Croup vs. COVID-19 in Children: Symptoms, Differences, and Care

Understand the distinctions, overlap, and best care steps for croup and COVID-19 in children.

By Medha deb

Created on Sep 25, 2025

Understand the distinctions, overlap, and best care steps for croup and COVID-19 in children.

Croup and COVID-19 are both viral illnesses that affect children’s airways and can share overlapping symptoms. Differentiating between them is crucial for effective management, minimizing complications, and providing peace of mind for caregivers. This comprehensive guide explains the causes, symptoms, differences, similarities, diagnostic approach, treatment options, and important scenarios for seeking emergency care for each illness.

Overview: Croup and COVID-19 in Children

Croup is a viral infection that primarily affects the upper airways, causing swelling around the vocal cords, trachea, and bronchi. It is most frequently seen in children between six months and five years old, though older children can also be affected.
COVID-19, caused by the SARS-CoV-2 coronavirus, is a respiratory illness that can impact children of all ages but tends to result in milder cases in children compared to adults.

Common Causes

Croup: Most frequently caused by parainfluenza viruses; other causes include influenza viruses, adenoviruses, enteroviruses, and respiratory syncytial virus (RSV).
COVID-19: Caused exclusively by SARS-CoV-2, the novel coronavirus.

Symptoms: Comparing Croup and COVID-19

Croup: Typical Symptoms

Fever
Runny nose
Sore throat
Barking cough that sounds like a seal
Stridor (a harsh, noisy sound when inhaling, especially noticeable with rapid or shallow breathing and nostril flaring)
Symptoms often worsen at night

Note: Some children can experience spasmodic croup, which generally lacks cold-like symptoms but features the characteristic cough; symptoms may recur over time.

COVID-19: Typical Symptoms in Children

Fever
Fatigue
Cough
Body aches and pains
Headache
Sore throat
Shortness of breath or rapid breathing
Runny or stuffy nose
Loss of smell or taste
Abdominal pain
Digestive symptoms (diarrhea, nausea, vomiting)
Loss of appetite or poor feeding

CDC data suggest as many as half of children with COVID-19 may have no symptoms at all.

Comparison Chart: Croup, COVID-19, and Similar Childhood Illnesses

	Croup	COVID-19	Whooping Cough	RSV	Common Cold	Flu
Cough	Barking cough	Cough	Violent, rapid cough with “whoop” sound	Cough, may include wheezing	Cough	Cough
Fever	Yes	Yes	Yes	Yes	Yes	Yes
Runny or Stuffy Nose	Yes	Yes	Yes	Yes	Yes	Yes
Sore Throat	Yes	Yes			Yes	Yes
Fatigue		Yes	Yes, due to frequent coughing		Yes	Yes
Body aches and pains		Yes			Yes	Yes
Headache		Yes			Yes	Yes
Shortness of Breath		Yes
Abdominal Pain		Yes
Nausea or Vomiting		Yes	Can vomit during cough fits			Yes
Diarrhea		Yes				Yes
Loss of appetite or poor feeding		Yes		Yes
Loss of Smell or Taste		Yes			Yes

How to Tell the Difference: Key Features

Seasonality: Croup is most common in fall and winter, while COVID-19 occurs year-round.
Classic Croup Sounds: The barking cough and stridor distinguish croup from most other respiratory infections.
COVID-19 Red Flags: Loss of taste or smell, digestive symptoms (like vomiting or diarrhea), and headache are more likely COVID-19 than croup.
Exposure History: Recent contact with a sick person diagnosed with either illness increases the chance your child has that condition.
Testing Required: The only sure way to distinguish COVID-19 is with a specific test.

Diagnosis: When to Seek Medical Advice

If your child develops a cough, fever, or other signs of respiratory illness, contact your pediatrician for guidance. Testing may be recommended, especially if your child has known COVID-19 exposure, or if symptoms are severe, persistent, or atypical.

The diagnosis is generally based on:

History of symptoms
Physical examination
COVID-19 testing as indicated

At-Home Care for Croup and COVID-19

Rest: Encourage your child to rest as much as possible.
Fluids: Keep your child well-hydrated with water, breast milk, or formula.
Comfort Measures: Use a humidifier or sit in a steamy bathroom to help ease breathing (especially for croup).
Fever or Discomfort: Acetaminophen or ibuprofen can help, but avoid aspirin in children.
Monitor Symptoms: Watch closely for signs of worsening respiratory distress.
Isolation for COVID-19: Prevent spread by keeping the child at home and limiting close contact with others until cleared by their doctor.

Many cases of both croup and COVID-19 are mild and can be managed at home, but always err on the side of caution and seek advice if concerned.

Medical Treatment

Croup: Severe cases may require steroid medications (such as dexamethasone) to reduce airway inflammation and improve breathing. Rarely, hospitalization or nebulized treatments are needed.
COVID-19: Most children do not require prescription medications. Severe cases may require hospitalization for respiratory support or other interventions.

Emergency Warning Signs: When to Seek Urgent Care

Difficulty breathing or rapid, labored breathing
Stridor (audible harsh noise with breathing)
Retractions (skin sucking in between or under ribs when breathing)
Blue tint to lips, fingernails, or skin
Decreased alertness or difficulty waking
Trouble swallowing or drooling
Unable to keep fluids down or showing signs of dehydration
High, persistent fever unresponsive to medication

Prevention Tips

Handwashing: Wash hands frequently, especially before eating or after coughing or sneezing.
Vaccination: Stay up to date on recommended childhood vaccines and COVID-19 vaccines (where eligible).
Masking: Masks can help reduce spread of COVID-19 in high-risk settings for both children and adults.
Avoid Sick Contacts: Whenever possible, keep your child away from others who are ill.
Disinfect high-touch surfaces regularly during cold and flu season.

Frequently Asked Questions (FAQs)

Can COVID-19 cause croup?

Yes, COVID-19 can sometimes present with croup-like symptoms (barking cough, stridor). Some children with SARS-CoV-2 have developed true croup, especially during certain COVID-19 variant surges.

Is croup contagious?

Yes. Croup is caused by viruses that spread through droplets from coughing, sneezing, or talking. Good hand hygiene and careful avoidance of sharing cups or utensils help reduce spread.

What should I do if my child has both croup and tests positive for COVID-19?

Follow the guidance for both illnesses: provide supportive care at home, monitor closely for breathing difficulties or other warning signs, and seek medical care right away if symptoms worsen or your child seems very ill.

How long do symptoms last in children?

For croup, mild cases often improve within 3–5 days. Most children with mild COVID-19 recover within 1–2 weeks, though some symptoms (such as cough) may linger slightly longer.

Should my child be tested for COVID-19 if they have a cough?

Yes, especially if COVID-19 is circulating in your area or your child has been in contact with a confirmed case. Only a COVID-19 test can reliably distinguish the two illnesses.

Key Takeaways

Croup and COVID-19 can have overlapping symptoms, making diagnosis challenging without a test.
The classic barking cough and stridor are hallmark signs of croup, while loss of taste/smell and digestive symptoms are more typical for COVID-19.
Most children recover at home with rest and supportive care.
Emergency care is needed immediately if your child has difficulty breathing, stridor, bluish skin or lips, or decreased alertness.
If you are unsure about your child’s symptoms, consult your pediatrician promptly.

References

Author

medha deb

Medha Deb is an editor with a master's degree in Applied Linguistics from the University of Hyderabad. She believes that her qualification has helped her develop a deep understanding of language and its application in various contexts.

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