COVID-19 vs. Flu vs. Cold

Reviewed on 3/30/2020

What are the differences and similarities between the common cold, flu, and COVID-19 (2019 novel coronavirus)?

It's easy to confuse the symptoms of the common cold and flu with the symptoms of a COVID-19 infection.
It's easy to confuse the symptoms of the common cold and flu with the symptoms of a COVID-19 infection.

The following article is designed to answer the following question. "What are the differences and similarities between the common cold, flu, and COVID-19?" The table below summarizes the similar and different signs and symptoms of the common cold, flu, and COVID-19.

Cold vs. Flu vs. COVID-19 Symptoms
Signs and Symptoms Cold Flu (Influenza) COVID-19 (Wuhan Coronavirus)
Fever Mild if present Often Often
Fatigue, Tiredness Occasional, mild Common Occasional
Sneezing Common Infrequent Infrequent
Body Aches Common Common Occasional
Headache Very infrequent Common Occasional
Sore Throat Common Occasional Occasional
Stuffy or Runny Nose Common Occasional Infrequent
Diarrhea No Occasional Infrequent
Watery eyes Common Common Infrequent
Cough Mild Dry cough A dry cough, often severe
Shortness of Breath No Rare With mild/moderate infection
Difficulty Breathing* No In severe infections* Common in severe infections*
*Needs oxygen or ventilator

Although the table covers the signs and symptoms of these three conditions, it does not clearly prioritize the similarities and differences that medical professionals mainly use to differentiate or diagnose them. Consequently, the following will summarize the main features of each disease and actual and/or proposed treatment.

Colds

Flu (influenza)

  • Influenza (commonly termed the flu) is a viral infection of the upper respiratory and/or lower respiratory system.
  • Influenza viruses cause the flu. These viruses usually cause more serious symptoms in the respiratory system than cold-causing viruses.
  • The flu is contagious, can spread from person to person, and has an incubation period of about 1-4 days.
    • The flu's duration varies from about 5 days to 2 weeks depending upon the severity of the infection.
  • The flu can become an intense and potentially fatal illness (pneumonia) in some individuals.
  • Hallmarks of the flu include
    • mild to high fever,
    • moderate to severe headache,
    • cough,
    • fatigue, and
    • body aches/pains.
  • Severe flu may have symptoms that develop rapidly and require supportive care.
  • Doctors diagnose the flu based on clinical symptoms and by readily available lab tests.

COVID-19 (2019 novel coronavirus)

  • COVID-19 (also termed the Wuhan coronavirus, 2019 novel coronavirus, 2019-nCoV, and others) is a single-stranded, positive-sense RNA coronavirus.
  • It is a new strain of coronavirus (the term corona means crown) responsible for causing a pandemic of serious respiratory problems that started in Wuhan, China. Researchers believe it originated from infected animals and jumped over to infecting people in a large open seafood/animal market. Also, it has been able to spread from person to person and is rapidly spreading worldwide.
  • It is related to the SARS and MERS coronaviruses.
  • It has an incubation period ranging from 2-14 days.
    • Person-to-person spread may happen even if the infected person has no symptoms during the incubation period.
    • Infected people may also not be aware they have the virus and may not show symptoms.
  • The main symptoms of COVID-19 are
    • fever (usually high),
    • moderate to severe coughing, and
    • shortness of breath.
  • Other symptoms and signs may include
  • At first, it seemed to target people over 60 years old and have severe underlying health conditions like heart disease, lung disease, and diabetes, but recent data from Italy suggests that people 20-60 years of age may get the disease at about the same rate.
  • About 80% recover without specific treatment, while about 20% may require some respiratory support (oxygen and/or ventilator support).

Treatments for COVID-19, flu, and the common cold

Colds: Doctors recommend rest, fluids, and over-the-counter (OTC) medications like ibuprofen (Advil) and acetaminophen (Tylenol). No vaccine is available for the common cold.

Flu: Early treatment with an antiviral drug like oseltamivir (Tamiflu), rest, fluids, and acetaminophen and respiratory support can help if flu symptoms become severe. Vaccines are available to reduce symptoms or prevent the flu.

COVID-19: Medical professionals recommend rest, fluids, acetaminophen, and respiratory support if COVID-19 symptoms become severe. Antiviral drug and vaccine research is very active but none are currently available.

Antibiotics are not indicated for these three viral diseases. However, they may be useful if secondary bacterial infections.

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References
United States. Centers for Disease Control and Prevention (CDC). "Coronavirus (COVID-19)." Mar. 19, 2020. <https://www.cdc.gov/coronavirus/2019-ncov/index.html>.

United States. Centers for Disease Control and Prevention (CDC). "Influenza (Flu)." Mar. 13, 2020. <https://www.cdc.gov/flu/index.htm>.

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