Does COVID-19 Put You More at Risk for RSV?

We all find ourselves asking these questions from time to time: Do I have allergies or am I getting sick? Am I home sick with a cold or the flu? Should I be treating my child for diaper rash or eczema?

Since 2020, we’ve collectively started playing a new version: Is it RSV or COVID-19? Are they the same? Do the differences really matter?

The quick answer: COVID-19 and RSV are completely different. And yes, the differences matter. We asked infectious disease specialist Ryan Miller, DO, about both viruses.

Is RSV COVID-19 related?

RSV isn’t related to COVID-19 at all, though they share certain common features:

• They’re both respiratory viruses that, while mild for most people, can cause pneumonia and other severe illness in high-risk individuals. Both can lead to hospitalization and death in some cases.
• COVID-19 and RSV are both highly contagious, in part because you can pass them both on before showing any signs of being sick.
• You can be infected by each virus multiple times.
• While COVID-19 is still very new, the data we have to date suggests that both COVID-19 and RSV cases peak in the fall and winter months, just like the flu.
• Both COVID-19 and RSV can cause fever, runny nose and a cough. But Dr. Miller notes that the kind of cough is different. “RSV is usually more associated with a croup-style, barking cough with airway irritation, whereas COVID-19 can actually make a productive cough.”
• Tests are available for both RSV and COVID-19.
• Vaccines are also available for both RSV and COVID-19, though the RSV vaccine is only approved for use in people over the age of 60.

But for all these similarities, RSV and COVID-19 aren’t closely related conditions. So, where does that misconception come from? News coverage of RSV went through the roof during the early days of the pandemic, which led some people to think it was a new virus. It’s not. RSV has been around for a very long time, and most children contract it before turning 2 years old. In fact, you can expect to get RSV multiple times throughout your life without realizing it. That’s because, in typical cases, the symptoms mimic those of the common cold or flu.

Is RSV a coronavirus?

RSV isn’t a coronavirus. You may remember from biology courses that all living organisms — including viruses — are classified by realm, kingdom, phylum, class, order, family, genus and species. If you compare COVID-19 and RSV’s classifications, it looks like this:

While the symptoms and seasonal nature of these two conditions can make them difficult to tell apart, COVID-19 and RSV aren’t even in the same phylum. In other words, lobsters and scorpions are more closely related to each other than these two viruses are.

Can COVID-19 cause RSV?

COVID-19 can’t cause RSV. “They are distinct syndromes, and they attack different parts of the respiratory system,” Dr. Miller explains.

“COVID-19 tends to cause more damage inside the lung itself, whereas RSV tends to cause more airway issues — in other words, RSV affects the pipes going into the lungs.” That’s why an RSV cough is usually drier than a COVID-19 cough.

While COVID-19 can’t cause RSV and vice versa, both viruses can lead to the development of conditions like bronchiolitis and pneumonia. And — while it’s exceedingly rare — there have been some reports of people having RSV and COVID-19 at the same time. In those cases, one virus isn’t causing the other. It’s just extremely bad luck.

Prevention methods

“Most individuals will not get severely ill with RSV, and the same is true of COVID-19 at this point,” Dr. Miller says. “But it is wise to try to prevent spreading the viruses of it so that we don’t have our neighbors, grandparents or children getting sick with it.”

It’s especially important to know who is at a high risk for complications from either COVID-19 or RSV:

High risk for COVID-19 complications

• Adults over the age of 60.
• Adults and children who are immunocompromised.
• Adults, children and teens who have one or more of the chronic conditions the CDC has identified as risk factors.
• People who are pregnant.

High risk for RSV complications

• Adults over the age of 60.
• Adults and children who are immunocompromised.
• Adults and children who have chronic heart or lung disease.
• Children (and some adults) who have neuromuscular conditions like muscular dystrophy.
• Infants under 6 months old and infants born pre-term.

The prevention advice we had drilled into our heads in the early days of the COVID-19 pandemic still applies — and also helps prevent RSV:

• Cover your cough (or sneeze). Both RSV and COVID-19 spread through respiratory droplets or aerosols, so an uncovered cough is like a virus slingshot. Ideally, you should cough or sneeze into the crook of your arm, not your hands.
• Wash your hands. Wash your hands thoroughly throughout the day, especially if you’ve been coughing.
• Wear a mask. During the early days of the COVID-19 pandemic — when we were wearing masks, social distancing and quarantining — RSV rates plummeted downward. COVID-19, RSV, influenza and several other respiratory viruses tend to peak around wintertime, so it’s a good idea to wear a mask at large indoor gatherings and around people who are high risk. You should also wear a mask at home if you’re sick, to protect your loved ones.
• Stay home if you’re sick. While you can unknowingly spread both RSV and COVID-19 before you start feeling sick, once you do feel sick, it’s important to try and stay home. “Let people know you’re sick,” Dr. Miller says, “so you’re not holding somebody’s brand new baby. If you’re not feeling well, don’t visit grandma in the skilled nursing facility.”

COVID-19 and RSV may be minor inconveniences for most people, but both conditions can be deadly, so it’s important to do your part to keep the people you love safe.