Is the common cold (upper respiratory tract infection) associated with fever (pyrexia) and what is its duration?

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From the Guidelines

The common cold can sometimes be associated with a low-grade fever, though this is more common in children than adults, and typically lasts about 7-10 days, with symptoms peaking around days 2-3 and gradually improving thereafter, as noted in the study by 1. The fever, if present, usually occurs early in the illness and rarely exceeds 100.4°F (38°C). Higher or persistent fevers suggest a different infection like influenza or strep throat rather than a common cold. Some key points to consider include:

  • Most people experience symptoms such as runny nose, congestion, sore throat, and cough, which evolve throughout the illness.
  • Treatment focuses on symptom relief with rest, hydration, over-the-counter medications like acetaminophen or ibuprofen for fever and discomfort, and decongestants or antihistamines for nasal symptoms.
  • Antibiotics are not effective against the viral infections that cause colds, as stated in the study by 1.
  • The common cold is self-limiting, meaning it resolves on its own as the immune system fights off the viral infection, typically rhinoviruses or coronaviruses that cause these upper respiratory infections. It's also important to note that the duration and severity of the common cold can vary depending on the individual and the specific virus causing the infection, as discussed in the study by 1. In general, the common cold is a mild and self-limiting illness that can be managed with supportive care and symptom relief, and antibiotics should only be prescribed for patients with persistent symptoms for more than 10 days, onset of severe symptoms or signs of high fever (>39 °C) and purulent nasal discharge or facial pain lasting for at least 3 consecutive days, or onset of worsening symptoms following a typical viral illness that lasted 5 days that was initially improving, as recommended by 1.

From the Research

Association with Fever

  • The common cold is often associated with low-grade fever, as stated in the study 2.
  • Over-the-counter analgesics, such as aspirin, paracetamol, and ibuprofen, are commonly used to treat pain and fever symptoms of the common cold, as mentioned in the study 3.

Duration of the Common Cold

  • Most symptoms of the common cold resolve within 1 week, but coughs often persist for longer, as reported in the study 4.
  • The duration of common cold symptoms is not well-studied, with none of the included studies in the review 5 reporting on this outcome.
  • The common cold is a self-limited illness, with patients typically recovering within a short period, as stated in the study 2.

Treatment and Management

  • Treatments with proven effectiveness for cold symptoms in adults include over-the-counter analgesics, zinc, nasal decongestants, and ipratropium for cough, as mentioned in the study 2.
  • The use of acetaminophen may help relieve some symptoms of the common cold, such as nasal obstruction and rhinorrhoea, but its effectiveness is not well-established, as reported in the study 5.

References

Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

Research

Treatment of the Common Cold.

American family physician, 2019

Research

Common cold.

BMJ clinical evidence, 2011

Research

Acetaminophen (paracetamol) for the common cold in adults.

The Cochrane database of systematic reviews, 2013

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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