The Difference Between COVID-19, Cold, Flu and Other Bugs Affecting Kids

COVID 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.” Testing, quarantine and isolation are still very important, especially as more contagious variants of the virus continue to spread.

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, mask up and stay away from others.

If you have been exposed but don’t have symptoms, it is a little more complicated:

• If you’re vaccinated and do not have symptoms: You don’t have to quarantine, but you should get tested 3 to 5 days after the exposure. You should also wear a mask around others for 10 days after the exposure.
• If you have not been vaccinated and you don’t have symptoms: Quarantine and get tested 5 days after the exposure. Be sure you continue to wear your mask around others.

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

Influenza symptoms include:

• 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 during the omicron surge and more people getting the flu vaccine, the number of flu cases in Colorado during the 2021 to 2022 season dipped as omicron peaked. Even so, Children’s Colorado had hospitalized at least 100 children with flu during the season as of late January. Flu season extends through April, so it’s still important to get the flu shot if you and your child haven’t already gotten it, 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 readily available for children, though we're still waiting to learn when kids younger than 5 will be able to get vaccinated against COVID.

“Everyone should get a flu shot every year, but especially during the pandemic, says Dr. Dominguez. Not only does it reduce your chances of getting the flu, but if you do get it, your symptoms will likely be less severe.”

“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.”

Both conditions can be very serious in kids. When we compare the numbers year by year in people younger than 18, it’s clear that COVID-19 has caused more cases, hospitalizations and deaths than the flu does in a typical year. Though COVID-19 has not been as serious in children compared to adults, proportionally speaking, claims that COVID isn’t as serious as the flu in kids are not accurate.

Read what we know about the burden of COVID-19 in children and adolescents. 

Yes. For the past 15 years, flu-related deaths in children reported to CDC during regular flu seasons have ranged from 37 to 199 deaths each year.

During the first two years of the COVID-19 pandemic, more than 1,000 children have died from COVID-19. That averages to more than 500 each year, far more than a bad year of the flu.

This means that COVID-19 has caused more than double the number of annual child deaths compared to the flu.

Common cold symptoms include:

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

It can be difficult to tell the difference between COVID-19 and a cold. The likelihood that it’s the new coronavirus versus another virus greatly depends on what is circulating in your community, which varies. This is another reason getting tested for COVID is important.

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. In very young children, fever may be the only symptom of flu infection. Learn more about how to tell the difference between a cold and the flu.

Call your pediatrician when you notice these symptoms of RSV:

• High fever and ill appearance (though not all children with RSV experience fever)
• Thick nasal discharge
• Worsening cough
• A cough with discolored mucus
• Signs of dehydration
• Trouble breathing
• Unusual irritability or inactivity
• Refusing to nurse or bottle feed

Most kids get RSV before they turn 2, and most recover quickly. In infants, preemies, and babies with lung or heart issues, however, RSV can cause serious complications.

RSV can be particularly dangerous for babies and young children with underlying medical conditions because it can lead to pneumonia and bronchiolitis, when the small airways in the lungs become inflamed and clogged with mucous. Kids and babies with more severe cases of RSV often require a trip to the emergency department or care in the hospital.

RSV can cause re-hospitalization for babies who have been in the neonatal intensive care unit (the NICU) due to prematurity or other medical conditions. Some NICU babies that require oxygen are eligible for an antibody that treats RSV, which the care team would recommend along with other vaccines for babies with medical conditions.

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 pulling 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 ENT 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.

Medical experts 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. A team of our multidisciplinary specialists developed comprehensive guidelines to effectively diagnose and treat children with MIS-C, including dozens who’ve been diagnosed at Children’s Colorado. The guidelines are now nationally recognized and shared with hospitals across the country.