COVID or just a cold? Pediatric nurse explains how to tell what illness your child has

Fall and winter mark the peak season for common respiratory infections such as COVID-19; respiratory syncytial virus or RSV; Influenza, better known as the flu; and the common cold. These illnesses often start with symptoms that look very similar, so telling them apart can be tricky – especially when the start of cold and flu season in the fall can be the tail end of summer seasonal allergies.

So if your child comes with symptoms such as cough, runny nose or sore throat, should you keep them at home?

As a primary care pediatric nurse, I help families make informed decisions about this issue and other aspects of their child’s health.

Sending your child to school when they are sick can prolong recovery and spread the illness to classmates and school staff. And all of these common infections can have serious consequences for some members of the school community – or their families – who have underlying health conditions that increase the risk of complications.

Parsing symptoms of common bugs

Finding out if your child has COVID-19, the flu, RSV, or the common cold is important because some of these illnesses can cause serious complications in certain children.

COVID-19 has a higher risk of severe or long-term health effects. The others are not harmless though. The flu can cause significant illness and hospitalization, and RSV can be especially serious for infants, young children, and those with chronic health conditions.

All four of these diseases spread easily. Keeping children at home when they are sick helps reduce this spread, protecting vulnerable children and school staff.

Colds are caused by various viruses – that’s why they are so common. Common cold symptoms include coughing, sneezing, sore throat and a runny nose. These symptoms are generally mild and usually improve on their own within about 7-10 days.

COVID-19, on the other hand, is caused by a single virus called “severe acute respiratory syndrome coronavirus 2, or SARS-CoV-2.

The symptoms of COVID-19 tend to last longer – 7-14 days, with some lasting for three to four weeks. In addition to common cold symptoms such as cough, sore throat and runny nose, people sick with COVID-19 often have body aches, shortness of breath and breathing difficulties, headache, fatigue, fever and loss of taste and / or smell.

Probably the biggest sign of COVID-19 is abdominal symptoms such as abdominal pain, vomiting and diarrhea. Not all children experience these symptoms, but they are not associated with the common cold.

The symptoms of the flu, caused by the influenza A or B virus, tend to appear very quickly, unlike the gradual onset of a cold or COVID-19. Symptoms last about 3-7 days, and are very similar to those of COVID-19 – except they do not include loss of taste or smell.

RSV symptoms align with those of a cold, but include a decreased appetite. RSV also affects the lungs and can lead to serious lung infections and hospitalization, especially for infants and toddlers. The symptoms may last three to four weeks.

Ann Sheehan is Assistant Dean for Practice, Innovation and Professional Education and Associate Professor of Nursing, Michigan State University. This article is released from The Conversation under a Creative Commons license. Read the original article.

Go to school or stay at home?

If your child has symptoms that could be one of these viruses, it’s a good idea to keep them home from school. It helps protect other children and school staff from getting sick.

A general rule of thumb for making the call is to consider whether your child can comfortably participate in classroom activities. If the answer is yes, then it is probably good to send them to school. But if they have had a fever in the last 24 hours, or diarrhea, nausea or vomiting, it is best that they stay home and rest.

The American Academy of Pediatrics notes that children with certain medical conditions, including obesity and diabetes, immune system deficiencies and complex medical conditions, are more likely to become seriously ill if they contract COVID-19, RSV or the flu.

Should my child have a COVID-19 test?

Finding out whether your child has COVID-19 from symptoms alone is often impossible. A home COVID-19 test can be a useful tool if you suspect Covid-19 – for example, if your child has some of the symptoms or has been exposed to someone with COVID-19 – or if your child has a chronic medical condition that puts them at high risk of complications.

A positive result is reliable, but a negative result does not completely rule out a COVID-19 infection. This could be because you made a mistake when following the test instructions, or because there is not enough virus present to make the test positive.

If the test is negative and symptoms persist, the Centers for Disease Control and Prevention recommend retesting within 48 hours or ordering a PCR test from your healthcare provider.

What about vaccines?

The American Academy of Pediatrics recommends vaccines for COVID-19 and the flu for all children over the age of 6 months, unless a child has a medical reason not to get it. A study published in December 2025 supports this recommendation.

The American Academy of Pediatrics and the CDC also recommend vaccinating infants against RSV based on certain criteria.

It is important to know that children can still be infected with these viruses after receiving the shot. However, when a child is vaccinated, their immune system recognizes the virus and responds more effectively.

Not only does the vaccine reduce your child’s risk of becoming seriously ill and being hospitalized if they get one of these viruses, but it also reduces the number of school days your child is likely to miss if they catch the virus.

When to seek health care

Regardless of which respiratory infection your child has, symptoms can usually be managed at home. There is no need to seek medical care for any cough and runny nose, even if their COVID-19 test is positive. Most children recover from these viruses without complications.

However, some symptoms may indicate a more serious illness and should not be ignored. You know your child best – if their fever does not go down with medication, they have difficulty eating and drinking, or if they have difficulty breathing, seek medical care.