Even Doctors Struggle To Tell A Cold And COVID Apart, But There Are Some Signs To Watch

·4 min read

We’re going into another cold and flu season during the COVID-19 pandemic, creating a trifecta of viral illnesses no one wants to deal with. Not to mention, there's a lot of confusion over cold versus COVID symptoms. Pre-pandemic, it was easy to brush off symptoms like a runny nose, cough, and congestion as just the common cold. But now, those symptoms can send anyone into a panic spiral of worrying that they have COVID-19.

Real talk? “There are no easy ways to tell the difference,” says Lewis Nelson, MD, the chair of emergency medicine at Rutgers New Jersey Medical School. Each illness can have its own range of severity, he points out, leaving a lot of gray area.

A common cold and COVID-19 share some symptoms, but there are differences in other symptoms, and their impact on you. Here's how to tell them apart—and when you need to see a doctor.

What’s the difference between the common cold and COVID-19?

You probably have this memorized by now, but it never hurts to go over it again: COVID-19 is a disease caused by the respiratory virus SARS-CoV-2, according to the CDC. The virus is thought to mainly spread through respiratory droplets that are produced when an infected person coughs, sneezes, or talks.

The common cold can actually be caused by many different viruses, the CDC says. These include rhinoviruses, respiratory syncytial virus, adenoviruses, and coronaviruses—excluding SARS-CoV-2, of course. The viruses that cause colds can also spread from infected people to others through the air and close personal contact.

But how serious these infections are can be very different. “COVID, if unvaccinated, can lead to hospitalization or worse,” Dr. Nelson says. “Clearly COVID is readily spread, and it can lead to more severe disease, primarily in the lungs at first.”

“The best way to think about cold viruses is that they’re pretty harmless,” adds Timothy Murphy, MD, senior associate dean for clinical and translational research at the University at Buffalo Jacobs School of Medicine and Biomedical Sciences. “We all get the common cold, sometimes several times a year. People get through colds just fine as opposed to COVID-19, which can cause a systemic illness and be far more dangerous.”

What are the common symptoms of a cold and COVID-19?

Common symptoms of a cold can include the following, according to the CDC:

  • Runny nose

  • Sore throat

  • Coughing

  • Sneezing

  • Headaches

  • Body aches

The CDC lists these as the most common symptoms of COVID-19:

  • Fever or chills

  • Cough

  • Shortness of breath or difficulty breathing

  • Fatigue

  • Muscle or body aches

  • Headache

  • New loss of taste or smell

  • Sore throat

  • Congestion or runny nose

  • Nausea or vomiting

  • Diarrhea

So, how can you tell if you have a cold or COVID-19?

Dr. Murphy says it’s hard for even doctors to know just from examining you and hearing about your symptoms if you have a cold or COVID-19. There is one symptom, though, that makes it more likely that you have COVID-19: losing your sense of taste and smell.

“Though that does occur sometimes with colds, it’s far more likely with COVID,” he says. “With colds, you would typically get really stuffy first before you lost your sense of smell. With COVID, many people just lose their sense of smell altogether.”

Still, plenty of people have COVID-19 and never lose their sense of taste and smell. Given that we’re still living through a global pandemic and COVID-19 is practically everywhere, Dr. Murphy says it’s important to at least consider that you could have the virus if you develop even mild symptoms.

Dr. Nelson agrees. “Anyone with viral illness symptoms, particularly if they’re not COVID vaccinated, should wear a mask and take a COVID test,” he says.

Who should get tested for COVID-19?

You should also take a test even if you’re fully vaccinated, Dr. Murphy says, given that breakthrough infections can happen. “It’s wise to do COVID testing now when people have respiratory symptoms,” he says.

That could mean using an at-home COVID-19 rapid antigen test or talking to your doctor about getting a PCR test, which is considered the gold standard of COVID-19 testing. At-home COVID tests aren’t 100 percent accurate, but they’re usually good at picking up infections if you have symptoms, Dr. Murphy says.

If you get a negative result, but your symptoms get worse or you develop a fever, Dr. Murphy recommends testing again or calling your doctor about next steps.

How should you treat a cold and COVID-19?

If you test positive for COVID-19, it’s important to isolate yourself from the public and other members of your household to lower the risk you’ll spread the virus to other people, per the CDC. If you’re just feeling a little lousy, Dr. Nelson recommends taking acetaminophen for fever and staying hydrated.

The rules are the same for a cold, he says. “Rest may help in terms of fighting off both viruses,” Dr. Murphy says.

But if you have COVID-19 and you develop more serious symptoms, like having trouble breathing, feeling disoriented, or developing bluish lips, see a doctor ASAP.

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