COVID-19 or RSV? Symptoms parents should watch for in kids

What is RSV?

RSV is a common respiratory virus that usually causes mild, cold-like symptoms.

The early emergence of the respiratory syncytial virus, or RSV, during the summer, is adding more strain on local hospitals — particularly children’s hospitals — that are experiencing a surge in pediatric COVID-19 admissions.

Increased cases of RSV coinciding with the increasing spread of the delta variant of the novel coronavirus among children may create difficulty for parents in differentiating between the two, because the two viruses exhibit many of the same symptoms.

RSV is a common cause of cold-like symptoms, usually seen during the winter months, and can be serious for infants and the elderly.

So how do you spot the difference? Here are some symptoms that can help parents differentiate between COVID-19 and RSV.

FILE - A nasal swab to two-month-old to test for the flu. (Alex Kormann/Star Tribune via Getty Images)

SARS-CoV-2, or the virus that causes COVID-19 disease, is a respiratory virus associated with a range of symptoms, and it takes a couple of weeks for an infected individual to fully recover, according to the U.S. Centers for Disease Control and Prevention.

Symptoms associated with COVID-19 include:

Fever or chills
Cough
Shortness of breath or difficulty breathing
Fatigue
Muscle or body aches
Headache
New loss of taste or smell
Sore throat
Congestion or runny nose
Nausea or vomiting
Diarrhea

According to the CDC, most children likely had an RSV infection by the age of 2. While most adults recover within one to two weeks, RSV can be dangerous for infants and the elderly.

For children younger than 1 year, RSV is the most common cause of bronchiolitis and pneumonia. Symptoms of RSV usually come in stages and can include, but are not limited to:

Runny nose
Decrease in appetite
Coughing
Sneezing
Fever
Wheezing

Cases of RSV dropped dramatically last year, with people staying home and social distancing, but began cropping up as pandemic restrictions eased.

"I’ve never seen anything like this before," Dr. Kate Dutkiewicz, medical director at Beacon Children’s Hospital in South Bend, Indiana, said after treating two RSV-infected infants recently. Both needed oxygen treatment to help with breathing. ‘’I’ve never seen cases in July, or close to July.’’

The CDC issued a health advisory on June 10 about an increase in RSV cases across parts of the South. Cases have appeared in many other states, too.

RSV had an approximate 3% positivity rate in June before rising to 13% by mid-July, according to the latest federal figures, which may represent an undercount due to lags in reporting.

Among U.S. kids under age 5, RSV typically leads to 2 million doctor’s office visits each year, 58,000 hospitalizations and up to 500 deaths — higher than the estimated toll on kids from COVID-19, according to the CDC.

Among adults aged 65 and up, RSV can lead to pneumonia and causes almost 180,000 hospitalizations and 14,000 deaths yearly.

Meanwhile, data from the U.S. Department of Health and Human Services showed on Aug. 16 that there are about 1,900 children in the U.S. hospitalized with COVID-19. Texas has one of the highest numbers of pediatric COVID-19 hospitalizations, with 170 confirmed cases. Florida leads with 199, and California has 107.

Banner Health, the largest hospital network in Arizona, raised concerns about a sharp increase in the number of children being hospitalized with the novel coronavirus on Thursday.

During the first two weeks of August, officials say they had a total of 71 pediatric COVID-19 patients - that was the number of total pediatric patients they treated in the entire month of July.

In Texas, a spike in COVID-19 cases has resulted in no pediatric ICU beds left in the North Texas region, hospital officials said on Aug. 12.

"We [have] no staffed pediatric ICU beds available in Trauma Service Area E," said Stephen Love, President/CEO, Dallas-Fort Worth Hospital Council.

Officials said there were 73 confirmed COVID-19 pediatric patients hospitalized as of last week. "Which is the highest level ever of pediatric COVID-19 patients we have ever treated," Love said. "We’ve got very talented and skilled people running these hospitals and I think they're going to do everything they can to surge and continue to care for the patients. It's just how big is the surge going to be?"

In addition to the spike in pediatric COVID-19 cases, Texas hospitals are also battling rising cases of RSV, which is proving extra difficult for children who are battling both viruses at the same time.

"The combination of RSV and COVID together has certainly proven to be very, very challenging, especially because that's where we'll see our younger kids who get COVID have trouble when they have both," said Dr. Seth Kaplan, president of the Texas Pediatric Society, in an interview with FOX 4 Dallas. "On that note, we're worried about what's coming later in the season when influenza makes its comeback."

The same increases in both RSV and COVID-19 in children are happening in Georgia.

Children's Healthcare of Atlanta has 22 kids hospitalized with COVID-19, up from just four months ago.

"Nearly every pediatric ER in the region, including our own, is very busy with a large number of individuals wanting their children tested for mild symptoms or prior exposure," Dr. Stephen Thacker, Memorial Health's associate chief medical officer and a pediatric infectious disease specialist, said. "Part of the messaging is that we need to reserve our emergency rooms, whether pediatric or adult, for those true emergencies."

ERs and urgent cares are seeing a rise in children coming in with RSV and other cold-like illnesses, after a year of seeing very few cases of respiratory illnesses, said Kaiser Permanente of Georgia chief of pediatrics Dr. Thomas Steimer.

"I didn't see a single case of influenza during the year, which was the first time in my over a 20-year career," Steimer said. "Now, my clinicians are telling me that urgent care in July seems more like urgent care in January."

As face masks are coming off and people are dropping their guard, Steimer said, children are once again picking up common respiratory viruses like RSV.

"RSV is very contagious, and once it takes hold, it spreads like wildfire," he said.

Despite the common symptoms between RSV and COVID-19, doctors urge parents of young children to contact their local health care provider to get tested if children exhibit symptoms of either virus.

The Associated Press, FOX News, FOX 7 Austin, FOX 5 Atlanta, FOX 4 News and FOX 10 Phoenix contributed to this report.

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