The Difference Between COVID-19, Cold, Flu and Other Illnesses You May Hear About This Season

Coronavirus testing is one crucial component of preventing the spread of COVID-19. It sometimes takes longer for people to show symptoms of COVID-19, and people can be contagious for longer. Getting a test for you, your child and your family will help you to know as soon as possible if you have COVID-19 — even if you aren’t yet showing symptoms.

“Knowing if you have the virus sooner means you can isolate sooner,” says Dr. Dominguez. “Getting a coronavirus test is one of the best things you can do to help control the spread of the virus.”

If your child is feeling sick, it’s best to call their pediatrician. (Or, if they don't have one, you can call our free ParentSmart Healthline.) They can help assess your child’s symptoms. Remember, the most accurate way to tell the difference between COVID-19 and other viruses is by getting tested. Depending on your child’s symptoms, your primary care provider may suggest testing as the next step.

Anyone with symptoms should get tested as soon as possible and stay away from others.

“If you think you’ve been exposed to COVID-19 but do not yet have symptoms, quarantine and wait at least five days from the date you were exposed before getting tested,” Dr. Dominguez says, “unless you start to develop symptoms before then.”

Children’s Colorado offers coronavirus testing for kids and their parents and caregivers. Learn where and how to get a COVID-19 test.

COVID-19 affects people differently. Coronavirus symptoms range from mild to severe and not everyone will have every symptom. In general, symptoms in kids and teens may include:

• Fever/chills
• Cough
• Shortness of breath or difficulty breathing
• Fatigue
• Muscle or body aches
• Headache
• New loss of taste or smell
• Sore throat
• Runny or stuffy nose
• Nausea or vomiting
• Diarrhea

• Possible fever/chills
• Cough
• Sore throat
• Runny or stuffy nose
• Muscle or body aches
• Headaches
• Tiredness
• Nausea or vomiting
• Diarrhea

Likely due to COVID-19 restrictions and more people getting the flu vaccine, the number of flu cases in the U.S. is currently low compared to this time during a normal year. That could change at any time, though, says Dr. Dominguez.

One symptom that sets COVID-19 apart from the flu or other viruses is loss of taste and smell. But only a small portion of people have that symptom, says Dr. Dominguez, so you can’t rely on that alone.

Another key difference is that the flu vaccine is widely available, whereas the new COVID-19 vaccines are not yet available for children.

“That’s really important for parents to keep in mind,” says Dr. Dominguez. “Everyone should get a flu shot every year, but especially this year. Not only does it reduce your chances of getting the flu, but if you do get it, your symptoms will likely be less severe.”

If fewer people get the flu and their symptoms are less severe, that means there will be more resources available to care for patients with COVID-19.

“We’re also concerned about coinfection, which is when a patient has the flu and COVID-19 at the same time,” says Dr. Dominguez. “We think outcomes may be worse if that happens, and a flu shot can decrease that risk.”

Common cold symptoms include:

• Runny or stuffy nose
• Sneezing
• Sore throat
• Gray, yellow or green nasal discharge
• Cough
• Scratchy voice

A fever is common with COVID-19, but rare if you have a cold. Alternately, sneezing is rare with COVID-19, but common if you have a cold.

A cold is generally milder than the flu, and symptoms appear gradually. Flu symptoms are sudden and severe. With the flu, your child will likely have a high fever, a headache, severe tiredness, achy muscles and chills. For a common cold, they may have a low fever to start, but they won’t have a headache or muscle aches, and they won’t have chills. Learn more about how to tell the difference between a cold and the flu.

Some conditions of the ear, nose and throat are often the result of a respiratory illness like a cold or the flu. Interestingly, during the COVID-19 pandemic, doctors are diagnosing less ear and sinus infections in children than expected.

“We think this might be related to public health measures like social distancing and school closures, which have resulted in less transmission of the bacteria and viruses that commonly cause these infections,” says Children’s Colorado pediatric otolaryngologist Sarah Gitomer, MD.

Ear infections

Ear infections are common, and about 85% of children experience at least one during childhood. Some ear infections can resolve without antibiotics. But Dr. Gitomer says parents should call their child’s primary care provider if they see a combination of the following symptoms:

• Ear pain
• Drainage of fluid from the ear
• Tugging or pull at an ear
• Fussiness or crying more than usual
• Trouble hearing sounds
• Loss of balance
• Headache

When kids have multiple ear infections in a matter of months, it may be time to meet with one of our ear, nose and throat specialists to discuss surgery.

The sinuses are the system of nasal cavities in the skull. These cavities are usually empty, but they can become blocked with fluid and germs when you have a viral infection like a common cold. The blockage causes the tissue along these cavities to become inflamed, and that’s when a sinus infection can occur.

Sinus infection symptoms are similar to a cold but may also include pain and tenderness in the face and a fever. A sinus infection typically resolves on its own with over the counter medications and does not require parents to seek medical care for their child.

“In rare cases, it can progress to a bacterial infection that spreads to areas around the sinuses,” says Dr. Gitomer. “When this happens, symptoms can include a red, puffy or bulging eye; decreased or painful movement of the eye; or vision loss.”

That’s when it’s time to call your primary care provider, she says. Your child will likely need antibiotics and may need to be seen by an otolaryngologist — an ear, nose and throat surgeon.

“A sore throat is a common symptom of the flu and a cold, so there’s always a question of how to tell when it’s something more,” says Dr. Gitomer. “A sore throat with a cough, runny nose or raspy voice, indicates that your child likely has a viral infection, not a bacterial infection like strep throat.”

Strep throat symptoms can include:

• A sore throat that comes on rapidly
• Painful swallowing
• Fever
• Headache
• Swollen tonsils
• Red spots on the roof of the mouth or tonsils
• Swollen lymph nodes in the neck
• White streaks of pus on the tonsils

If your child is experiencing these symptoms, you should call your child’s primary care provider and tell them you suspect your child may have strep throat.

Symptoms of MIS-C can include: 

• Fever 
• Severe abdominal pain 
• Vomiting 
• Diarrhea 
• Rash 
• Red eyes, red lips 
• Trouble breathing
• Seeming confused/sleepy 

If your child is showing these symptoms, you should call your primary care provider. In a life-threatening emergency, you should always call 911.

Doctors suspect a connection between MIS-C and COVID-19, and most experts think that MIS-C is caused by the body’s immune response to having had an infection with SARS-CoV-2. Read what we know about MIS-C and its link to COVID-19.

Much remains unknown about MIS-C, and Children’s Colorado is involved in several national research studies to learn more. Led by Children’s Colorado critical care fellow Christina Osborne, MD, a team of multidisciplinary specialists developed comprehensive guidelines to effectively diagnose and treat children with MIS-C, including dozens who’ve been diagnosed within the last few months at Children’s Colorado. The guidelines are now nationally recognized and shared with hospitals across the country.