Doctor diagnoses COVID sans test

Dear Dr. Roach: I’m a 71-year-old male in excellent health, and I don’t take any medications.

Recently, after experiencing mild headaches, mild muscle aches, a runny nose, sneezing, coughing and a sore throat, I went to an urgent care facility near me to find out which of the viruses I had been infected with.

After listening to my lungs and asking me if I had had any fever, difficulty breathing, nausea, or a loss of taste or smell (which I did not), the doctor told me I had COVID.

Knowing that all of the symptoms that I experienced can also be associated with the flu, respiratory syncytial virus (RSV), and colds, I asked him how he can be sure without testing me for it. He responded, “Because it’s the most prevalent, and even if you tested negative, I still think it’s COVID.”

Needless to say, I was surprised to hear him say this and told him that I wanted to take a polymerase chain reaction (PCR) test just to be sure.

Turns out, he was right!

I tested positive for COVID for the first time, even though I was vaccinated for COVID, the flu and RSV. My symptoms only lasted three days.

My question is, was his conclusion an educated guess, or was there something he heard in my lungs that convinced him it was COVID?

Answer:

COVID symptoms are variable, depending on the person, the variant, whether the person is vaccinated, and if (and how recent) they had the disease. There are no specific findings to look for when listening to the lungs, but I would take the doctor at his word.

During times of high prevalence, pretty much everyone you see with respiratory symptoms has COVID. People with a high fever and muscle pains that start suddenly are more likely to have the flu, but there really aren’t findings by a history review or an exam that are definitive.

Finally, your story proves again that the PCR test is more sensitive than at-home tests, but at-home tests can be very specific.

If you have symptoms and the at-home test is positive, you really do have COVID.