Symptoms of COVID-19 during the early days of infection differ between age groups and also between men and women, new research has found.

The study, which has been published in The Lancet Digital Health journal, was put together by researchers at King’s College in London, using data from the ZOE COVID Symptom Study app.

They examined 18 symptoms, including loss of smell, chest pain, a persistent cough, abdominal pain and blisters on the feet.

In people aged over 60, loss of smell was not significant and it was not at all relevant in people over 80, they found. But these older age groups were more likely to suffer diarrhoea.

For individuals aged 40 to 59, a persistent cough had a higher relevance to detect COVID-19 and chills or shivers had a lower relevance to detect the virus compared with individuals 80 years or older.

Chest pain, unusual muscle pain, shortness of breath, and loss of smell were the most relevant features for people aged 60 to 70.

Like 60 to 70-year-olds, those aged 80 and older were found to have chest pain and unusual muscle pain among their most relevant symptoms but also diarrhoea, sore throat, eye soreness, and chills or shivers.

Fever, while a known symptom of disease, was not an early feature of the virus in any age group.

Men were most likely to report shortness of breath, fatigue, chills and fever.

Women were more likely to report loss of smell, chest pain and a persistent cough.

For people aged 16 to 39, loss of smell, chest pain, abdominal pain, shortness of breath, and eye soreness were the most relevant symptoms during the initial three days of self-reporting.

The data was collected between April and October last year.

Lead author and reader at King’s College London, Claire Steves, said: “It’s important people know the earliest symptoms are wide-ranging and may look different for each member of a family or household.

“Testing guidance could be updated to enable cases to be picked up earlier, especially in the face of new variants which are highly transmissible. This could include using widely available lateral flow tests for people with any of these non-core symptoms.”

Dr Marc Modat, who is a senior lecturer at King’s College London, said the study’s findings suggest the “criteria to encourage people to get tested should be personalised using individuals’ information such as age” or a “larger set of symptoms could be considered, so the different manifestations of the disease across different groups are taken into account.”

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