Coronavirus and RSV

Medically Reviewed by Murtaza Cassoobhoy, MD on March 28, 2023
5 min read

Coronavirus and respiratory syncytial virus (RSV) are two kinds of respiratory illnesses that have some similar symptoms. So far, the new coronavirus appears to be more dangerous for adults, especially older ones. RSV is riskier for young children, but it can also be serious for older people and those who have other health problems.

Coronaviruses are a group of common viruses that infect the respiratory tract. The newest one is the virus that causes COVID-19.

Though COVID-19 can affect children, adults make up most of the cases diagnosed so far. Adults are also more likely to have serious symptoms from the coronavirus, especially if they're over 65 or have a condition like diabetes, lung disease, or heart disease.

RSV can also affect people of ages, but it's especially common in infants and young children. By age 2, nearly every child will have been infected. Most cases are mild. But some children are more likely to get seriously ill, including:

  • Infants 6 months or younger
  • Babies who were born early
  • Children under 2 with chronic lung or heart disease
  • Children with a weak immune system
  • Children who have trouble swallowing

Each year, RSV sends more than 57,000 children to the hospital.

When adults and older children catch RSV, they usually have only minor symptoms that are similar to a cold. RSV can also be serious for some, though, including:

  • People over 65
  • Those with a weakened immune system
  • Those with heart or lung diseases

Some 60,000-120,000 older adults are hospitalized for RSV each year in the United States, and 6,000-10,000 of them die.

Both illnesses spread the same way: Someone who is infected coughs or sneezes, sending droplets containing the virus into the air. You can get sick if the droplets land on you, or if you touch a surface that has the virus on it and then put your fingers in your nose, mouth, or eyes.

Both COVID-19 and RSV can cause these symptoms:

Children with coronavirus often have mild symptoms. Some have no symptoms at all. Adults with COVID-19 often also notice shortness of breath. Their symptoms can range from mild to life-threatening.

Along with cold-like symptoms, RSV causes:

RSV can also lead to more serious problems like:

  • Bronchiolitis, which causes swelling in the small air sacs in the lungs
  • Pneumonia, a lung infection


The coronavirus and its variants are very contagious. Kids face the same risk of catching it as adults, although the disease is usually milder in children. They can also spread it to others.

Some children may have a serious illness from the coronavirus. Adults are more likely to get seriously sick from COVID-19 starting in their 50s, and if they have conditions such as:

  • Heart disease
  • Lung disease
  • Diabetes
  • A weak immune system

But even young adults are at risk of getting seriously ill from COVID-19. One study found that one-fifth of those ages 25-40 were sick enough to go to a hospital.

In June 2021, the CDC issued an official “health advisory” about a rise in RSV cases across the southern United States. It recommended that health care providers test for RSV in all people of any age who have signs and symptoms of respiratory illness, but test negative for the coronavirus.

The rise of RSV in summer is unusual because it typically takes off in the fall and winter. Doctors worry that if both viruses increase at the same time, it could put serious stress on the nation's emergency care capacity. 

There is some evidence that the rise in RSV may be due in part to the relaxing of coronavirus prevention steps such as masks and social distancing. It may also be that because people have less exposure to RSV and other viruses due to these precautions, they have less immune protection.

Normally, mothers pass an immune response to their babies during pregnancy. Some doctors think this response is now compromised. This is because new mothers aren’t being exposed to as many viruses like RSV. This is a cause for concern because infants and toddlers are especially at risk for RSV.

The RSV rise mirrors a rise in coronavirus infections due to new variants. New variants are more contagious than previous versions of the virus. They also seem to infect kids much more easily. 

Doctors are also seeing many more children with more than one respiratory infection at a time; for example, RSV plus coronavirus. This can cause more serious symptoms and may be more difficult to treat.

The best measure you can take to protect yourself and those around you is to get vaccinated against COVID-19. Vaccines against RSV should be available to people 60 and older later in 2023. You may want to get a vaccine against seasonal flu as well. Talk to your doctor about how to time your vaccinations.

Here are a few prevention tips that work well for both illnesses:

  • Wash your hands with soap and water for 20 seconds at a time, especially after you use the bathroom and before you eat. Use an alcohol-based hand sanitizer if soap and water aren't available.
  • Keep your hands away from your mouth, nose, and eyes. For kids, that means no thumb-sucking or nose-picking.
  • Ask everyone in the house to cough and sneeze into their elbow or a tissue, not their hand.
  • Clean and disinfect things that are often touched, like doorknobs, countertops, and toys.
  • Don't let kids share personal items like utensils or cups with anyone.
  • Practice social distancing, and stay away from anyone who might be sick.

Most kids with coronavirus have a mild case and get better on their own. While they're sick, keep them at home and away from everyone else in the house who's healthy. Do the same for yourself if you have symptoms of COVID-19.

Call your doctor's office or local health department for advice if RSV or COVID-19 symptoms get worse for you or your child. Get medical help right away if you notice:

  • Trouble breathing (In babies, the signs include flaring nostrils or the belly sucking in.)
  • Pain or pressure in the chest
  • Confusion
  • Trouble waking up
  • Blue lips or face
  • Not eating or drinking well
  • A hard time talking or saying sentences

Because RSV can turn serious quickly, call your doctor if your child:

  • Has symptoms like a runny nose, fever, and cough and is less than 6 months old
  • Runs a fever of 100.4 F and is under 6 months old, or has a fever over 104 F at any age
  • Is wheezing or breathing quickly
  • Doesn't eat or drink much
  • Isn't as alert or active as usual
  • Wets fewer than one diaper every 8 hours, which could be a sign of dehydration