Differentiating between COVID-19 and chronic rhinosinusitis

UAB’s Jessica Grayson, M.D., clears the confusion on how to tell COVID-19 from other respiratory illnesses.

Sick man on couch holding cup of tea.UAB’s Jessica Grayson, M.D., clears the confusion on how to tell COVID-19 from other respiratory illnesses.As fall arrives, so does another allergy season, as well as rhinitis and influenza. However, during the COVID-19 pandemic, many people may be concerned when they experience symptoms that are associated with one or more of these illnesses. 

It can be confusing to differentiate, but Jessica Grayson, M.D., assistant professor with the University of Alabama at Birmingham’s Department of Otolaryngology, says that knowing when to get tested and when to see a physician can be two of the most important things to remember.

Chronic rhinosinusitis is chronic inflammation of the nose and sinuses for 12 or more weeks. Rhinitis is inflammation of the nasal airway that can occur with viral illnesses, allergens or irritants.

“Rhinitis can be seen in COVID-19, as well as nasal congestion and a runny nose,” Grayson said. 

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Grayson says CRS presents after more than 12 weeks of facial pain, pressure, drainage, nasal obstruction, purulence or changes in smell.

CRS is treated with saline or steroid nasal irrigations, occasional courses of antibiotics and oral steroids, and potentially sinus surgery. 

Rhinitis is treated with over-the-counter steroid nasal sprays, antihistamines if driven by allergy and potentially allergy immunotherapy.  

Jessica Grayson, M.D.Jessica Grayson, M.D.
(Photography: Lexi Coon)
COVID-19 has an acute onset of congestion, rhinorrhea, smell loss, fevers or cough.

If you have symptoms consistent with COVID-19 and you have been around other people, Grayson says you should be tested. She adds that, if you have fevers, cough, sudden smell loss, acute gastrointestinal symptoms and/or headaches, you should consider the possibility that this is COVID-19.

“It’s complicated and understandable to be confused,” she said. “In the setting of the pandemic, we cannot assume that symptoms are just a random virus. We have to be vigilant about COVID-19 to prevent spread to others.”

Grayson adds that the best way to reduce the risk of hospitalization is to receive the COVID-19 vaccine.

Schedule your vaccine appointment at uabmedicinevaccine.org