The Difference Between a Sinus Infection and a Cold

If left untreated, however, sinusitis can cause permanent damage to the sinuses and, in very rare cases, can lead to meningitis, Dr. Marshall said. If patients miss work or other activities due to sinus infections, or if their symptoms recur frequently, they should see a healthcare provider for evaluation.

Sinus Infection vs. COVID-19

Emily is a health communication consultant, writer, and editor at EVR Creative, specializing in public health research and health promotion.

Updated on February 02, 2023

John Carew, MD, is board-certified in otolaryngology-head and neck surgery. He is an adjunct assistant professor at Mount Sinai Medical Center and NYU Medical Center.

Table of Contents
Table of Contents

The overlap in symptoms between COVID-19 and sinus infections (sinusitis) make it difficult to tell the two apart. Congestion, headache, fever, sore throat, and cough are some examples of symptoms that the two share.

The problem isn’t a shortage of people wanting to be doctors, but rather, too few opportunities for training. Medical schools have increased class sizes by 30% since 2002, but federal funding for residency training – an essential step in the process of becoming a practicing physician – has not increased since 1997, according to Inside Higher Ed.

Despite their overlap, there are some notable differences between sinus infections and COVID-19 as well. Aside from what causes them, this includes another battery of more unique symptoms. A lost of smell or taste is a pretty clear indication its COVID-19, for instance.

This article explains how to tell the difference between a a sinus infection and COVID-19. It also details treatment options for both, why a proper diagnosis is important, and when to see your healthcare provider.

Symptoms of Sinus Infection vs. COVID-19

During the pandemic, the general public has become more aware of COVID-19 symptoms. While you may experience a fever, headache, and cough if you have COVID, you can also have these and other respiratory symptoms if you have another infection or condition.

Some symptoms are more common in one condition than the other. For example, shortness of breath and difficulty breathing are more likely with COVID-19, while facial pain is more specific to a sinus infection.

The lists of symptoms below are just a starting point and do not include all possible symptoms of COVID-19 or a sinus infection. If you develop any respiratory symptoms and they do not seem to be getting better, it’s important to see your doctor.

Additionally, if you have any symptoms which are in any way associated with COVID-19, you should follow the Centers for Disease Control and Prevention (CDC) guidelines regarding testing and quarantining and contact your healthcare provider.

Sinus Infection Symptoms

A sinus infection (sinusitis) occurs when the lining of your sinuses becomes inflamed. This leads to mucus buildup. Two main symptoms of sinus infections include congestion and pain or pressure in your face, nose, or ears.

A sinus infection can have a range of other symptoms as well, though they mostly involve the respiratory system.

Possible signs and symptoms of a sinus infection include:

• Runny nose or cold symptoms that last longer than seven to 10 days
• Drainage down your throat from your nose
• Headaches
• Facial pain (pain or pressure in your cheeks, nose, ears, and forehead, or between your eyes)
• Cough
• Fever
• Bad breath
• Sore throat
• Swelling around the eyes (may get worse in the morning)

COVID-19 Symptoms

The signs and symptoms of COVID-19 often involve the respiratory system, but they can also occur in other parts of the body.

While there is a range of COVID symptoms, some of the most common include:

• Fever or chills
• Cough
• Shortness of breath or difficulty breathing
• Fatigue
• Headache
• Muscle or body aches
• New loss of taste or smell
• Congestion or runny nose
• Sore throat
• Nausea or vomiting
• Diarrhea

Several symptoms of COVID overlap with those of a sinus infection, which means you will not be able to be sure of which condition you have by how you feel alone.

If you have respiratory symptoms, it’s best to talk to your doctor. They can run tests to determine whether or not you have COVID, a sinus infection, or another condition.

Causes

While COVID and sinus infections share some symptoms, they are caused by completely different things.

Sinus Infection

The cause of a sinus infection is inflammation of the sinuses. Sinus infections most often occur after a cold or an allergy flare-up or in relation to a nasal condition.

For example, the virus that causes the common cold attacks the lining of your sinuses and causes them to swell up. As more mucus is produced, buildup occurs and provides a place for bacteria to grow, which leads to infection.

COVID-19

COVID-19 is caused by the SARS-CoV-2 virus, a type of coronavirus. The virus spreads from person to person and can cause mild to severe illness. The best way to protect yourself from COVID is to get vaccinated and practice protective measures like wearing a face mask, social distancing, and washing your hands.

Diagnosis

If you have respiratory symptoms, your doctor can use several tests to find out what is causing them—for example, if you have a sinus infection, COVID, or another condition.

Sinus Infection Diagnosis

A sinus infection is diagnosed based on your symptoms and an examination of your nose and face. Your doctor might check your mucus or do an imaging test to confirm the diagnosis.

COVID-19 Diagnosis

COVID-19 can only be diagnosed through a test that specifically looks for the SARS-CoV-2 virus in your body. The diagnosis cannot be made just by asking you about your symptoms or by doing an exam because the symptoms can also be caused by other conditions. Additionally, some people who have COVID do not have any symptoms.

Several types of COVID tests are available. Your doctor will decide which is appropriate based on factors like your symptoms and whether you know you were exposed to someone with the virus.

You might be able to get an over-the-counter test at your local pharmacy or have a test performed at a local health clinic or pharmacy that is sent off to a lab. You will be notified of your result, which will be either positive (you have COVID) or negative (you do not have COVID).

If you test negative but still have symptoms or were exposed, your doctor might want you to be tested again in a few days.

Treatment

The treatments for a sinus infection and COVID are very different. An accurate diagnosis from a healthcare professional is required to ensure that you get the appropriate treatment.

Sinus Infection Treatment

There are several ways to treat a sinus infection. The appropriate treatment for you will depend on what is causing the infection.

For example, if you have a sinus infection that is caused by allergies, your doctor may prescribe an allergy medicine.

Some common sinus infection treatments include:

• Saline nasal spray
• Nasal irrigation (e.g., neti pot)
• Decongestant medicines
• Over-the-counter pain relievers (to relieve aches and fever)
• Allergy medication (if allergies are a cause)

Antibiotics

According to the CDC, antibiotics are usually not needed for viral sinus infections.

Your doctor might take a “watchful waiting” approach to see if your immune system can fight the infection. They might also choose “delayed prescribing,” where they prescribe an antibiotic for you but suggest that you wait a few days before taking it to see if the infection clears up on its own.

Doctors try not to prescribe antibiotics unless they are definitely necessary because the over-prescription of antibiotics contributes to the rise of bacteria that is resistant to these drugs.

COVID-19 Treatment

Treatments include a combinations of medications that are approved to treat COVID-19 and new drugs that have emergency-use authorizations to use for COVID-19, and ones that COVID-19 is an off-label use.

As of February 2023, the Food and Drug Administration (FDA) had approved two drugs to treat COVID-19:

• Veklury (remdesivir), an antiviral drug, for adults and children
• Olumiant (baricitinib), and immune modulator, for certain hospitalized adults

The FDA has granted emergency-use authorizations to a handful of medications that have not yet completed the formal FDA-approval process. These include:

• Paxlovid (nirmatrelvir and ritonavir) and Lagevrio (molnupiravir), oral antiviral medications for people with mild-to-moderate COVID-19 cases and are at high risk of developing severe COVID-19, including hospitalization and death

The best way to treat COVID-19 depends on how sick a person is. For example, if someone has a mild case, they can generally treat their symptoms at home. People with severe COVID illness usually need to be in the hospital, and some end up needing to be in the intensive care unit (ICU).

Another factor in appropriate treatment is a person’s risk factors for severe disease. If they have mild to moderate illness and can stay home, but they have certain medical comorbidities, an antiviral treatment may be offered.

Ways that you can deal with a mild COVID infection at home include:

• Taking medication (ibuprofen or acetaminophen) to reduce fever
• Resting
• Staying hydrated (drinking plenty of water or receiving intravenous fluids, if necessary)

If you are hospitalized with COVID, you might be given:

• Antiviral medications
• Medications to treat complications (e.g., blood thinners to treat blood clots)
• Treatments to reduce an overactive immune response and/or support the body’s immune function

Prevention

There are certain things you can do to prevent sinus infections and protect yourself from the COVID-19 virus. Some steps that you can take will help reduce your risk of either condition, but each also has specific precautions that will help lower your risk.

Preventing Sinus Infection

A sinus infection often follows a viral infection, such as a cold or the flu. Therefore, preventing a sinus infection often means trying to avoid the illnesses that usually precede it.

For example, make sure you wash your hands often and try not to touch your face, nose, or eyes during cold/flu season. It’s also important to avoid being around people who are sick.

Getting a flu shot will help protect you from the flu virus, which can cause inflammation in your sinuses and lead to a sinus infection.

If you have allergies, figuring out your triggers and trying to avoid them will help prevent a flare-up of symptoms that could lead to a sinus infection.

Preventing COVID-19

COVID-19 is a viral infection, which means that many of the same steps that you would take to protect yourself from a cold or the flu (such as washing your hands and avoiding people who are sick) can help lower your risk of getting the virus.

There are also other precautions that you should take not just to protect yourself from COVID but to help ensure that you do not spread the virus to other people.

COVID precautions include:

• Get vaccinated
• Wear a mask in indoor public settings
• Maintain social distance (six feet apart) between you and people who do not live with you
• Avoid crowds and indoor spaces with poor ventilation
• Wash your hands properly and often
• Clean and disinfect high-touch surfaces in your home and/or workplace daily

Summary

COVID-19 and sinus infections both involve the respiratory system. The two conditions can have symptoms that overlap, but some symptoms are more likely to occur in one and not the other.

Sinus infections and COVID are not caused by the same things. COVID is caused by the SARS-CoV-2 virus. A sinus infection can happen after a viral illness but can also be caused by allergies.

The treatments for each condition are also different, which is why it’s important to see a doctor and get an accurate diagnosis. You might need antibiotics for a sinus infection that does not get better on its own with home remedies or over-the-counter medications.

If you have a mild case of COVID, you might be able to rest at home and avoid other people until you recover. However, if you develop severe illness, you may need to receive medical care in the hospital.

A Word From Verywell

If you have respiratory symptoms, you might fear that you have COVID. While it’s possible that you have the virus, your symptoms could also be caused by another condition, such as a cold or a sinus infection.

The only way to know for sure is to see your doctor. They can talk to you about your symptoms, screen you for COVID risk factors, perform diagnostic tests to determine what is making you sick, and make sure that you get the appropriate treatment.

Frequently Asked Questions

What’s the main difference between sinus infection and COVID-19?

The main difference between COVID and a sinus infection is what causes them. A sinus infection is caused by inflammation of the sinuses and often follows a cold or allergy flare-up. COVID-19 is only caused by the SARS-CoV-2 virus.

How can you tell if you have a sinus infection or COVID-19?

You cannot tell if you have COVID or a sinus infection just based on your symptoms alone, especially because so many overlap. While you can take an at-home COVID-19 test, these are not 100% accurate. The only way to know what you have for sure is to see a healthcare provider.

Are you contagious before COVID-19 symptoms appear?
Yes. In general, people are contagious for two to three days before COVID-19 symptoms start.
How long are you most contagious after a COVID-19 infection?

COVID-19 is most contagious in the 48 hours before symptoms start and the first five days of symptoms. Asymptomatic cases of COVID-19 are considered contagious for five days after a positive test.

The information in this article is current as of the date listed, which means newer information may be available when you read this. For the most recent updates on COVID-19, visit our coronavirus news page.

Verywell Health uses only high-quality sources, including peer-reviewed studies, to support the facts within our articles. Read our editorial process to learn more about how we fact-check and keep our content accurate, reliable, and trustworthy.

1. Johns Hopkins Medicine. Sinusitis.
2. Centers for Disease Control and Prevention. Symptoms of COVID-19.
3. American Academy of Family Physicians. Sinusitis.
4. Centers for Disease Control and Prevention. Sinus infection (sinusitis).
5. U.S. Food & Drug Administration. Know your treatment options for COVID-19.
6. Centers for Disease Control and Prevention. Treatments your healthcare provider might recommend if you are sick.
7. Centers for Disease Control and Prevention. How to protect yourself & others.
8. Centers for Disease Control and Prevention. COVID-19 quarantine and isolation.

By Emily Brown, MPH
Emily is a health communication consultant, writer, and editor at EVR Creative, specializing in public health research and health promotion. With a scientific background and a passion for creative writing, her work illustrates the value of evidence-based information and creativity in advancing public health.

The Difference Between a Sinus Infection and a Cold

Tammy Worth is a freelance healthcare reporter with over 20 years of experience. Her work appears across several publications including The Economist, Bloomberg, Health, Leader’s Edge, WebMD, and KCPT, Kansas City’s public television station.

Updated on November 16, 2022
Medically reviewed by

Jennifer Pollard Ruiz, MD, is a family medicine physician and experienced medical writer. She has practiced primary care for more than 20 years in the public, private, and government sectors.

Symptoms like stuffy nose, headache, and sore throat may sound a lot like your run-of-the-mill cold, but they could also be acute bacterial sinusitis, a type of sinus infection. But the two conditions—the common cold and sinus infections—have similar enough symptoms that they’re often confused.

So how do you tell if you have a cold versus a sinus infection? Unfortunately, it’s not a clear-cut answer. “The distinction can be difficult and no one rule applies to everybody,” said Neil Bhattacharyya, MD, a professor of otolaryngology at Harvard Medical School. “Only about 2% to 6% of common colds progress to become a true bacterial sinus infection that could benefit from antibiotics,” said Dr. Bhattacharyya. Here’s what you need to know about both types of illnesses.

Defining Sinus Infection and the Common Cold

Each year, about 31 million people experience sinus infections—also called sinusitis—which is usually caused by germs growing in the sinuses, the hollow cavities found behind the nose, eyes, brows, and cheekbones.

Most often, viruses cause sinus infections, but bacterial infections can cause sinusitis too. Bacterial or viral infection causes mucous membranes in the sinuses to swell and block the tiny openings into the sinuses, which interferes with their ability to drain. The trapped mucus allows bacteria to breed, causing pain and pressure in the head and face.

Colds are mild viral upper respiratory infections, and they are not caused by a buildup of germs and inflammation in the sinuses. However, a cold can lead to a sinus infection.

Antibiotics can be helpful for those with bacterial sinus infections, but these medications are useless when it comes to fighting cold viruses or viral sinus infections.

Symptoms

While some symptoms of a cold and a sinus infection may be similar—stuffy nose, sore throat, and cough—there are some differences.

The color of your nasal discharge can clue you in about whether you have a cold or sinusitis. Unlike colds, which generally produce clear mucus, bacterial infections can produce green or yellow mucus. However, viruses sometimes produce colorful discharge as well, so this isn’t considered a fail-safe test.

Cold Symptoms

The main difference between the symptoms of a cold and sinus infection is how long they linger. Dr. Bhattacharyya said cold sufferers typically have a runny nose for two to three days, followed by a stuffy nose for two to three days. Most people will recover in 7–10 days from their symptoms.

The following symptoms are common with colds:

• Sneezing
• Stuffy nose
• Runny nose
• Sore throat
• Coughing

Sinus Infection Symptoms

Alternately, sinus infections usually last longer than a common cold and may hang around for 3–8 weeks. A fever may also signal a bacterial infection. Sinus infections are sometimes accompanied by a low-grade fever, while colds typically are not. Other viral infections (such as the flu) do cause fevers, however.

Here are some other symptoms of sinus infections:

• Runny nose
• Stuffy nose
• Facial pain/pressure
• Headache
• Mucus dripping down the throat (post-nasal drip)
• Sore throat
• Cough
• Bad breath

Dr. Bhattacharyya said there is no rhyme or reason as to why some people tend to develop sinus infections and others don’t.

Treatment

For most people, there are some preventive measures that can help stave off a sinus infection, or, if one occurs, help relieve symptoms, said William Marshall, MD, an infectious disease specialist previously on staff at the Mayo Clinic. Dr. Marshall recommended the same things “mothers recommend for a cold,” like rest, drinking lots of fluids, breathing steam, and irrigating the sinuses with saline spray or a neti pot, a container used to rinse the sinuses with saline solution.

Over-the-counter decongestants can also be helpful, but Dr. Marshall said they should not be used for more than three days because some products can exacerbate congestion and raise patients’ blood pressure and heart rate.

Bacterial sinus infections can last for up to 8 weeks, but the use of antibiotics speeds up the recovery process. Still, according to Dr. Bhattacharyya, about 70% of sinus infections resolve on their own, and many patients prefer to let them run their course.

“Antibiotics mainly help to speed up the healing process,” Dr. Bhattacharyya said. “But before antibiotics were around, people weren’t dropping dead of sinus infections—and they still aren’t,” Dr. Bhattacharyya explained.

If left untreated, however, sinusitis can cause permanent damage to the sinuses and, in very rare cases, can lead to meningitis, Dr. Marshall said. If patients miss work or other activities due to sinus infections, or if their symptoms recur frequently, they should see a healthcare provider for evaluation.

A Quick Review

While colds and sinus infections may have similarities, they also have differences. Both illnesses can cause sore throat, stuffy nose, and cough. But as far as treatment, you can treat a sinus infection with antibiotics but antibiotics will not treat the common cold. Both illnesses can benefit from rest and drinking plenty of fluids. If you have any questions regarding how to treat your symptoms, always seek advice from your healthcare provider.

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