Common Cold vs COVID-19 in Children: Key Differences

Content reviewed against published CDC, AAP, WHO guidelines

Editorial policy

Last reviewed:

Colds and COVID-19 share many symptoms in children, making them difficult to distinguish without testing. Understanding key differences helps parents know when to test and when to seek care.

Key takeaways

  • COVID is more likely to cause GI symptoms (vomiting, diarrhea) than a common cold
  • Loss of taste or smell is a distinguishing feature of COVID (though less common in kids)
  • COVID can rarely lead to MIS-C (multi-system inflammatory syndrome) 2-6 weeks after infection
  • A cold almost never causes significant fatigue; COVID may cause fatigue lasting beyond acute illness

: Cause

Common Cold: Rhinovirus (most common), 200+ viruses

COVID-19: SARS-CoV-2 virus

: Onset

Common Cold: Gradual over 1-2 days

COVID-19: Can be gradual or sudden

: Fever

Common Cold: Usually low-grade or absent

COVID-19: Often higher fever, may persist 3-5 days

: Loss of taste/smell

Common Cold: Rare (only from nasal congestion)

COVID-19: Possible though less common in young children than adults

: GI symptoms

Common Cold: Uncommon

COVID-19: Diarrhea, vomiting, and abdominal pain more common

: Duration

Common Cold: 7-10 days

COVID-19: 5-14 days; some have prolonged fatigue

: Severity in children

Common Cold: Usually mild

COVID-19: Usually mild but can rarely cause MIS-C weeks later

: Diagnosis

Common Cold: Clinical (no testing needed)

COVID-19: Rapid antigen or PCR test

: Isolation needed

Common Cold: No formal isolation (stay home if sick)

COVID-19: Follow current public health guidance for isolation

: Vaccine available

Common Cold: No

COVID-19: Yes (COVID vaccine available for children 6 months+)

When to Worry

  • Difficulty breathing, rapid breathing, or chest pain
  • Persistent high fever (over 104°F/40°C) or fever beyond 5 days
  • New rash, red eyes, swollen hands/feet, or abdominal pain 2-6 weeks after COVID (signs of MIS-C)
  • Inability to keep fluids down or signs of dehydration
  • Child is confused, excessively sleepy, or difficult to wake
  • Any infant under 3 months with fever needs immediate medical evaluation regardless of suspected cause

Frequently asked questions

What is the main difference between Common Cold and COVID-19?
COVID is more likely to cause GI symptoms (vomiting, diarrhea) than a common cold
How can I tell if my baby has Common Cold or COVID-19?
COVID is more likely to cause GI symptoms (vomiting, diarrhea) than a common cold. Loss of taste or smell is a distinguishing feature of COVID (though less common in kids). COVID can rarely lead to MIS-C (multi-system inflammatory syndrome) 2-6 weeks after infection
When should I worry?
Difficulty breathing, rapid breathing, or chest pain. Persistent high fever (over 104°F/40°C) or fever beyond 5 days. New rash, red eyes, swollen hands/feet, or abdominal pain 2-6 weeks after COVID (signs of MIS-C). Inability to keep fluids down or signs of dehydration. Child is confused, excessively sleepy, or difficult to wake. Any infant under 3 months with fever needs immediate medical evaluation regardless of suspected cause

Sources

All content follows our editorial policy and is reviewed against published clinical guidelines.

2,705 evidence-based guides6 authoritative medical sources

Bottom line

Both Common Cold and COVID-19 are common in young children. The key differences in symptoms can help you identify what your child may have, but when in doubt, consult your pediatrician.

Trust your instincts. If something feels wrong, reach out to your pediatrician. Worrying about your baby means you care — that is a good thing.