Overview
Also known as acute coryza, the common cold is a catarrhal viral upper respiratory tract infection, characterised by a runny nose, congestion, and sneezing (coryzal features). It is usually mild and self-limiting. Rhinovirus is the most common cause. Since it can be caused by a wide range of viruses, it does not have many specific preventative or curative treatments.
Pathophysiology
The common cold is transmitted via direct contact and small- and large-particle aerosols. Children tend to spread infection as they have fewer antibodies and are more susceptible, tend to have higher viral levels and shed viruses for longer. Viruses invade the upper respiratory tract mucosa, resulting in inflammation and blood vessel engorgement, leading to congestion and discharge.
Epidemiology
- Although it can affect all ages, the common cold is more common in children
- Adults can experience an average of 2-3 colds per year and children can experience 5-8
- The common cold is more common in the winter months
Presentation
Features of the common cold can be described as coryzal symptoms:
- Nasal discharge, congestion, and sneezing
- Nasal discharge is often clear and profuse to start with but can thicken and darken
- Sore throat – often the most common first feature
- Cough and sore throat
- Fever – more common in children
- Some viral infections can cause conjunctivitis (e.g. adenovirus)
Complications
Complications tend to be more common in immunocompromised people or people with comorbidities such as diabetes mellitus, asthma, COPD, and heart failure.
Sinusitis – the infection may spread to the sinuses, resulting in facial pain and prolonged nasal congestion.
Acute otitis media – more common in children and may be seen in around 20% following common colds.
Lower respiratory tract infection – infections such as acute bronchitis, infective asthma/COPD exacerbation, and pneumonia may occur.
Complications in young children and babies – including bronchiolitis, croup, and pneumonia.
Prognosis
- The common cold is usually self-limiting. Symptoms tend to peak within 2-3 days then resolve over a week.
- Symptoms tend to be more severe in people who smoke and their risk of lower respiratory tract infection is higher
