Skip to content
  • About
  • Contact
  • Contribute
  • Book
  • Careers
  • Podcast
  • Recommended
  • Speaking
  • All
  • Physician
  • Practice
  • Policy
  • Finance
  • Conditions
  • .edu
  • Patient
  • Meds
  • Tech
  • Social
  • Video
    • All
    • Physician
    • Practice
    • Policy
    • Finance
    • Conditions
    • .edu
    • Patient
    • Meds
    • Tech
    • Social
    • Video
    • About
    • Contact
    • Contribute
    • Book
    • Careers
    • Podcast
    • Recommended
    • Speaking

Viral upper respiratory infections in the age of COVID

David Epstein, MD
Conditions
December 14, 2021
63 Shares
Share
Tweet
Share

Your toddler has had a cough and runny, stuffy nose on and off for months. They also attend daycare and have a sibling in preschool. You are worried about the symptoms. You are also exhausted because your child’s coughing and congestion is not letting either of you sleep at night. Does this sound familiar?

You ask yourself, “Is this normal?” and “What is wrong with my child?”

Well, to calm your fears, this is a common scenario for families with young children in daycare and preschool. We see children like this at pediatric clinics, urgent cares and emergency rooms daily. In the United Kingdom and the United States, viral respiratory tract infections or “colds” account for over a third of pediatric consultations in primary care. A brief discussion about the frequency of young children becoming infected and how long the symptoms of infection last will give you more of a proper perspective on how concerned you should be.

Most upper respiratory tract infections are caused by viruses which represent approximately 90% of all respiratory infections. These infections mainly occur in children less than 5 years of age who can experience up to 5 or 6 episodes a year.

Viral respiratory infections are more prevalent in children who attend daycare or kindergarten as they can experience a 2 to 3 times greater risk of acquiring infections in these settings. Also, one study showed that 3 to 6 different viruses may spread in the same kindergarten at the same time and another study revealed that children could be infected with more than one virus approximately 5% of the time.

The impact of young children getting together in settings like daycare and kindergarten cannot be stressed enough. This has been especially apparent during the COVID-19 pandemic. With the public health interventions instituted to try and reduce the spread of COVID-19 (i.e., discontinuing in-person schooling, wearing masks, environmental disinfection, etc.), one study discovered an approximate 80% decrease in childhood viral respiratory infections. The bottom line is that kids frequently get sick when they gather.

Aside from the regularity of contracting viral respiratory infections, the length of illness is often a concern for parents. In a systematic review of the literature, one study evaluated the length of “cold” symptoms in children. Cough only resolved in 50% of children by 10 days (about 1 and a half weeks) and 90% by 25 days (about 3 and a half weeks). Common “cold” symptoms lasted from 7 to 15 days (about 1 to 2 weeks), and only about 50% of children improved by the 10th day of the illness. For nonspecific respiratory symptoms, 50% of children improved by day 7 or 8, and 80% improved by the 14th day of the illness. So, it seems that cough, congestion, runny nose, and other “cold” symptoms can last for quite a while without concern for severe illness.

Nevertheless, warning signs of a more serious respiratory infection are prolonged fever, appearance of new or worsening symptoms and trouble breathing. These warning signs should prompt further evaluation and management by your medical team. While fevers can persist for a while, clinicians usually feel less comfortable if the fever lasts for a week or more.

The longer a “cold” lasts with prolonged fever or a fever starting after an initial period of no fever, we become concerned that the viral infection has allowed a bacterial infection to develop on top of the initial viral infection.

Viral upper respiratory tract infections commonly precede bacterial ear infections and pneumonia. New symptoms, like ear pain, can indicate an ear infection. Also, a worsening cough with a prolonged fever or new-onset fever while having a persistent cough can be suspicious for bacterial pneumonia.

Finally, when an infant or child breathes faster than normal for age, develops retractions (sucking in of the skin just above the sternum at the base of the neck and the area below the ribcage just above the stomach area) and/or starts nasal flaring (widening of the nostrils with taking breaths inward), the child shows that he/she is having trouble breathing. The “cold” or viral upper respiratory tract infection, at this point, has moved from a normal course to something that should be evaluated by a health care professional.

So, when you ask, “Is this normal?” and “What is wrong with my child?” — the answer will most commonly be: “Yes, this is normal” and “Nothing is seriously wrong with your child.”

Symptoms of a “cold” or a viral upper respiratory tract infection can occur repeatedly and persist for quite a while, making it seem that your child has been sick for months at a time. With all this said, if you have any concerns or questions about your child’s health, you should always feel free to speak with your medical team because your concerns are always valid. It is the health care professionals’ duty to make sure that your child’s illness is following a normal course and nothing is seriously wrong with your child.

David Epstein is a pediatrician.

Image credit: Shutterstock.com

Prev

If you’re a nurse or an abuse survivor, you don’t have to be brave [PODCAST]

December 13, 2021 Kevin 0
…
Next

End the trauma, stop health care's great resignation, and protect care teams now

December 14, 2021 Kevin 2
…

Tagged as: COVID, Infectious Disease, Pediatrics

Post navigation

< Previous Post
If you’re a nurse or an abuse survivor, you don’t have to be brave [PODCAST]
Next Post >
End the trauma, stop health care's great resignation, and protect care teams now

More by David Epstein, MD

  • If growing a hospital pediatric program was only this easy

    David Epstein, MD
  • They didn’t teach social media in medical school

    David Epstein, MD
  • A perspective on comorbidities and severity of illness in children with COVID-19

    David Epstein, MD

Related Posts

  • State sanctioned executions in the age of COVID-19

    Kasey Johnson, DO
  • Rethinking consent in the age of Facebook and Cambridge Analytica

    Peter F. Nichol, MD, PhD
  • Finding happiness in the time of COVID

    Anonymous
  • Birthing in the era of COVID

    Jennifer Roelands, MD
  • How to get patients vaccinated against COVID-19 [PODCAST]

    The Podcast by KevinMD
  • COVID-19 divides and conquers

    Michele Luckenbaugh

More in Conditions

  • The surprising medical mystery of a “good” Hitler: How a rescued kitten revealed a rare movement disorder

    Teresella Gondolo, MD
  • The power of coaching for physicians: transforming thoughts, changing lives

    Kim Downey, PT
  • Unlocking the secrets of cancer conferences: an end-of-life counselor’s journey among pharmaceutical giants

    Althea Halchuck, EJD
  • An obstetrician-gynecologist reveals the truth about reproductive planning and how to navigate society’s expectations

    Yuliya Malayev, DO, MPH
  • Nose-brain connection: The surprising link between allergies and mental health revealed

    Kara Wada, MD
  • Is the rise in mental illness due to greater awareness or a true increase in incidence?

    Zahid Awan, MD
  • Most Popular

  • Past Week

    • A patient’s perspective on the diminishing relationship between doctors and patients

      Michele Luckenbaugh | Conditions
    • Unmasking wage disparity in health care: the truth behind the Elmhurst Hospital physician strike

      Kevin Pho, MD | KevinMD
    • Why affirmative action is crucial for health equity and social justice in medicine

      Katrina Gipson, MD, MPH | Policy
    • The power of coaching for physicians: transforming thoughts, changing lives

      Kim Downey, PT | Conditions
    • How electronic health records preserve patients’ legacies in the words of oncologists

      Marc Braunstein, MD, PhD | Physician
    • Unmasking the brutal reality of gun violence in America: a call to action for unity and meaningful change

      Osmund Agbo, MD | Policy
  • Past 6 Months

    • The growing threat to transgender health care: implications for patients, providers, and trainees

      Carson Hartlage | Policy
    • It’s time to replace the 0 to 10 pain intensity scale with a better measure

      Mark Sullivan, MD and Jane Ballantyne, MD | Conditions
    • Breaking point: the 5 reasons American doctors are dreaming of walking away from medicine

      Amol Shrikhande, MD | Physician
    • “Is your surgeon really skilled? The hidden threat to public safety in medicine.

      Gene Uzawa Dorio, MD | Physician
    • Revolutionize your practice: the value-based care model that reduces physician burnout

      Chandravadan Patel, MD | Physician
    • Breaking the cycle of racism in health care: a call for anti-racist action

      Tomi Mitchell, MD | Policy
  • Recent Posts

    • Physician entrepreneurs offer hope for burned out doctors

      Cindy Rubin, MD | Physician
    • Uncovering the truth about racial health inequities in America: a book review

      John Paul Mikhaiel, MD | Policy
    • Why electronic health records are failing patients: the dark side of copy and paste [PODCAST]

      The Podcast by KevinMD | Podcast
    • The hidden factor in physician burnout: How the climate crisis is contributing to the erosion of well-being

      Elizabeth Cerceo, MD | Physician
    • The surprising medical mystery of a “good” Hitler: How a rescued kitten revealed a rare movement disorder

      Teresella Gondolo, MD | Conditions
    • The power of coaching for physicians: transforming thoughts, changing lives

      Kim Downey, PT | Conditions

Subscribe to KevinMD and never miss a story!

Get free updates delivered free to your inbox.


Find jobs at
Careers by KevinMD.com

Search thousands of physician, PA, NP, and CRNA jobs now.

Learn more

Leave a Comment

Founded in 2004 by Kevin Pho, MD, KevinMD.com is the web’s leading platform where physicians, advanced practitioners, nurses, medical students, and patients share their insight and tell their stories.

Social

  • Like on Facebook
  • Follow on Twitter
  • Connect on Linkedin
  • Subscribe on Youtube
  • Instagram

CME Spotlights

From MedPage Today

Latest News

  • 'Medically Relevant to Saving the Life of Your Patient': What We Heard This Week
  • Want to Solve the Nurse Shortage?
  • Why Are Female Doctors Sued Nearly Half as Often as Male Doctors?
  • What Drug Did FDA Just Approve for COVID?
  • PET Scan for Alzheimer's Dx; Predicting Colon Cancer Survival

Meeting Coverage

  • No Access to Routine Healthcare Biggest Barrier to HPV Vaccination
  • Trial Results Spark Talk of Curing More Metastatic Cervical Cancers
  • Cross-Border Collaboration Improves Survival in Pediatric Leukemia Patients
  • Monoclonal Antibody Reduced Need For Transfusions in Low-Risk MDS
  • Less-Invasive Surgery for Pancreatic Cancer Proves Safe, Effective
  • Most Popular

  • Past Week

    • A patient’s perspective on the diminishing relationship between doctors and patients

      Michele Luckenbaugh | Conditions
    • Unmasking wage disparity in health care: the truth behind the Elmhurst Hospital physician strike

      Kevin Pho, MD | KevinMD
    • Why affirmative action is crucial for health equity and social justice in medicine

      Katrina Gipson, MD, MPH | Policy
    • The power of coaching for physicians: transforming thoughts, changing lives

      Kim Downey, PT | Conditions
    • How electronic health records preserve patients’ legacies in the words of oncologists

      Marc Braunstein, MD, PhD | Physician
    • Unmasking the brutal reality of gun violence in America: a call to action for unity and meaningful change

      Osmund Agbo, MD | Policy
  • Past 6 Months

    • The growing threat to transgender health care: implications for patients, providers, and trainees

      Carson Hartlage | Policy
    • It’s time to replace the 0 to 10 pain intensity scale with a better measure

      Mark Sullivan, MD and Jane Ballantyne, MD | Conditions
    • Breaking point: the 5 reasons American doctors are dreaming of walking away from medicine

      Amol Shrikhande, MD | Physician
    • “Is your surgeon really skilled? The hidden threat to public safety in medicine.

      Gene Uzawa Dorio, MD | Physician
    • Revolutionize your practice: the value-based care model that reduces physician burnout

      Chandravadan Patel, MD | Physician
    • Breaking the cycle of racism in health care: a call for anti-racist action

      Tomi Mitchell, MD | Policy
  • Recent Posts

    • Physician entrepreneurs offer hope for burned out doctors

      Cindy Rubin, MD | Physician
    • Uncovering the truth about racial health inequities in America: a book review

      John Paul Mikhaiel, MD | Policy
    • Why electronic health records are failing patients: the dark side of copy and paste [PODCAST]

      The Podcast by KevinMD | Podcast
    • The hidden factor in physician burnout: How the climate crisis is contributing to the erosion of well-being

      Elizabeth Cerceo, MD | Physician
    • The surprising medical mystery of a “good” Hitler: How a rescued kitten revealed a rare movement disorder

      Teresella Gondolo, MD | Conditions
    • The power of coaching for physicians: transforming thoughts, changing lives

      Kim Downey, PT | Conditions

MedPage Today Professional

An Everyday Health Property Medpage Today
  • Terms of Use | Disclaimer
  • Privacy Policy
  • DMCA Policy
All Content © KevinMD, LLC
Site by Outthink Group

Leave a Comment

Comments are moderated before they are published. Please read the comment policy.

Loading Comments...