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Concerned mother looking at daughter as she blows her nose.

COVID-19, Flu, or a Cold?

By Dr. Peter Grosso, Nansemond Pediatrics

A child’s cough, sniffle, or sore throat can trigger warning signals in any parent’s head:

COVID-19? Flu? Allergies? A simple cold?

Wintertime is the prime season for viruses, because people gather inside to keep warm. If you think your child is sick with a virus like COVID-19 or the flu, it’s important that they stay home to keep from spreading the virus to others.

Some children can recover just fine at home with rest, lots of fluids, and over-the-counter pain or fever reducers. As a parent, trust your instinct as to whether you need to seek medical care for your child. If you are uncertain, call your pediatrician for advice as to whether to treat your child at home, have a telehealth or in-person doctor’s visit, or seek immediate care.

Call 911 if your child is struggling to breathe, is too out of breath to talk or walk, turns blue, or has fainted.

COVID-19 or the flu?

According to the American Academy of Pediatrics, the flu and COVID-19 share many similar symptoms:

  • Fever or feeling feverish/having chills.
  • Cough.
  • Shortness of breath or difficulty breathing.
  • Fatigue (tiredness).
  • Sore throat.
  • Runny or stuffy nose.
  • Muscle pain or body aches.
  • Headache.
  • Vomiting and diarrhea.

Loss of taste and smell is more common with COVID-19 than the flu.

How viruses spread

Flu and COVID-19 are spread similarly. They’re transmitted by small particles that come from the nose and mouth when kids sneeze, cough, sing, or talk, raising the possibility of infecting those nearby. Infected people may not have symptoms, but can still pass along the virus.

Another similarity is that both viruses can be spread before your child starts feeling symptoms.

Someone with flu usually experiences symptoms one to four days after being infected. A person with COVID-19 typically shows symptoms two to 14 days after exposure.

Most children who have the flu experience a rapid onset of symptoms and start to feel sick with a fever, cough, and runny nose for several days. Children with COVID-19 may not have any symptoms or may have a fever for a short period of time accompanied by congestion, a cough, and fatigue.

Other viruses and conditions


Colds are also caused by viruses. Your child may have a runny nose, cough, congestion, and sore throat, but they won’t usually have the aches and fever that are common with COVID-19 and flu. Often, your child will feel better in a couple of days.

Respiratory syncytial virus (RSV)

RSV is a viral illness that can cause breathing trouble. It most often 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 or have breathing or heart problems are more likely to have complications from RSV. 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. Children with RSV usually show symptoms within four to six days after being infected. In very young infants with RSV, the only symptoms may be irritability, poor feeding, decreased activity, and breathing difficulties.


Allergies occur when the body produces an abnormal immune response to something in the environment or something that is consumed. Allergies can be seasonal or can occur when children encounter 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, usually fall and spring, and are less likely to affect babies and toddlers.

Symptoms of allergies may include:

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

Multisystem inflammatory syndrome in children (MIS-C)

Multisystem inflammatory syndrome in children, or MIS-C, is a rare, but serious condition associated with COVID-19. Several weeks after children are exposed to or infected with COVID-19, they experience symptoms of inflammation affecting different body systems including the lungs, heart, brain, kidneys, blood vessels, skin, eyes, and gastrointestinal system. This condition requires immediate medical attention.

Here are some of symptoms of MIS-C:

  • Stomach pain.
  • Diarrhea.
  • Dizziness or light-headedness.
  • Skin rash.
  • Vomiting.
  • Bloodshot eyes.

When to seek emergency care:

  • Prolonged fever.
  • Pain or pressure in the chest that does not go away.
  • New confusion.
  • Inability to wake or stay awake.
  • Bluish lips or face.
  • Severe abdominal pain.
  • Refusal to eat and drink.


Many of the same precautions to protect against COVID-19 work for other viruses as well:

  • Masking.
  • Maintaining social distance.
  • Washing hands frequently.
  • Staying home when sick.
  • Getting your children vaccinated to protect them from the flu and COVID-19. Kids 6 months of age and older should get the flu vaccine. Children who are 5 years and older should get a COVID-19 vaccine, and kids 12 and older should also get a booster dose.

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About CHKD Medical Group

About CHKD Medical  Group Children’s Hospital of The King’s Daughters has been the region’s most trusted name in pediatric care for more than 50 years. As members of CHKD Health System, our pediatricians work closely with CHKD’s full range of pediatric specialists and surgeons. They also share a commitment to quality, excellence and child-centered care. With 18 practices in 29 locations throughout the region, a CHKD pediatrician is never far.