COVID-19 Update

Flu, COVID-19, Cold—What’s the Difference?

COVID-19 has many similarities to the flu since they’re both contagious respiratory viruses. But there are key differences as well. It may be difficult for parents to distinguish the symptoms of COVID-19 from that of the flu, common cold, allergies and other illnesses. Here’s what to look for.

When a child starts feeling sick, it’s often a challenge for parents to figure out what it is that their kid has—and how serious it is. Is it a cold or the flu? Or maybe allergies or some other virus?

And now we have COVID-19, too.

The short answer is that it’s not always going to be clear what infection your child has. COVID-19, other respiratory viruses and the flu have many symptoms in common. As the months progress, lessons learned about COVID-19 may help parents figure out what to do when their kids feel sick during the pandemic.

What are the biggest differences between COVID-19 and the flu?

Most children who have the flu experience rapid onset of symptoms and start to feel sick with a fever, cough and runny nose for several days.

In contrast, children with COVID-19 may not have any symptoms or may have a fever for a short period of time, congestion, a cough, and loss of taste and smell.

Girl with the flu blowing nose

COVID-19 is a new respiratory virus, and we’re still learning about it. People with COVID-19 have reported a range of symptoms, and not everyone infected with the virus will have all these symptoms.

Some people with COVID-19 become severely ill, others have mild symptoms and still others show no symptoms at all—but may still transmit the virus without getting sick themselves. Symptoms tend to appear from two to 14 days after exposure to the virus.

What are the most common symptoms of COVID-19?

Symptoms of COVID-19 may include:

  • Cough
  • Brief episodes of fever
  • Shortness of breath
  • Abdominal pain
  • New loss of taste or smell
  • Congestion
  • Fatigue
  • Sore throat
  • Nausea or vomiting
  • Diarrhea
  • Muscle or body aches
  • Headache

The loss of taste or smell seems to be unique to COVID-19; most other illnesses don’t have this symptom. But it’s important to know that plenty of people with COVID-19 never experience loss of taste or smell, so just because your child shares that he can taste and smell doesn’t mean he doesn’t have COVID-19.

What should I do if my child has symptoms that could be either COVID-19 or the flu?

Because any symptom could mean that your child could be infectious with any virus, you should keep your kids at home if they are experiencing any of these symptoms.

“If your child has a temperature or fever, keep him at home,” says Andi Shane, MD, MPH, MSc, System Medical Director, Infectious Diseases at Children’s Healthcare of Atlanta. “Have him remain at home for 24 hours to see if symptoms progress.”

If your child develops a fever or cough, use our COVID-19 Pediatric Assessment Tool, designed to help parents answer two questions:

  1. What should I do if my child has a fever and/or a cough?
  2. What should I do if my child has been around someone with COVID-19 but has no symptoms?

Check Symptoms

What about MIS-C?

Multisystem Inflammatory Syndrome in Children (MIS-C) is a recently described condition, found to rarely develop in some children three to four weeks after contracting COVID-19 or being exposed to someone with COVID-19.

You should contact your child’s doctor or an urgent care clinic right away if your child is showing the following symptoms, which may suggest MIS-C:

  • Fever
  • Abdominal pain
  • Vomiting
  • Diarrhea
  • Neck pain
  • Rash
  • Bloodshot eyes
  • Feeling extra tired

Be aware that not all children will have all the same symptoms.

The seasonal flu (influenza) can cause mild to severe illness, and it can even cause serious complications that lead to death in children. The flu usually comes on very suddenly; your child may feel perfectly fine one day and be very sick the next, unlike COVID-19, which tends to start gradually.

What are the most common symptoms of the flu?

A child with the flu will typically experience:

  • Fever
  • Chills
  • Headache
  • Runny nose
  • Nausea
  • Fatigue
  • Loss of appetite
  • Sore throat

The best news about the flu is that flu shots can protect you and your children from having severe infections or, in some cases, from infection altogether.

Since some flu symptoms are similar to symptoms of COVID-19, preventing a flu infection by getting your annual flu shot could reduce confusion or concerns about possible COVID-19 infection in your family. Remember, it’s never too late to get a flu shot.

“It is very, very important for parents to make sure that they and their children receive their flu vaccines as soon as possible,” Dr. Shane says. “It’s something parents can actively do to protect children and themselves.”

COVID-19 and the flu aren’t the only common respiratory illnesses parents should be on the lookout for. It’s important to know the differences between respiratory syncytial virus (RSV), allergies and the common cold.

What are the symptoms of RSV in kids?

RSV is a viral illness that causes people to have trouble breathing. It mostly affects the very young and is extremely common: Almost all children will have an RSV infection by their second birthday. A child’s first RSV infection is usually the most severe, and children who are born prematurely, with breathing or heart problems are more likely to have complications from an RSV infection.

Symptoms of an RSV infection may include:

  • Runny nose
  • Decreased appetite
  • Coughing
  • Sneezing
  • Fever
  • Wheezing
These symptoms usually appear in stages and not all at once. Kids infected with RSV usually show symptoms within four to six days after getting infected. In very young infants with RSV, the only symptoms may be irritability, decreased activity and breathing difficulties.

What are the most common symptoms of allergies in kids?

  • Runny nose
  • Sniffling
  • Itchy, watery eyes
  • Sneezing

Allergies occur when the body produces an abnormal immune response to something. Allergies can be seasonal or can happen when children come into contact with an allergen, such as something they ate or environmental factors like pollen or dust. Allergies are more likely to occur at certain times of the year (fall and spring) and are more likely to affect older children.

What are the symptoms of the common cold?

Symptoms of a cold usually peak within two to three days and may include:

  • Cough
  • Sore throat
  • Runny or stuffy nose
  • Watery eyes
  • Sneezing

While it may be incredibly hard to tell which of these illnesses your child has, the bottom line during these pandemic times is that if your child is exhibiting any symptoms at all, you should keep him at home. It’s important to try to keep anyone with symptoms physically separate from those who do not have symptoms, encouraging everyone to wash their hands. Those with symptoms should maintain a safe distance of at least 6 feet from people without symptoms at all times. And as your family continues to battle any illness, people with and without symptoms over the age of 2 should wear masks when they cannot be physically distant from each other in the home.

Rest assured we’re here for you if you need us.

At Children’s, safety is our top priority. We are working hard to protect our patients, families and staff. Whether you have an appointment or need to visit us for emergency care, we’ve put extra precautions in place to keep your family safe.

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This content is general information and is not specific medical advice. Always consult with a doctor or healthcare provider if you have any questions or concerns about the health of a child. In case of an urgent concern or emergency, call 911 or go to the nearest emergency department right away. Some physicians and affiliated healthcare professionals on the Children’s Healthcare of Atlanta team are independent providers and are not our employees.