Does Your Child Have a Cold or COVID-19?

Common colds can share some symptoms with COVID-19, including sore throat, runny nose, and fever. Here's how to tell the difference in children.

Symptoms like fatigue, fever, and runny nose are unpleasant at the best of times. But since the start of the coronavirus pandemic, these symptoms have caused a lot more worry. Are you wondering, "Does my child have a cold or COVID-19?" Keep reading to learn how to tell the difference.

Does My Child Have a Common Cold?

Children get colds when a virus (such as a rhinovirus) enters the body through the mouth, nose, or eyes. Symptoms appear within a few days, and the virus will replicate until your immune system or medication fights it off. Symptoms of a common cold in children can include:

  • Stuffy nose or congestion
  • Runny nose
  • Cough
  • Sore throat
  • Sneezing
  • Low-grade fever
  • Muscle aches
  • Minor headache

Does My Child Have COVID-19?

Like the common cold, COVID-19 is a respiratory illness that spreads when a person who is infected talks, coughs, sneezes, or breathes. Airborne transmission is also possible. Symptoms generally appear within two to 14 days of exposure to the virus, according to the Centers for Disease Control and Prevention (CDC), and they include:

  • Fever
  • Cough
  • Breathing difficulties
  • Muscle aches
  • Runny nose or congestion
  • Sore throat
  • Headache
  • Fatigue
  • Loss of taste or smell
  • Gastrointestinal issues (like abdominal pain, nausea, vomiting, or diarrhea)

Many of these symptoms overlap with colds and the flu, the CDC acknowledges. This is particularly true for children, who are more likely to have mild or asymptomatic cases of COVID-19, and who get colds frequently.

It's also important to note that infection with the coronavirus presents differently for everyone. Some children have no symptoms whatsoever, others have mild illnesses that resemble colds or the flu, and some experience serious complications that result in hospitalization or death (though this remains rare).

Father helping his son blow his nose

Halfpoint Images/Moment/Getty Images

How to Differentiate Between Colds and COVID-19

"It can be difficult to tell the difference between COVID-19 and the common cold in children," says Zachary Hoy, M.D., pediatric infectious disease specialist at Nashville Pediatric Infectious Disease. "If you think your child has symptoms that could be related to COVID-19, they should be evaluated by their pediatrician and possibly get COVID-19 testing."

Indeed, the CDC states that the best way to differentiate between COVID-19 and the flu (as well as other viral illnesses like colds) is to get tested. A PCR test is a highly sensitive test used for identifying the presence of the coronavirus in a person's respiratory tract. A nasal swab is processed and analyzed for the presence of viral DNA, which can be detected in very low amounts. This test must be processed by a lab, using specialized equipment, and the turnaround time can vary from several hours to several days, depending on local testing capacity.

You can also take an antigen test (also referred to as a "rapid test"), which can be used at "point of care" locations, in a doctor's office, or at home. Antigen tests are less sensitive than PCR tests, so they might not return a positive result if the person has very low levels of the virus. But they're also less likely to return a "false positive" result (meaning the person isn't actually infected), and they can still identify infectious people who could transmit COVID-19 to others. Michael Mina, M.D., Ph.D., an associate professor of epidemiology at the Harvard T.H. Chan School of Public Health, has described how antigen tests can be useful in making sure people don't isolate when they don't need to.

That said, don't rule out the possibility that your child could have a common cold and COVID-19 simultaneously. "It's common to have co-infections with COVID-19," says Dr. Hoy. "We have seen a lot of other common cold viruses—rhinovirus, enterovirus, and respiratory syncytial virus (RSV)—with children that are positive with COVID-19. Sometimes it can be difficult to tell which symptoms are from COVID-19 and which are from other co-infections," which is why testing is so important.

Should My Child Go to School With Symptoms?

If your child tests positive for COVID-19 and is showing symptoms, the CDC recommends keeping them home and isolating them from healthy family members as best you can for five full days. Complete isolation from family members can be tricky—and it's near impossible for families with young children who require active care. To help prevent healthy family members from getting sick, experts recommend adults and children over 2 years old wear a well-fitting mask when around each other during the isolation period.

If after five full days, your child's symptoms are improving and they are fever-free for at least 24 hours (without the use of fever-reducing medication like acetaminophen), you can end isolation.

Beyond the CDC's recommendations, many schools or workplaces have encouraged, or even required, people to stay home if they have any symptoms of COVID-19, which often overlap with symptoms of a common cold. Some school districts require a negative test result to return to school instead of waiting for a set period after symptoms resolve. Check with your local school district or child care provider to see whether a PCR test is required or if an antigen test will be accepted. Antigen tests, like the BinaxNOW by Abbott, are available over the counter.

Also take care to monitor your child's symptoms, as they can also stem from other illnesses like RSV. "It's possible other respiratory infection tests or a chest X-ray may be done at the same time if symptoms are more severe," says Dr. Hoy.

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