Coronavirus and RSV

Written by Stephanie Watson, Kendall K. Morgan
Medically Reviewed by Zilpah Sheikh, MD on March 31, 2025
11 min read

Coronavirus and respiratory syncytial virus (RSV) are two kinds of respiratory viruses that can infect you and have similar symptoms. It can be hard to tell the difference between infections caused by coronavirus, RSV, the common cold, and the flu. Coronavirus and RSV are common causes of respiratory illness in the fall and winter, but you can get them any time of year. Learn more about similarities and differences in symptoms, prevention, and other key aspects between RSV and coronavirus.

Coronaviruses are a group of common viruses that can infect the respiratory tract of people and animals. The newest one to make people sick causes COVID-19, also known as severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2).

The first record of illness linked to SARS-CoV-2 was in China in December 2019. In March 2020, the World Health Organization (WHO) declared the spread of SARS-CoV-2 and COVID a pandemic after thousands of cases in 114 countries and more than 4,000 deaths. Now, SARS-CoV-2 circulates along with other common respiratory viruses, including RSV.

The virus that causes COVID isn't the first or only coronavirus to infect people. In fact, SARS-CoV-2 got its name because it's closely related to the coronavirus that causes SARS. The SARS outbreak happened in 2003. Another coronavirus called MERS-CoV also infects people, causing a condition known as Middle East respiratory syndrome. There's a chance that another coronavirus will jump from other animals into people, leading to illness, outbreaks, or another pandemic.

RSV was first discovered in 1956. It belongs to a different group of viruses called pneumoviruses. Estimates show RSV infects 33 million kids under 5 each year.

RSV vs. COVID

COVID spreads through particles and droplets when an infected person breathes them out and another person breathes them in. Sometimes, it can spread even when a person has no symptoms. Many people with COVID have mild or no symptoms. It can infect people of all ages, but it can make some people very sick. You're more likely to get very sick with COVID when you:

  • Are older
  • Have a weakened immune system
  • Have a disability or another health condition

Some people who get COVID develop a condition called long COVID. Long COVID can cause a wide range of symptoms that last long after infection with SARS-CoV-2 ends. You're more likely to get long COVID after having COVID when you:

  • Are a woman or were assigned female at birth
  • Are Hispanic or Latinx
  • Had more severe COVID
  • Have other health conditions
  • Are 65 or older
  • Aren't vaccinated against COVID

From the beginning of the pandemic in 2020 to November 2024, more than 770 million cases of COVID had been confirmed, with more than 7 million deaths.

RSV can also affect people of all ages, but it's especially common in infants and young children. By age 2, nearly every child will have been infected. Most cases are mild. But some children are more likely to get seriously ill, including:

  • Infants aged 6 months or younger
  • Babies who were born early (premature babies)
  • Children under 2 with chronic lung or heart disease
  • Children with a weak immune system
  • Children who have trouble swallowing

Each year, RSV sends more than 57,000 children to the hospital.

When adults and older children catch RSV, they usually have milder symptoms that are similar to those of a cold. But RSV can be serious for some, including:

  • People over 65
  • Those with a weakened immune system
  • Those with heart or lung diseases

RSV doesn't usually come with long-term symptoms. But it may worsen conditions such as asthma or chronic obstructive pulmonary disease (COPD). It also might affect your chances of having a lung condition later in life. About 60,000-120,000 older adults are hospitalized due to RSV each year in the U.S., and 6,000-10,000 of them die.

RSV spreads the same way as COVID. Someone who's infected coughs or sneezes, releasing droplets containing the virus into the air. You can get sick if the droplets land on you, or if you touch a surface with the virus on it and then put your fingers in your nose, mouth, or eyes.

Both COVID and RSV can cause these symptoms:

  • Runny nose
  • Fever
  • Cough
  • Fever

Children with COVID often have mild symptoms. People of any age can have COVID with no noticeable symptoms. Adults with COVID may have shortness of breath. Their symptoms can range from mild to life-threatening.

Symptoms of COVID also may include:

  • Loss of taste of smell
  • Tiredness or fatigue
  • Stomach upset
  • Diarrhea
  • Headache and other aches and pains
  • Chills
  • Sore throat

Along with cold-like symptoms, RSV may cause:

  • Appetite loss
  • Sneezing
  • Trouble breathing (shortness of breath or wheezing)
  • Crankiness (in young children)

RSV can also lead to more serious problems, such as:

  • Bronchiolitis, which causes swelling in the small airways (bronchioles) in your lungs
  • Pneumonia, a lung infection

"With RSV, there can definitely be a lot more cough and respiratory distress symptoms, especially in babies and younger kids," says Gina Robinson, MD, a pediatrician at Cleveland Clinic Children's in Cleveland, OH. "So there may be wheezing. Sometimes there's a dip in oxygen levels that requires support. There's definitely more of that cough and respiratory component in RSV compared to COVID."

The SARS-CoV-2 coronavirus and its variants can be very contagious if you don't have immunity against them. Although the disease is usually milder in children, they face about the same risk of catching it as adults. Kids can also spread it to others.

Some children may have a serious illness from the coronavirus. Adults are more likely to get seriously sick from COVID starting in their 50s and if they have conditions such as:

  • Heart disease
  • Lung disease
  • Diabetes
  • A weak immune system

But even young adults are at risk of getting seriously ill from COVID. One study found that one-fifth of those aged 25-40 were sick enough to go to a hospital. Long COVID is also a concern in people who've had COVID, even if it was mild.

RSV is especially dangerous for young babies. But now there are maternal vaccines and antibodies to help protect babies from RSV early in life. Infants and children are at more risk when they:

  • Were born prematurely
  • Have chronic or congenital heart or lung conditions
  • Have weak immune systems
  • Have severe cystic fibrosis
  • Have a neuromuscular disorder that affects the ability to clear mucus

RSV poses a higher risk for older adults, especially if they:

  • Are 75 or older
  • Have chronic heart or lung disease
  • Have a weak immune system
  • Have other underlying conditions
  • Are elderly or frail
  • Live in a nursing home

The only way to know for sure what type of viral illness you have is through testing. You can see your doctor or buy home tests to check for COVID. Some tests can detect multiple viruses at once, such as flu, COVID, and RSV.

"Especially if you have a baby in the house, if you have an older relative or someone who's immunocompromised who might get more severe symptoms and be more at risk for severe consequences of illness, it's useful to test," Robinson says. 

"Sometimes it's helpful just to know what to expect. So if you've got RSV, you know that you might get some wheezing. You might get some severe cough. The cough might take a few weeks to completely resolve."

If you have a respiratory illness and go to your doctor, they may order a test or just do a physical exam. They'll likely listen to your lungs and ask you about your symptoms. 

They may order other tests depending on how sick you are or your risks for severe illness. These tests include:

  • Blood tests
  • Chest X-rays
  • Throat or nasal swabs
  • Pulse oximetry to check your oxygen levels

Viruses can change over time, some faster than others. The coronavirus that causes COVID is always changing to form new variants. Most changes don't affect your chances of getting sick or how sick you get if you're infected with a new COVID variant. But some changes can make COVID spread more easily or cause worse symptoms.

RSV also changes to make new variants. Those changes can make RSV spread more easily or have worse symptoms. One study found that the rise in the number of RSV cases in 2021 was linked to multiple RSV variants spreading at the same time.

Your risk of getting sick with RSV or COVID depends on many factors, including whether you have immune protection from an earlier infection or you're vaccinated. In recent years, doctors have seen more children with more than one respiratory infection at a time — for example, RSV plus COVID. Having multiple viral illnesses at once may come with worse symptoms and may be more difficult to treat.

Mostly, you manage symptoms of RSV and COVID in similar ways. Most treatments are supportive, which means they make you feel better but won't get rid of the virus. Your doctor may suggest:

  • Over-the-counter pain relievers and fever reducers
  • Saline drops or sprays
  • Fluids

If you have COVID, you might consider taking an antiviral medicine. Antivirals are approved for both kids and adults. You have to start taking them within a few days of symptoms for them to work. 

There isn't an antiviral approved for treating RSV. You shouldn't take an antibiotic to treat RSV or any other viral illness. But your doctor may prescribe an antibiotic if you have a secondary bacterial infection, such as pneumonia.

"For RSV, there's no medication that's necessarily going to shorten the illness or make it go away any faster," Robinson says.

If you get severe RSV or COVID, you may need to stay in the hospital. Your treatments may include:

  • IV fluids
  • Humidified oxygen
  • Mechanical ventilation

When you have any contagious illness, it's a good idea to rest and stay home to avoid spreading it to other people.

Getting vaccinated can help. Also, it's important to stay away from anyone who's sick with these viruses, if you can.

"If you're sick and you've got a fever and respiratory symptoms, staying home, not going to day care and school, getting checked and tested so that if you do have one of them, you can try to keep from spreading it to other people, too," Robinson says.

Vaccines against COVID and RSV are available. Ask your doctor what vaccines you should get. RSV vaccines aren't suitable for everyone, but the Advisory Committee on Immunization Practices (ACIP) recommends certain groups get a single dose of it. Those groups include:

  • People aged 75 years and older
  • People aged 60 to 74, and those who are older and at a higher risk of severe RSV disease
  • Pregnant women during weeks 32-36 of pregnancy

Infants can be protected from RSV early in life with an RSV antibody given soon after they're born. An RSV antibody is recommended for babies up to 8 months old whose mothers weren't vaccinated during pregnancy. They're recommended for children 8-19 months old who are at a higher risk for severe RSV. RSV antibodies and vaccines are given to infants or pregnant mothers during times of year when RSV is most active.

You may want to get a vaccine against seasonal flu as well. Talk to your doctor about how to time your vaccinations to get the best protection.

These tips may help protect you from COVID, RSV, and flu:

  • Wash your hands with soap and water for 20 seconds at a time, especially after you use the bathroom and before you eat. Use an alcohol-based hand sanitizer if soap and water aren't available.
  • Keep your hands away from your mouth, nose, and eyes. For kids, that means no thumb-sucking or nose-picking.
  • Ask everyone in the house to cough and sneeze into their elbow or a tissue, not their hand.
  • Clean and disinfect things that are often touched, such as doorknobs, countertops, and toys.
  • Don't let kids share personal items, such as utensils or cups, with anyone.

Most cases of coronavirus are mild and get better on their own. You or your child should stay home while sick, away from everyone who's healthy. Call your doctor's office or local health department for advice if your RSV or COVID symptoms get worse. 

Get medical help right away if you notice:

  • Trouble breathing (In babies, the signs include flaring nostrils or the belly sucking in.)
  • Pain or pressure in the chest
  • Confusion
  • Trouble waking up
  • Blue lips or face
  • Not eating or drinking well
  • Trouble talking or saying sentences

Because RSV can turn serious quickly, call your doctor if your child:

  • Has symptoms such as a runny nose, fever, and cough and is less than 6 months old
  • Runs a fever of 100.4 F and is under 6 months old, or has a fever over 104 F at any age
  • Is wheezing or breathing quickly
  • Doesn't eat or drink much
  • Isn't as alert or active as usual
  • Wets fewer than one diaper every eight hours, which could mean dehydration

RSV and COVID are common illnesses, with similar symptoms, caused by respiratory viruses. The only way to know which one you have is to be tested. You can boost your protection from severe RSV and COVID by getting vaccinated, as recommended by your doctor. RSV antibodies can protect young infants, who are at more risk for severe illness.

Does RSV need antibiotics? How about COVID?

No. RSV and COVID are caused by viruses. Antibiotics aren't used to treat viruses. You may need an antibiotic if your RSV or COVID leads to bacterial pneumonia.

Is RSV serious?

Most of the time, RSV isn't serious. But it can become serious quickly in young infants and older people, especially if there are other health conditions or if they have a weakened immune system. If you or your child has RSV, COVID, or any other severe respiratory illness, see your doctor.

Can RSV turn into pneumonia?

Yes. RSV can turn into pneumonia when the virus infects the lower airways. This is more likely in infants than in older children.

Is there a vaccine for RSV?

Yes. The RSV vaccine is recommended for people aged 75 and older, or those aged 60 and above with risk factors for severe RSV illness. It's also recommended for pregnant mothers to give some protection to young infants when they're most at risk. Ask your doctor if you should get vaccinated against RSV. Another type of immunization is also available for infants entering their first, and sometimes their second, RSV season. This immunization for infants is an antibody, not a vaccine.

At what age is RSV life-threatening?

The risks of RSV are greatest in young infants under age 6 months. It can also be life-threatening in older people, especially when they have other health conditions or weakened immune systems. In the U.S. each year, up to 10,000 older people die from RSV and related complications.