This story originally ran December 16, 2021, and was updated Nov. 8, 2024.
Along with falling temperatures and shorter days, sinus infections are a common part of winter. The symptoms of a sinus infection include coughing, congestion, fever and headache—all of which are symptoms of COVID-19, too. So how can you tell the difference?
You can’t, unfortunately, because the symptoms are so similar, and you won’t always test positive for COVID-19 on the first day of symptoms, according to UNC Health family medicine physician Sarah Ruff, MD.
“If you have a fever, stay home until you’re fever-free for 24 hours without using an anti-fever medication, such as ibuprofen and acetaminophen,” Dr. Ruff says. “You can take these medications to help with body aches and headaches, but you should ensure you don’t have a fever and are feeling better before going to work or school.”
If you have a fever, you may want to continue to test every day or so for COVID-19, and if you do test positive, ask your primary care provider if you’d benefit from the antiviral drug Paxlovid. If you test negative, your provider can recommend other treatment. Dr. Ruff explains what you can expect if you have a sinus infection.
Sinusitis: Viral vs. Bacterial Infection
A sinus infection, sinusitis, occurs when your sinuses become inflamed and blocked. This is why you may feel pain or pressure in your face. Sinusitis is usually caused by a virus, but bacterial infections also can cause it.
A viral sinus infection will usually begin to improve after five to seven days. A bacterial sinus infection will last seven to 10 days or longer and may get worse after a week.
To help alleviate your symptoms, stock up on nonprescription pain relievers, fever reducers, decongestants and cough drops. Stay home, rest and drink lots of fluids. Using a humidifier in your bedroom might help. Your provider may prescribe antibiotics if your symptoms last longer than 10 to 14 days.
“You don’t ever treat with antibiotics unless it’s been more than 10 to 14 days because, in that situation, you may have a bacterial infection,” Dr. Ruff says.
A sinus infection that lasts for months is chronic sinusitis, which can be caused by an infection or growths in the nasal cavity. If you have a sinus infection that is not going away, talk to your doctor about medications and other treatments that can bring you relief.
To help prevent sinus infections, COVID-19 and other respiratory infections, get vaccinated for the flu and COVID-19, wash your hands frequently and consider wearing a mask in crowded indoor settings.
If you’re not feeling well, talk to your doctor or find one near you.