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?
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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.
RSV isn’t related to COVID-19 at all, though they share certain common features:
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.
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:
Respiratory syncytial virus (RSV) | SARS-CoV-2 (COVID-19) | |
---|---|---|
Realm | Riboviria | Riboviria |
Kingdom | Orthornavirae | Orthornavirae |
Phylum | Negarnaviricota | Pisuviricota |
Class | Monjiviricetes | Pisoniviricetes |
Order | Mononegavirales | Nidovirales |
Family | Pneumoviridae | Coronaviridae |
Genus | Orthopneumovirus | Betacoronavirus |
Species | Human orthopneumovirus | Severe acute respiratory syndrome-related coronavirus |
Realm | ||
Respiratory syncytial virus (RSV) | ||
Riboviria | ||
SARS-CoV-2 (COVID-19) | ||
Riboviria | ||
Kingdom | ||
Respiratory syncytial virus (RSV) | ||
Orthornavirae | ||
SARS-CoV-2 (COVID-19) | ||
Orthornavirae | ||
Phylum | ||
Respiratory syncytial virus (RSV) | ||
Negarnaviricota | ||
SARS-CoV-2 (COVID-19) | ||
Pisuviricota | ||
Class | ||
Respiratory syncytial virus (RSV) | ||
Monjiviricetes | ||
SARS-CoV-2 (COVID-19) | ||
Pisoniviricetes | ||
Order | ||
Respiratory syncytial virus (RSV) | ||
Mononegavirales | ||
SARS-CoV-2 (COVID-19) | ||
Nidovirales | ||
Family | ||
Respiratory syncytial virus (RSV) | ||
Pneumoviridae | ||
SARS-CoV-2 (COVID-19) | ||
Coronaviridae | ||
Genus | ||
Respiratory syncytial virus (RSV) | ||
Orthopneumovirus | ||
SARS-CoV-2 (COVID-19) | ||
Betacoronavirus | ||
Species | ||
Respiratory syncytial virus (RSV) | ||
Human orthopneumovirus | ||
SARS-CoV-2 (COVID-19) | ||
Severe acute respiratory syndrome-related coronavirus |
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.
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.
“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:
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:
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.
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