Viral infections are not fun. Runny noses, sore throats, and general fatigue are among the mildest symptoms of a viral illness. More severe symptoms can include fevers, headaches, and a loss of senses (like taste and smell). Any illness can be a pain, but some effects of being sick are worse than others.

A sinus infection and a coronavirus-19 (COVID-19) infection can appear similarly. COVID-19, like a sinus infection, can cause symptoms such as congestion, headaches, sinus pain, and more. These two illnesses do have some marked differences, though. Understanding these discrepancies can help you take the proper precautions and receive appropriate treatment.

Sinus Infection Causes and Symptoms

Sinusitis, commonly called a sinus infection, is characterized by the inflammation and infection of the air-filled cavities in the skull, particularly behind the nose, cheekbones, and forehead. Within these cavities, a delicate mucosal lining exists. Sinus infections typically result from pathogens, often viruses, infiltrating these cavities, provoking inflammation, nasal passage blockage, and an elevation in mucus production. These outcomes are responsible for the typical symptoms associated with sinus infections.

Acute and chronic sinusitis are distinct forms of sinus infections that differ primarily in duration, symptoms, and underlying causes. Acute sinusitis is a short-term condition, usually lasting less than four weeks, and is often triggered by a viral infection, a bacterial infection, or allergens. On the other hand, chronic sinusitis is characterized by persistent inflammation of the sinus cavities lasting for 12 weeks or longer. It may result from various factors, including recurring acute infections, nasal polyps, or underlying medical conditions. Symptoms of chronic sinusitis can be milder but are long-lasting.

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Common symptoms of sinus infections include:

• Facial pain or pressure, particularly around the eyes, nose, and forehead
  
• Nasal congestion or stuffiness
  
• Runny or stuffy nose
  
• Post-nasal drip (nasal drainage in the back of the throat)
  
• Thick, discolored nasal discharge
  
• Cough, often worse at night
  
• Sore throat
  
• Fatigue or general weakness
  
• Headache
  
• Bad breath
  
• Loss of taste
  
• Loss of smell
  
• Toothache, especially in the upper teeth
  
• Fever (more common in acute sinusitis)
  
  

The severity and duration of sinus infection symptoms may vary.

Sinus infections are also often confused with the flu or a common cold. Colds are generally shorter-lasting and do not cause symptoms such as toothaches, bad breath, or facial pain. A good rule of thumb to differentiate between a cold and a sinus infection is the location of symptoms: sinus infections rarely cause sneezing, coughing, or symptoms below the neck. This means you probably have a cold if you are experiencing body aches.

COVID-19 Causes and Symptoms

The novel SARS-CoV-2 virus is the cause of COVID-19, also known as Coronavirus Disease 2019. COVID-19 primarily spreads through respiratory droplets when an infected person coughs, sneezes, talks, or breathes, and it can also spread by touching contaminated surfaces and then touching the face. Symptoms of COVID-19 can range from mild to severe. Efforts to combat COVID-19 infections have included vaccination campaigns, social distancing, mask-wearing, and widespread testing to reduce transmission and protect public health.

Common symptoms of COVID-19 include:

• Fever or chills
  
• Cough
  
• Fatigue
  
• Muscle or body aches
  
• Headache
  
• Reduced sense of smell and taste
  
• Sore throat
  
• Congestion or runny nose
  
• Nausea or vomiting
  
• Diarrhea
  
  

The severity of these symptoms can differ among individuals. While some may only experience mild discomfort, others may face severe symptoms such as difficulty breathing and high fevers, often requiring hospitalization.

Individuals in high-risk populations are especially at risk of severe respiratory symptoms and severe cases of COVID-19.

The Centers for Disease Control and Prevention (CDC) consider the following as “high-risk” populations:

• Adults over the age of 65
  
• People with weakened immune systems (including those with cancer, HIV/ AIDS, or those who are immunocompromised due to medical treatment)
  
• People with chronic heart, kidney, liver, and lung disease
  
• People with type 1 or type 2 diabetes
  
• People who have had an organ transplant
  
• People with dementia or Alzheimer’s disease
  
• Disabled individuals (such as those managing Down syndrome or cerebral palsy)
  
• Overweight or obese individuals
  
• People managing mental health disorders
  
• Cigarette smokers
  
• Pregnant women (at any stage of pregnancy)
  
  

Most of these populations include children as well as adults.

While all individuals are at risk for severe symptoms and complications, these populations are at higher risk for advanced problems such as:

• Pneumonia
  
• Acute Respiratory Distress Syndrome (ARDS)
  
• Blood clotting issues (thrombosis)
  
• Organ damage (heart, kidneys, liver)
  
• Long COVID (persistent symptoms)
  
• Secondary bacterial infections
  
• Neurological symptoms (loss of taste/smell, confusion)
  
• Multisystem Inflammatory Syndrome in Children (MIS-C)
  
• Respiratory failure
  
• Death
  
  

Developed in response to the pandemic, COVID-19 vaccine options are now available to protect against severe infections, variants, and complications. In addition to practicing preventive measures, adults and children 6 months and older should receive the COVID-19 vaccine. For those already immunized against COVID-19, periodic booster shots can further enhance protection against the disease.

A quick symptom check can help differentiate between these two illnesses:

Sinus Infection Treatment

Viral sinus infections, like other infectious diseases caused by viruses, usually go away independently with self-care strategies and rest. Bacterial sinus infections or chronic sinus infections may require more intensive medical care and, occasionally, prescription medications such as antibiotics. If you experience sinus infections caused by allergies, you can use an antihistamine nasal spray or oral tablet to treat the underlying condition.

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Self-care strategies can help reduce symptoms and hasten recovery from a viral sinus infection.

These include:

• Hydration: Drink plenty of water and clear fluids to stay hydrated, which helps thin mucus and ease congestion.
  
• Steam Inhalation: Inhaling steam from a bowl of hot water or taking a hot shower can relieve nasal congestion and soothe irritated sinuses.
  
• Nasal Irrigation: Use a saline nasal spray or a neti pot to rinse nasal passages, reducing congestion and promoting nasal drainage.
  
• Warm Compress: Apply a warm, damp cloth over your sinus areas to alleviate pain and pressure.
  
• Rest: Get ample rest to help your body recover more effectively.
  
• Elevate Your Head: Sleeping with your head elevated can facilitate better sinus drainage and reduce congestion.
  
• Humidify the Air: Use a humidifier in your room to add moisture to the air, relieving dry nasal passages and making breathing easier.
  
• Avoid Irritants: Avoid smoke, strong odors, and other environmental irritants that can exacerbate sinus symptoms.
  
• Proper Nutrition: Eat a balanced diet rich in vitamins and minerals to support your immune system.
  
• Avoid Allergens: Minimize exposure to allergens that can worsen sinus symptoms, such as pollen, pet dander, or dust mites.
  
  

Remember that while these self-care strategies can provide relief and support recovery from viral sinus infections, they may not replace the need for medical treatment if your condition worsens or persists. Always consult a health care provider if you have concerns about your sinus infection.

Over-the-counter medications used to treat sinus infection symptoms include:

Saline Nasal Spray: Easily found over the counter in most pharmacies, products like Sinex provide a means to cleanse and rinse nasal passages, effectively reducing symptoms associated with sinus infections.

Steroid Nasal Sprays: Nasal sprays containing the steroid fluticasone (such as Flonase) can mitigate inflammation resulting from sinus infections. This soothing effect helps alleviate symptoms like facial pain, headaches, and congestion.

Decongestants: Over-the-counter decongestant medications containing pseudoephedrine (like Sudafed) are available in various forms, including nasal sprays, oral liquids, and tablets. Decongestants work to clear nasal passages, alleviating facial pressure and reducing symptoms of nasal discharge. Using nasal decongestants for only a few days is crucial, as prolonged use can lead to worsening congestion.

Over-the-counter Pain Relievers: Pain relievers like ibuprofen and acetaminophen can effectively minimize discomfort associated with body aches, sinus pain, and fever stemming from viral infections. While these medications won't directly address runny or stuffy noses, they relieve the discomfort linked to upper respiratory viral infections.

COVID-19 Treatment

COVID-19 will usually go away on its own after a week or so. At the time of publication, the CDC recommends that individuals who have tested positive for COVID-19 self-isolate for ten days if symptomatic. If you have tested positive but are not experiencing symptoms (asymptomatic), it is recommended that you self-isolate for five days, followed by five days of masked social distancing around others.

Refer to the CDC’s Isolation and Precaution protocols for up-to-date guidelines.

While self-isolating, use these self-care methods to reduce your symptoms and speed up recovery:

• Isolation: Stay in isolation to prevent the spread of the virus to others.
  
• Rest: Get plenty of rest to help your body recover.
  
• Hydration: Drink fluids like water, herbal teas, and clear broths to stay hydrated.
  
• Fever Reducers: Over-the-counter medications like acetaminophen or ibuprofen can help reduce fever and alleviate discomfort. Follow your healthcare provider's advice for medication use.
  
• Cough Suppressants: Over-the-counter cough medications may help relieve cough symptoms.
  
• Humidifier: Use a humidifier in your room to maintain comfortable humidity levels and ease respiratory symptoms.
  
• Monitor Symptoms: Keep an eye on your symptoms and seek medical attention if they worsen or you have difficulty breathing.
  
• Nutrition: Support your immune system with a diet rich in fruits and vegetables.
  
  

A health care provider may prescribe medication for individuals who have tested positive for COVID-19 and are at high risk for hospitalization or severe complications caused by the disease.

Antiviral medications used to treat COVID-19 include:

• Nirmatrelvir and ritonavir (Paxlovid): Administered as two oral tablets
  
• Molnupiravir (Lagevrio): Administered as an oral tablet
  
• Remdisivir (Veklury): Administered in a medical care setting through an IV
  
  

Vaccinations and periodic booster shots will also help protect you and your loved ones from infection and severe illness caused by COVID-19.

Unfortunately, there is no vaccine for sinus infections. However, you can fight both sinus infections and COVID-19 with the at-home measures listed above.

COVID-19 Testing

A viral PCR (polymerase chain reaction) test can differentiate between a sinus infection and COVID-19 by targeting specific genetic material unique to the COVID-19 virus. In this test, a patient's respiratory sample, usually obtained via a nasal swab, is analyzed for the presence of genetic material from the SARS-CoV-2, the virus responsible for COVID-19. PCR amplifies and detects viral RNA or DNA sequences, and primers are designed to match distinct regions of each virus's genome. By identifying the genetic signature of COVID-19, the test can accurately determine whether or not this specific virus is responsible for the patient's symptoms, aiding in appropriate diagnosis and management.

If you’re concerned about your symptoms or are looking for more information, book an online doctor appointment on Sesame. These visits connect patients directly with licensed health care providers over video platforms (similar to Skype or Facetime). An online appointment is convenient and safe: you can conduct the visit from your home while avoiding close contact with others. Start feeling better and talk to a provider today.

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Sources:

• Ah-See, K. W., & Evans, A. S. (2007). Sinusitis and its management. BMJ (Clinical research ed.), 334(7589), 358–361. https://doi.org
  
• Centers for Disease Control and Prevention (2023, May 26). COVID-19 Treatments and Medications. CDC.gov. https://www.cdc.gov
  
• DeBoer DL, Kwon E. Acute Sinusitis. [Updated 2023 Aug 7]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan-. https://www.ncbi.nlm.nih.gov
  
• National Institutes of Health (2023, July 21). Overview of COVID-19. NIH.gov. https://www.nih.gov