What Is the Difference Between Sinus Infections and COVID?

Sinus infections and COVID have very similar symptoms, including congestion, headaches, fever, sore throat, and cough. This would be expected because COVID is caused by a virus, and viruses cause most sinus infections.

Most adults get 2 to 3 upper respiratory infections each year. Sinus infections typically develop after a respiratory infection. When a virus or bacteria causes an infection, it can cause inflammation and fluid build-up in the sinuses. Sinuses are air-filled cavities in the facial bones. When inflamed, infected fluid can accumulate in the sinuses, causing symptoms.

The virus that causes COVID is a coronavirus. Most coronaviruses cause mild-to-moderate upper respiratory infections, but some cause more serious diseases. Like most viruses, COVID can easily spread from person to person.

The best way to tell the difference between a sinus infection and COVID-19 is to take a COVID-19 test.

Symptoms

The symptoms associated with COVID-19 infections and sinus infections are very similar.

Sinus Infections

Sinus infection symptoms typically involve the nose, sinuses, and throat. Classically, a person will get a respiratory infection. Their symptoms will start to improve after 5 to 7 days and then take a turn for the worse. The worsening symptoms may indicate that fluid in the sinuses has become infected. Pressure builds up in the sinuses. Pain and discomfort typically worsen when they lean forward.

Typical sinus infection symptoms include:

• Facial pain or pressure
• Nasal congestion
• Nasal drainage
• Post-nasal drip
• Cough
• Sore throat
• Tooth discomfort
• Fatigue
• Ear pressure
• Headache
• Bad breath
• Altered sense of smell

Symptoms of acute bacterial sinusitis include:¹

• Discolored, thick nasal discharge
• Fever
• Facial pain localized to the sinuses

COVID

While sinusitis symptoms are more localized to the face, COVID-19 symptoms can involve the entire body. Symptoms of COVID-19 may include:

• Dry cough
• Fever
• Shortness of breath
• Difficulty breathing
• Chest pain
• Loss of taste or smell
• Fatigue
• Muscle aches
• Stomach ache
• Diarrhea
• Chills
• Congestion

Causes

The causes of COVID-19 and sinusitis are similar, only in that the virus that causes COVID-19 is a virus that can also cause sinus infections. But many more viruses, bacteria, and fungi cause sinus infections and are not the coronavirus that causes COVID-19.

Sinus Infections

A sinus infection can develop after the sinuses become inflamed from an infection or severe allergies. Typically, a sinus infection develops after an upper respiratory infection or cold.

When you blow your nose, pressure increases in the nasal and sinus cavities. This can cause reflux of contaminated mucus into the sinuses. When viruses (bacteria or fungi) enter the sinus cavity, this stimulates an immune response. Blood flow increases to the sinuses, and blood vessels become leakier. Fluid and immune cells leak into the surrounding tissues, increasing swelling and inflammation.

Congestion and swelling increase as the lining of the nose and sinuses become inflamed. Fluid collects in the sinuses. When the sinus openings connecting them to the nose swell, it can become more difficult for the sinuses to drain. When fluid sits in the sinuses, it allows viruses and bacteria to overgrow, causing acute sinusitis, pressure, and pain.

COVID

COVID-19 is caused by the SARS-CoV-2 virus, a coronavirus. This respiratory virus is spread from person to person via droplets and aerosols that are expelled into the air when an infected person is coughing or sneezing.

Prevention Options

While you cannot entirely prevent COVID-19 and sinus infections, there are steps you can take to reduce your risk.

Sinus Infections

Try these steps to reduce inflammation in the sinuses and reduce your risk of sinus infections.

• Avoid pollutants and allergens
• Get an influenza vaccine
• Stop smoking
• Avoid touching your face and eyes
• Rinse your sinuses with a saline solution
• Use a humidifier to thin secretions
• Stay hydrated
• Treat medical conditions such as gastroesophageal reflux disease or enlarged tonsils and adenoids

COVID

The underlying cause of most acute sinus infections is viral. Since the cause of COVID-19 is also a virus, these steps can reduce your risk of getting COVID-19 and a subsequent sinus infection.

• Wash your hands frequently with soap and water.
• Avoid touching your face, especially your eyes and nose.
• Get vaccinated and verify whether you are eligible for a booster vaccine.
• Wear a mask in indoor settings and when you may be exposed to people who are ill.
• Maintain social distance when possible.
• Avoid crowded areas, especially if they have poor ventilation.
• Clean high-touch surfaces in your home, car, and place of business.

Protect others as well by staying home when you are ill, coughing or sneezing into a tissue or your elbow, and wearing a mask.

Diagnosis

Diagnosing sinus infections can be challenging, but diagnosing COVID-19 infections is more straightforward.

Sinus Infections

Typically, your doctor can diagnose sinusitis based on your symptoms and physical exam. Facial pain and pressure, a history of a respiratory infection, nasal congestion, and post-nasal drip are symptoms that indicate a sinus infection.

If the diagnosis is unclear, your doctor may order imaging studies to visualize your sinuses.

COVID

The best way to diagnose COVID-19 is by using an approved COVID-19 test kit. However, sometimes you need an evaluation before returning to work, or your plans for international travel require proctored COVID-19 tests.

Making an appointment with an online doctor makes this much easier. An online doctor can evaluate your symptoms and provide an online diagnosis. Many people hesitate to make an appointment with an online doctor because they do not know how much a doctor’s visit costs. You will probably find that online doctor visits are much more affordable than you would have thought, especially if you do not have health insurance.

Treatments

The treatment options for COVID-19 and sinusitis overlap since a virus causes COVID -19 and viruses are the most common causes of sinus infections.

Sinus Infections

The key to treating a sinus infection is to determine the underlying cause. For example, if severe allergies are causing your sinus symptoms, it is appropriate to start allergy treatments. If your doctor believes that the cause of your sinus inflammation is a bacterial infection, they will prescribe antibiotics.

In most cases, sinusitis is caused by a viral infection, and the symptoms can be improved by:

• Avoiding exposure to irritants such as cigarette smoke, allergens, and pollutants
• Using a saline nasal spray or nasal wash
• Trying a decongestant to reduce swelling and increase drainage
• Using a humidifier to loosen and thin secretions

COVID

The SARS-CoV-2 virus causes COVID-19. In most cases, COVID-19 treatment is symptomatic if your case is mild. Make an appointment with an online doctor to discuss your symptoms and determine whether an online prescription medication would help relieve your symptoms.

The Food and Drug Administration has approved remdesivir, an antiviral medication that treats COVID-19 in adults and children. This intravenous (IV) therapy is approved for use in hospitalized and non-hospitalized settings. Other medications are authorized for emergency use for people with mild-to-moderate COVID-19 symptoms.

Severity

Both COVID-19 and sinus infections have a wide range of severity.

Sinus Infections

Sinus infections can vary in severity from mild acute sinusitis that resolves on its own or with symptomatic care to serious conditions that require hospitalization.

The sinuses are located close to the eyes and the brain. If the infection spreads to the tissues surrounding the brain or eye, it can cause serious complications and even be fatal. This is a very rare situation but must be considered in anyone whose symptoms are severe and worsen with time.

COVID

COVID infections also vary in severity. Some people may experience mild symptoms or even no symptoms at all. In this case, symptomatic treatment is all that is needed. Other people, especially people with chronic diseases, may experience serious symptoms and require hospitalization.

Contagiousness

Viruses cause most sinus infections, and the SARS-CoV-2 virus causes COVID-19. Viruses are easily spread from person to person.

Sinus Infections

Acute sinusitis commonly has a viral cause. A virus can be spread easily from person to person. Whether a person develops a sinus infection from the virus depends on many factors. So, technically, sinus infections are not contagious.

COVID

COVID-19 is caused by a virus and is contagious, especially in tight indoor spaces with poor ventilation. The SARS-CoV-2 virus is spread when an infected person coughs or sneezes into the air and another person inhales the droplets or touches their eyes or nose after touching objects containing the infected droplets.

A person with mild COVID-19 is contagious for about 5 to 10 days. People with more severe disease can be contagious for up to 21 days.  

Possible Complications

People with chronic disease or a compromised immune system are more prone to complications than people who do not have these conditions.

Sinus Infections

While rare, sinusitis is associated with some serious potential complications, including:

• Cellulitis: Infection of the eye or the tissues around the eye is a potentially serious complication that, when untreated, can cause blindness or infections in the tissues around the brain.
• Meningitis: The sinuses are anatomically close to the meninges, which are coverings over the brain and spinal cord. Meningitis is when these membranes become inflamed or infected.
• Osteomyelitis: If an infection spreads outside the sinuses and into the bones, a serious condition called osteomyelitis may occur.

COVID

COVID-19 can cause a wide range of complications that are beyond the scope of this article. Pneumonia and respiratory failure are common reasons for requiring hospitalization for a COVID-19 infection. However, COVID-19 can damage nearly any organ in the body.

Disclaimer

While we strive to always provide accurate, current, and safe advice in all of our articles and guides, it’s important to stress that they are no substitute for medical advice from a doctor or healthcare provider. You should always consult a practicing professional who can diagnose your specific case. The content we’ve included in this guide is merely meant to be informational and does not constitute medical advice.

References:

1. Morcom S, Phillips N, Pastuszek A, Timperley D. Sinusitis. Aust Fam Physician. 2016 Jun;45(6):374-7. PMID: 27622225.