Kathmandu, May 7: By now, people are very familiar with the three main symptoms of the coronavirus – cough, difficulty in breathing and fever. These are the symptoms suggested by the World Health Organisation (WHO) and these are the symptoms that the countries and health facilities around the world are using as identifying criteria to determine the need for testing and/or placing individuals in isolation. But on April 18, the US’s Center for Disease Control and Prevention (CDC) expanded its list of symptoms of COVID-19 and changed its website to include six new health signs as possible indicators of the disease. These include chills, repeated shaking with chills, muscle pain, headache, sore throat and loss of smell or taste. The CDC’s move echoes the observations made by healthcare professionals all over the world. While coronavirus primarily causes respiratory distress, other symptoms that accompany the infection vary widely, doctors and researchers have reported. With the number of positive cases increasing exponentially worldwide, medical workers are seeing patients experience nasal congestion, runny nose and loose motion, symptoms not previously associated with this illness. The WHO has also taken account of these reports and has posted on its website that some patients may have aches and pains, congestion, sore throat or diarrhoea which usually begin gradually and are mild in nature. With more than 99 confirmed coronavirus cases, and the number rising day by day, how should Nepal perceive the addition of new symptoms by America’s federal public health agency? According to Dr Anup Bastola, consultant tropical medicine physician at Sukraraj Tropical and Infectious Disease Hospital, there is no need to be alarmed. “Cough, difficulty in breathing and fever remain the three principal symptoms with the lungs being the primary organ affected by the virus,” explained Dr Bastola, adding that the additional symptoms were only experienced by some patients. “These are patient-specific symptoms that people experience based on their infection level, immune system, age, etc,” he said. He stressed that various symptoms would appear in varying degrees in various people based on their health situation and said that most cases around the world appeared to be asymptomatic or mild as shown by studies conducted in China and Europe. He also urged everyone to not be side-tracked from the need of the hour, which is, adopt proper safety measures to prevent coronavirus infection. “We should stay updated on new information related to the current pandemic, but it is important that we are not distracted by it,” he said, adding, “Our main focus should be on taking precautions to avoid getting infected in the first place.” Meanwhile, though not officially listing them as symptoms, the CDC has asked people to seek immediate medical attention should they experience sudden confusion, lack of alertness or if their lips or face turn bluish, calling them warning signs of COVID-19.