic management of hospitalized adults depends on the severity of illness and the body’s ongoing response to the virus, as the chart below from the UK’s NHS website indicates.

Many hospitalized cases recover during hospitalization and are discharged as soon as oxygen levels rise and stabilize. However, for others, the body continues to succumb to the effects of the virus without any signs of recovery, warranting the need for intubation and supplemental oxygen.

Critical illness and possible death – Day 21 to 60

After hospitalization, much now depends on how the body responds to treatment, whether the immune system is strong enough to combat the infection, and the extent of damage caused by the virus to various body organs like the brain, lungs, kidneys, and heart. During this period, which can last up to sixty days, the lungs are the most affected because of severe pulmonary disease.

Due to inflammation and accumulation of fluid in the lung’s structures, lung oxygen absorption capacity plummets, leading to the following symptoms, considered end-stage Covid-19 symptoms:

• Shortness of breath
• Agitation and delirium (confusion)
• Hypoxia (low blood oxygen levels)

If the lungs become severely damaged, it becomes impossible to maintain normal breathing functions without supplemental oxygen. While it is possible to keep an individual on a respirator, in most cases, this loss of lung function cascades into other issues like heart and other organ failures, resulting in death.

Full recovery and contagiousness – Day 14 onwards

If your infection did not escalate to severe illness, you skipped the severe and critical illness stages and are now well on your way to recovery. For most people, complete recovery occurs from day fourteen onwards post-infection, with all symptoms resolving and regular health returning.

Inside your body, viral levels have fallen precipitously, and your immune system is now hunting down any stragglers as it mops up the infection. During this time, it is crucial to maintain Covid-19 anti-spread protocols like masking up when around others and maintaining social distancing in closed spaces.

According to the CDC’s isolation guidelines, mild-to-moderate Covid-19 remains contagious up to ten days after symptom onset, while severe-to-critical Covid-19 can remain contagious for up to twenty days.

Reinfection and breakthrough infections

After full recovery, it is still possible to get reinfected with the Covid-19 virus in the same way people get reinfected with the flu. In most cases, the reinfection is usually mild and disappears after a few days.

However, the new Omicron variant poses a threat to people who caught and recovered from previous variants. Data from South Africa, where the Omicron variant is believed to have emerged, indicates that the variant is mutated enough to slip past the body’s defense systems and cause reinfection.

Similarly, these mutations are causing what the CDC is calling breakthrough infections, where people who are vaccinated get reinfected with the Omicron variant and develop clinically significant symptoms. Scientists are still studying the effects of Omicron and its infection timeline, so it is still too early to say whether it will conform to previous variant timelines or follow a different one.

Long Covid: long-term Covid-19 symptoms and effects

While full recovery occurs after a few weeks for most people, for a small number, symptoms can persist for months in what is now known as long Covid.

In such cases, people report experiencing a combination of the following long-Covid symptoms:

• Difficulty breathing or shortness of breath
• Tiredness or fatigue
• Symptoms that get worse after physical or mental activities (AKA post-exertional malaise)
• Difficulty thinking or concentrating (AKA “brain fog”)
• Cough
• Chest or stomach pain
• Headache
• Fast-beating or pounding heart (AKA heart palpitations)
• Joint or muscle pain
• Pins-and-needles feeling
• Diarrhea
• Sleep problems
• Fever
• Dizziness on standing (lightheadedness)
• Rash
• Mood changes
• Change in smell or taste
• Changes in menstrual period cycles

Besides these symptoms, long Covid is also linked to multi-organ effects on brain, heart, kidney, lung, and skin function. There have even been reports of people’s vision changing while others develop diabetes after getting Covid-19. As scientists continue to investigate the effects of long-Covid, one of the things they are seeking to uncover is whether these symptoms persist for years.

Meanwhile, doctors recommend self-care as the best way to manage long Covid, including reducing stress, eating healthy and balanced meals, getting plenty of quality sleep, and avoiding alcohol and drugs.

Covid-19 symptoms for different age and gender groups

Another area of significance in understanding the Covid-19 symptom timeline is age and gender. In one comprehensive study conducted in the UK with the ZOE Covid Symptom Study app, scientists determined that age and gender impact what symptoms emerge first.

For example, the machine-learning-driven results discovered that loss of smell was a more critical infection indicator in younger people than in people over sixty. Concomitantly, men were more likely to report shortness of breath, chills, shivers, and fatigue, while women reported a loss of smell, persistent cough, and chest pain.

These findings are clinically significant because they offer a means of customizing Covid-19 early detection and treatment while presenting a window into how it affects different age and gender groups.

How different Covid-19 variant symptoms progress

Covid-19 variants have been a critical component of understanding infection and transmission rates worldwide. As the virus mutates, its structural components evolve to evade the immune system, making it harder to form resilient immunity, even with vaccines. A consequence of these mutations is a change in the symptoms that appear first, plus how long they take. For example, Delta was a ‘slow cook’ variant that showed symptoms after several days.

On the other hand, Omicron is exhibiting a faster infection rate while its symptoms are less severe and shorter-lived than those of its predecessor.

These factors indicate one of two things:

• The virus will continue to mutate to a less dangerous but easily transmissible variant (like the flu), OR
• Mutate into a more dangerous variant that evades the immune system and causes serious illness.

When to contact a doctor

The most important thing you can do if you suspect that you have Covid is to get a Covid-19 test. If the test results confirm the infection, stay calm and monitor your symptoms while following CDC guidelines on self-isolation and self-care.

However, the CDC also advises that you should contact your doctor, urgent care center, or the nearest ER immediately if you experience any of the following symptoms:

• Persistent pain or pressure in the chest
• Trouble breathing
• New confusion
• Inability to wake or stay awake
• Pale, gray, or blue-colored skin, lips, or nail beds, depending on skin tone

These symptoms are likely to indicate that you are developing severe Covid-19 symptoms that can be life-threatening if left untreated.

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