UNC Health Talk

Do You Have COVID-19 or a Sinus Infection?

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, you should be tested for COVID-19. This is especially important as cases continue to rise. A positive COVID-19 test means you need to isolate.

“You cannot rule out COVID-19 without a test,” says UNC Health family medicine physician Sarah Ruff, MD. “There are differences, but step one if you start to feel bad is to get a COVID test.”

Many locations offer drive-thru COVID-19 tests, or you can buy a rapid test from your local pharmacy, which gives you results in about 15 minutes.

“The rapid ones are getting better and better as far as accuracy goes. And they’re better than nothing, especially on a weekend if you don’t have other choices,” Dr. Ruff says. “I recommend that everyone stock up.”

Infographic that shows a two column check list (on x axis) of what symptoms (on Y axis) are COVID symptoms versus sinus infections symptoms.

Sinusitis: Viral vs. Bacterial Infection

After you’ve tested, call your primary care doctor to schedule an in-person or virtual visit. Talk through your symptoms, and then your provider can help you determine the best next steps, Dr. Ruff says.

“If you have a negative COVID test, we can see you and determine if you have an actual sinus infection and then determine the best treatment,” Dr. Ruff says. “We’re swabbing everyone at my clinic with a respiratory viral panel, which is the same COVID swab, but in addition to COVID, it tells you what virus you have, such as rhinovirus (common cold) or a number of other respiratory viruses; even the flu.”

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, wear a mask in indoor public places and in a crowd whether you’re indoors or outdoors. Wash your hands frequently and avoid touching your nose, mouth or eyes. If you’re not vaccinated for COVID-19 and the flu, do so right away to reduce your chances of getting sick and spreading these infections to others.


If you’re not feeling well, talk to your doctor or find one near you.