Is it a cold, sinus infection or COVID-19, and am I contagious?

You wake up with a stuffy nose, headache, pressure around your eyes and maybe a cough. Is it just a cold? A sinus infection? Or could it be COVID-19?

Because these illnesses share many symptoms, it can be hard to tell the difference. Understanding what’s happening in your body and when to seek care can help you feel more confident about your next steps.

Brian Curtis, MD, vice president and chief medical officer, OSF Medical Group, explains how to tell them apart and what to do.

What is a sinus infection?

Your sinuses are the air-filled spaces behind your cheeks, forehead and eyes. A sinus infection, also called sinusitis, happens when the sinuses become swollen and filled with fluid. When mucus can’t drain properly, germs can grow and cause infection.

Most sinus infections start after a cold or other upper respiratory virus. In some cases, bacteria can cause or worsen the infection.

Factors that can increase your risk of developing a sinus infection include:

• Allergies
• Smoking or secondhand smoke
• A recent cold or respiratory illness

Cold, sinus infection or COVID-19: What’s the difference?

Many of these symptoms overlap, but there are a few helpful clues that can help you decide which condition you have.

Common cold

Colds usually:

• Cause a runny or stuffy nose, mild cough and sore throat
• Do not typically cause severe facial pain or pressure
• Improve within seven to ten days

Sinus infection

Sinus infections often:

• Cause facial pain or pressure, especially around the eyes or cheeks
• Include thick nasal drainage or post-nasal drip
• Cause headaches, bad breath or swelling around the eyes
• Last longer than seven to ten days

COVID-19

COVID-19 may include:

• Fever or chills
• Body aches and fatigue
• Dry cough
• Shortness of breath
• New loss of taste or smell
• Headache, sore throat or congestion

“COVID-19 symptoms often come on more quickly and affect the whole body,” Dr. Curtis said. “Sinus infections tend to cause more facial discomfort, pressure and congestion.”

Are sinus infections contagious?

While colds and COVID-19 are considered highly contagious, with a sinus infection, it just depends.

“Most sinus infections begin as a cold, which means you may be contagious during the first several days,” said Dr. Curtis. “If symptoms last longer than about a week, the infection may become bacterial, and at that stage, it’s usually not contagious.”

However, good hygiene still matters:

• Wash your hands often
• Cover coughs and sneezes
• Clean frequently touched surfaces
• Avoid close contact with others while you’re feeling sick

How are sinus infections treated?

Many sinus infections clear up on their own without antibiotics.

“Antibiotics don’t help viral infections, but if bacteria are causing the infection, antibiotics may be prescribed,” Dr. Curtis said. “The vast majority of sinus infections are viral and don’t require antibiotics.”

If it is a viral sinus infection, your provider may recommend symptom relief such as:

• Saline nasal spray or rinse
• Decongestants
• Acetaminophen or ibuprofen for pain or fever
• Warm compresses to relieve facial pressure

When should you seek medical care?

Most cold and sinus symptoms can be managed at home and improve with time. However, certain signs may mean you need medical care to prevent complications or get the right treatment. Contact a health care provider if:

• Symptoms last longer than ten days without improvement
• Symptoms get worse after initially improving
• You have severe facial pain or headache
• Fever lasts more than three to four days
• You develop swelling around the eyes or vision changes

If you have trouble breathing, chest pain or severe symptoms, seek urgent or emergency care.

How to lower your risk for sinus infection

“Prevention is really the key,” Dr. Curtis said. “Staying healthy by drinking plenty of fluids, getting adequate rest, decreasing stress and washing your hands are all good preventive steps.”

Make sure you get recommended vaccines, such as the flu vaccine . Also, avoid smoking and secondhand smoke, as well as close contact with others who have colds or upper respiratory infections.