What’s the Difference between COVID-19, Flu and a Cold?

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CHARLOTTE – You’re feeling sick; which one do you have?

It could get confusing if you become ill this fall and winter.

COVID-19, the flu, and the common cold are contagious respiratory illnesses that have similar symptoms. It can be difficult to tell the difference between them, based on symptoms alone.

That could make things tricky when flu season, which typically peaks in the winter, overlaps with the COVID-19 pandemic. The flu and COVID-19 are caused by different viruses, and in general, testing is needed to help confirm a diagnosis.

While the three illnesses share several symptoms, one key thing that sets COVID-19 apart is the loss of taste and smell it causes.

Dr. Karan Shukla
Dr. Karan Shukla

“Both COVID-19 and the flu can spread before you know you have an illness or symptoms,” said Dr. Karan Shukla, of Novant Health Randolph Family Medicine in Charlotte, North Carolina. “COVID-19, though, is much more contagious among certain populations and age groups versus the flu. COVID-19 has been shown to spread quickly and is more known to have super-spreader events compared to the flu.”

The best defense against the flu is vaccination, but it isn’t the only defense. It is important to remember that all three illnesses spread mainly through respiratory droplets. Previously, masks weren’t recommended as a prevention for the flu or a cold, but the same safety measures that help limit the spread of COVID-19 also work with flu and cold:

  • Wear a face mask.
  • Maintain a social distance of at least 6 feet, and avoid close physical contact (like hugging or shaking hands).
  • Wash your hands thoroughly and frequently.
  • Avoid commonly touched surfaces that could be contaminated.

If you get sick this fall, the Centers for Disease Control and Prevention recommends your first step should be to contact your primary health care provider to determine if testing should take place.

Here are the symptoms of each illness:


Symptoms can range from mild to severe and may appear 2-14 days after exposure to the virus. COVID-19 symptoms include:

  • Fever or chills
  • Cough
  • Shortness of breath or difficulty breathing
  • Fatigue
  • Muscle or body aches
  • Headache
  • New loss of taste or smell
  • Sore throat
  • Congestion or runny nose
  • Nausea or vomiting
  • Diarrhea


Influenza can cause mild to severe illness, and at times can lead to death. Flu is different from a cold. Flu usually comes on suddenly. People who have flu often feel some or all of these symptoms:

  • Fever or feeling feverish/chills
  • Cough
  • Sore throat
  • Runny or stuffy nose
  • Muscle or body aches
  • Headaches
  • Fatigue
  • Vomiting and diarrhea, though this is more common in children than adults.

“Getting the yearly flu vaccine is the best way to protect against flu,” Shukla said. “It can reduce the risk of flu illness, the rates of hospitalizations, and flu-related deaths. You should generally get the flu vaccine before the flu virus starts circulating in your community. The CDC recommends that in early fall everyone starts to get vaccinated.”

Flu vaccinations are a strong preventative tool for people with chronic health conditions, Shukla said. It can help women who are expecting and their newborn babies from getting the flu. Flu vaccines have been shown to prevent and reduce the severity of the illness for people who get vaccinated, but still get sick.  Getting vaccinated protects you, your family, neighbors, and the people around you.


Symptoms of a cold usually peak within 2-3 days and can include:

  • Sneezing
  • Stuffy nose
  • Runny nose
  • Sore throat
  • Coughing
  • Mucus dripping down your throat (post-nasal drip)
  • Watery eyes
  • Fever (although most people with colds do not have a fever)

Colds are usually milder than flu, according to the CDC. People with colds are more likely to have a runny or stuffy nose. Colds generally do not result in serious health problems, such as pneumonia, bacterial infections, or hospitalizations.

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