Is it RSV or COVID-19?

Symptoms of respiratory syncytial virus are similar to COVID, making it hard to tell the difference.

Maija Kappler 4 minute read August 24, 2021
RSV covid

Rates of RSV cases, which present in similar ways to COVID, are increasing. GETTY

It’s an understatement to say that most people’s approaches to their own health have changed drastically over the last year and a half. In the pandemic era, what used to be commonplace now has the potential to be completely terrifying.

For instance: a sneeze.

Because COVID-19 can present in ways similar to a cold or flu, the prospect of a tickle in our throat or a runny nose can be genuinely frightening. But there are many other potential causes: colds are now back in a big way, and there’s another viral infection for us to worry about: respiratory syncytial virus, or RSV.

What is RSV?
RSV is a very common infection of the lungs and respiratory tract that causes cold-like symptoms. It’s so prevalent that the Mayo Clinic says most children have been infected with RSV by the time they’re two years old. Much like the common cold, symptoms include a runny nose, dry cough, sore throat, mild fever, appetite loss, sneezing, and headache. In most cases, it’s not serious, and will subside after a few days.

Occasionally, though, RSV can have severe outcomes — especially in babies and very young children. Some of the symptoms of RSV in infants include struggling to breathe, shallow and rapid breathing, cough, irritability, lethargy, and trouble with feeding. RSV usually isn’t very serious for healthy babies, but it can be worrying for babies who were born very prematurely, or who have heart or lung conditions.

And in rare cases, it can be serious in older kids and adults as well. If the infection spreads to the lower respiratory tract, it can sometimes cause pneumonia or bronchiolitis.

Why are RSV levels spiking right now?
It’s likely similar to the reason so many people are getting summer colds — most of us didn’t consistently see people or go anywhere between March 2020 until this summer, so our immune systems are out of practice. Now that we’re being more social again, colds and other minor infections have more of an opportunity to spread.

For most adults, it’s only a little annoying. But it’s much more serious for infants. Over the last year and a half, young children who would normally be exposed to RSV — including babies born since the pandemic started — may not have successfully become immune to the virus in the way they normally would. That means hospitals could potentially face resourcing issues if many children become infected, a group of experts wrote in a letter published in the Canadian Medical Association Journal in July — especially because the virus has more severe outcomes in young children than adults.

How can I tell the difference between RSV and COVID-19?
It’s hard to tell for sure, and it’s likely that someone presenting with cold symptoms will be tested for COVID.

While the two infections share many symptoms — fatigue, fever, shortness of breath, dry cough — some are unique to each. A kid with cold-like symptoms who also has loss of appetite and irritability is more likely to have RSV. Vomiting, diarrhea, and a rash, meanwhile, may occur with COVID, but not with RSV.

COVID symptoms are usually more severe than RSV symptoms, especially in adults, the Mayo Clinic says.

Is it possible to have both RSV and COVID-19 at the same time?
It seems unfair, but the answer is yes — if you were exposed to both viruses, you can contract both infections at the same time.

“It’s not so common, but it’s definitely not impossible,” Dr. Daniel Ganjian, a pediatrician at Providence Saint John’s Health Center in Santa Monica, California, told Health. If that happens, RSV may make a COVID infection more severe.

How can I protect myself?
Another similarity between the two viruses is that they spread the same way. The good news is that taking a lot of the same precautions will help you ward off both COVID and RSV: wash your hands regularly and thoroughly, wear a mask if you’re indoors without good ventilation, avoid sharing food and drinks with other people. And if you think you’re sick, see a doctor.