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Common Cold

Clinical Subject Page

Common Cold

The common cold is an acute, self-limiting viral infection of the upper respiratory tract, mainly affecting the nose and throat.

Also called

Acute coryza

ICD-10

M32.13

Specialty

Pulmonology

Onset

Acute

Reviewed

July 2026

On This Page

Overview

The common cold is caused by many different respiratory viruses, with rhinoviruses being the most common cause. It mainly affects the:

  • Nose
  • Nasopharynx
  • Throat

Patients typically develop rhinorrhea, nasal congestion, sneezing, sore throat, and cough. The illness is usually mild and resolves spontaneously.

Etiology & Risk Factors

Most Common

  • Rhinoviruses

Other Viruses

  • Common human coronaviruses
  • Adenoviruses
  • Parainfluenza viruses
  • Enteroviruses
  • Human metapneumovirus

More than 200 respiratory viruses can cause cold symptoms.

Transmission

The infection spreads through:

  • Respiratory droplets and particles
  • Direct contact with infected secretions
  • Contaminated hands and surfaces

Risk Factors

  • Close contact with an infected person
  • Crowded environments
  • Poor hand hygiene
  • Exposure to young children
  • Weakened immune system

Pathophysiology

Exposure to respiratory virus
⬇
Virus enters the upper respiratory tract
⬇
Infection of respiratory epithelial cells
⬇
Activation of the immune response
⬇
Release of inflammatory mediators
⬇
Nasal and throat inflammation
⬇
Increased mucus production + Mucosal swelling
⬇
Rhinorrhea + Nasal congestion + Sore throat + Cough

Key Concept

Most symptoms result largely from the inflammatory immune response to viral infection.

Clinical Presentation

  • Common Symptoms

    • Rhinorrhea (runny nose)
    • Nasal congestion
    • Sneezing
    • Sore or scratchy throat
    • Cough
    • Hoarseness
    • Mild headache
    • Fatigue or malaise

    Fever

    • Usually absent in adults
    • May occur in children

    Typical Course

    Symptoms usually:

    • Begin gradually
    • Peak within the first few days
    • Improve spontaneously

History Taking

  • Ask about:

    • Runny nose?
    • Nasal congestion?
    • Sneezing?
    • Sore throat?
    • Cough?
    • Fever?
    • Headache?
    • Muscle aches?
    • When did symptoms start?
    • Sick contacts?
    • Shortness of breath?

Physical Examination

Look for:

  • General appearance
  • Fever
  • Respiratory distress
  • Hydration status

Nose & Throat Examination

May show:

  • Nasal discharge
  • Swollen nasal mucosa
  • Mild throat redness

Chest Examination

Usually:

  • Normal

May occasionally show:

  • Mild transmitted upper airway sounds

Important Note

Abnormal oxygen saturation, marked respiratory distress, or focal chest signs are not typical of an uncomplicated condition.

Investigations of Common Cold

  • Routine Testing

    Usually not required.

    Its Diagnosed clinically from:

    • Symptoms
    • History
    • Physical examination

    Viral Testing

    Consider when identifying a specific virus would change management, such as suspected:

    • Influenza
    • COVID-19
    • RSV in selected high-risk patients

    Chest Imaging

    Not routinely required.

    Consider only if:

    • Pneumonia is suspected
    • Symptoms are severe
    • An alternative diagnosis is suspected

Diagnosis of Common Cold

  • Diagnosis is based on:

    1. Typical Upper Respiratory Symptoms

    • Rhinorrhea
    • Nasal congestion
    • Sneezing
    • Sore throat
    • Cough

    2. Mild, Self-Limiting Clinical Course

    3. Absence of Features Suggesting a More Serious Disease

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Related Topics

Management of Common Cold

  • Main Goals

    • Relieve symptoms
    • Maintain hydration
    • Prevent spread
    • Identify complications or alternative diagnoses

    Supportive Management

    • Rest
    • Adequate fluids
    • Analgesics or antipyretics when needed
    • Saline nasal irrigation or drops
    • Symptomatic treatment for nasal congestion when appropriate

    Antibiotics

    • Not indicated
    • Because it is caused by viruses
    • Antibiotics do not shorten the illness

    Antiviral Therapy

    • No routine antiviral treatment for the common cold
    • Specific antivirals may be indicated if testing identifies another treatable infection, such as influenza or COVID-19, in an eligible patient

Complications of Common Cold

  • Acute sinusitis
  • Otitis media
  • Asthma exacerbation
  • COPD exacerbation
  • Secondary lower respiratory infection in susceptible patients

Prognosis of Common Cold

  • The prognosis is excellent.
  • It is usually mild and self-limiting.
  • Most patients recover without specific treatment.
  • Cough may persist longer than other symptoms.
  • Severe or prolonged symptoms should prompt evaluation for another diagnosis or a complication.

Key Points / Clinical Pearls of Common Cold

  • The common cold is an acute viral upper respiratory tract infection.
  • Rhinovirus is the most common cause.
  • Rhinorrhea, nasal congestion, sore throat, sneezing, and cough are typical symptoms.
  • Diagnosis is usually clinical.
  • Routine investigations are not required.
  • Treatment is mainly supportive.
  • Antibiotics are not indicated.
  • Cold weather itself does not cause the infection.