How to Tell the Differences Between COVID-19 and a Sinus Infection

Here are the main characteristics of each illness:

COVID-19

COVID-19 is a respiratory disease, meaning it affects the airways and lungs. However, its symptoms can involve multiple parts of the body, such as the digestive system.

In most cases, COVID-19 causes mild symptoms. But some people can get very sick from COVID-19. This includes older people and those with preexisting medical conditions, like diabetes.

Generally, symptoms take 2 to 14 days to appear after exposure to the virus.

Sinus infection

A sinus infection, or sinusitis, is an infection of the sinuses. The sinuses are air-filled cavities in the face. They’re located behind your cheekbones, forehead, nose, and along the area between your eyes.

There are two types of sinusitis:

• viral
• bacterial

Viral sinusitis is the most common. Most people experience symptoms of it when we have a viral infection. This includes when people have COVID-19, which is caused by a virus.

Normally, the sinuses produce mucus, which traps germs and other particles. But if the sinuses become inflamed, they’ll become swollen. This traps the mucus and causes sinus-related symptoms.

Sinusitis can be caused by:

• viral infections, like the cold or flu (COVID-19 is a virus; hence, COVID-19 can cause sinus infections)
• bacterial infections
• fungal infections
• asthma
• allergies
• physical irregularities in the nasal or sinus cavities, such as nasal polyps

Usually, the symptoms of a sinus infection develop suddenly.

COVID-19 and sinus infections share some symptoms. But there are also major differences:

COVID-19

The symptoms of COVID-19 can vary widely. Most commonly, it causes:

• fever
• headache
• dry cough
• sore throat
• nasal congestion
• shortness of breath
• loss of taste or smell
• muscle or body ache
• fatigue
• nausea
• vomiting
• diarrhea

Sinusitis

The symptoms of sinusitis include:

• nasal congestion
• runny nose
• postnasal drip
• fever
• facial pain or pressure
• coughing (with mucus)
• sore throat
• bad breath
• headache
• swelling around the eyes, especially in the morning

Upper respiratory infections are the most common cause of sinus infections.

That’s because a viral infection leads to swelling and inflammation in the nasal cavity. This thickens and traps the mucus, allowing bacteria to multiply and cause a sinus infection.

COVID-19 is a viral upper respiratory infection. Therefore, COVID-19 can theoretically cause a sinus infection, but there’s no research on the link.

So far, there are only reports of fungal sinusitis in people with COVID-19. Fungal sinusitis is a rare but serious form of sinus infection.

For example, in a 2021 case report, three people with COVID-19 developed fungal sinusitis. Each person had preexisting medical conditions, including diabetes and renal failure. The researchers noted that uncontrolled diabetes increases the risk for fungal sinusitis.

More research is necessary to determine the link between COVID-19 and non-fungal sinus infections in healthy people.

Generally, COVID-19 and sinus infections do not need treatment. They usually get better on their own.

For both conditions, a doctor will likely recommend the following remedies:

• plenty of rest
• staying hydrated
• over-the-counter pain relievers
• nasal decongestants or rinse (if COVID-19 is causing nasal congestion)

However, if you have a serious case of either illness, you’ll likely need medication.

For severe COVID-19 that requires hospitalization with oxygen therapy, a doctor may prescribe antiviral medication or drugs to treat complications. These treatments are typically given to people who have been hospitalized or are at risk for complications.

A severe sinus infection might require antibiotics.

Visit a doctor if you have:

• nasal congestion
• runny nose
• trouble breathing
• coughing
• sore throat
• new loss of taste or smell
• body aches
• unexplained fatigue
• nausea
• vomiting
• diarrhea
• facial pain or pressure
• fever

A doctor can determine what’s causing your symptoms and help you find relief.

You should also see a doctor if you’ve already been diagnosed with COVID-19 or sinusitis, but your symptoms do not improve.

Medical emergency

Call 911 if you or someone you know has any of the following symptoms:

• difficulty breathing
• constant pressure or pain in the chest
• severe pressure or pain in the face
• difficulty staying awake
• pale, blue, or gray lips or skin
• fainting
• high fever
• changes in vision
• swelling around one or both eyes
• severe diarrhea

Your doctor will ask questions about what you’re feeling. Often, they can make a diagnosis based on your symptoms alone.

They may also use a:

• Physical exam. A doctor will examine your throat and nose for redness, swelling, and other signs of irritation. They’ll also check for tenderness in your face.
• Nasal swab. A nasal swab involves taking a sample from your nose. Your doctor can test this sample for COVID-19.
• CT scan. A CT scan, or computed tomography, may be used to take an image of your sinuses. This will allow the doctor to examine the inside of your sinuses.

COVID-19 and sinus infections share several symptoms. Both conditions can cause nasal congestion, fever, and coughing. It’s also possible to lose your sense of taste and smell with both conditions.

But COVID-19 causes more respiratory symptoms. The cough is also drier. Additionally, a sinus infection can cause facial pain and swelling around the eyes, which is not seen in COVID-19.

In most cases, both conditions will go away on their own. See a doctor if your symptoms are severe or persist.