Flu, COVID, RSV or the common cold: when to go to the emergency room

With the arrival of winter and the increase in time spent in closed rooms, increases the circulation of respiratory viruses. In this context they coincide flu, COVID, respiratory syncytial virus (RSV), and the common coldall of them with symptoms that can overlap in the initial phases. Although it is not always easy to identify the origin of the condition at the beginning, in most cases the initial approach is similar and focuses on relieving symptoms. Therefore, from a health education point of view, it is especially important to recognize which profiles present the greatest risk and which signs indicate that it is advisable to consult with a health professional.

“In the beginning it is common the appearance of general malaise and congestion. The key is to observe how the symptoms evolve and how the condition progresses as the days go by. This evolution, together with the age and history of each person, helps to assess the level of risk and decide when it is appropriate to consult,” explains Alfonso Marco, head of the Emergency Department at the Sanitas La Moraleja University Hospital.

In general terms, The flu usually begins suddenly, with high fever, intense muscle pain and marked fatigue. that limits daily activity. Although a cough or sore throat appears in some cases, the general impact on the body stands out, rather than the symptoms located in the nose or throat. In the case of COVID, the onset can be gradual or sudden and the symptoms are more variable. It manifests itself with fever, cough, sore throat, headache or fatigue and, in certain people, with alterations in taste or smell, although these are not always present. This diversity of manifestations explains why, in the first days, it is difficult to differentiate it from other respiratory processes.

Respiratory syncytial virus presents different behavior depending on age. In babies and young children it usually manifests with persistent cough, difficulty feeding, and signs of respiratory effort. In young adults it usually presents as a mild condition, similar to a cold, while in elderly people, during pregnancy or when there are chronic pathologies or immunosuppressed situations, the risk of complications increases and an earlier clinical evaluation may be required.

“At advanced ages, a respiratory infection that seems mild can decompensate previous illnesses. That is why it is advisable to consult before shortness of breath, marked weakness, drowsiness or a progressive worsening of general condition“adds Miryam Piqueras, Director of Clinical Governance at Sanitas Mayores.

For its part, The common cold usually appears with nasal congestion, sneezing, runny nose, and sore throat.. Fever, when it occurs, is usually low and allows relatively normal activity to be maintained, although with discomfort. “It is not only the initial symptom that is relevant, but also how the condition progresses as the days go by. If the fever does not subside, the general condition worsens or respiratory difficulty appears, it is advisable to consult with a healthcare professional. It is also advisable to do so without delay in the event of signs such as confusion, chest pain, severe tiredness that does not improve, or difficulty maintaining adequate hydration“says Luis Fernando Diaz, pulmonologist at the Sanitas La Moraleja University Hospital.

Given this situation, Sanitas experts highlight some guidelines to take into account during this time of year:
• It is advisable to consult with the Primary Care doctor if there are risk factors (age, pregnancy, immunosuppression or chronic diseases) or if the condition does not follow an expected evolution.
• You should go to an emergency department if there are warning signs, such as difficulty breathing, chest pain, confusion, marked worsening of general condition or inability to maintain adequate hydration.
• As long as the discomfort persists, it is recommended reduce close contact with other people and reinforce the ventilation of interior spaces. Likewise, hand hygiene must be maintained frequently.
• The use of antibiotics is not indicated without a medical prescription, since it is not effective against infections of viral origin.
• Rest and adequate hydration promote best evolution. In case of lack of appetite, it is advisable to prioritize light and divided meals, according to tolerance.