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Is it allergies…or COVID?

Seasonal allergies hit this time of year. Here are the symptom differences.

Allergies vs. COVID | Symptoms | Transmission | Severity | Having allergies and COVID at the same time | Treatment | Prevention

CORONAVIRUS UPDATE: As experts learn more about the novel coronavirus, news and information changes. For the latest on the COVID-19 pandemic, please visit the Centers for Disease Control and Prevention.

You’ve noticed you’ve been sneezing more than usual. Come to think of it, you also have a scratchy throat and dry cough. Could you have COVID-19? Or is it run-of-the-mill allergies, the very kind that tend to pop up this time of year? Knowing the difference is important—not just for your health and the health of those around you, but for your peace of mind as well.

Do I have allergies or COVID-19?

  Seasonal allergies Coronavirus
Causes Trees, grasses, flowers, weeds, mold, fungi Infection with the SARS-CoV-2 virus
Transmission Cannot be transmitted from one person to another Is spread with the sneezes, coughs, and other droplets of infected people
Symptoms Sneezing, coughing, runny nose, watery, itchy eyes Fever or chills, cough, shortness of breath or difficulty breathing, fatigue

Muscle or body aches, headache, new loss of taste or smell, sore throat, congestion or runny nose, nausea or vomiting, diarrhea. You may have the COVID-19 virus and not exhibit any symptoms.

Treatment Antihistamine, decongestants, immunotherapy Paxlovid, sotrovimab, remdesivir, bebtelovimab, molnupiravir, fever reducer, rest, fluids
Severity Nonfatal, unless allergies become so severe they trigger breathing difficulties like asthma Coronavirus is fatal for 1.2% of those infected in the U.S., often from complications like pneumonia, cardiac events, and multi-organ failure
Prevention Avoiding triggers, using air conditioning and air filters, taking medication before symptoms start COVID-19 vaccine, wearing a face mask in public, Evusheld, frequent and thorough handwashing, disinfecting surfaces, avoiding touching face, social distancing 

 

Allergies vs. COVID symptoms

Seasonal allergies and coronavirus infection can produce a few similar symptoms, but that’s about where the resemblance ends. 

Seasonal allergy symptoms

Some 50 million Americans experience allergies each year, making them the sixth leading cause of chronic illness in the United States, according to the Asthma and Allergy Foundation of America (AAFA). Seasonal allergies tend to peak in the spring, summer, and early fall, when certain grasses, trees, weeds, and fungi bloom. 

Typical allergy symptoms include:

  • Sneezing
  • Runny nose or nasal congestion
  • Itchy, watery eyes
  • Cough

More severe allergy symptoms can cause wheezing or shortness of breath.

Coronavirus symptoms

Coronaviruses are nothing new—some, in fact, cause the ever-prevalent common cold. But, the novel coronavirus surfaced in Wuhan, China in late 2019 and caused a global pandemic. Common symptoms of COVID-19, says the U.S. Centers for Disease Control and Prevention (CDC), are:

  • Fever or chills
  • Cough
  • Shortness of breath or difficulty breathing
  • Fatigue
  • Muscle or body aches
  • Headache
  • New loss of taste or smell
  • Sore throat
  • Nasal congestion or runny nose
  • Nausea or vomiting
  • Diarrhea

Severe symptoms can include:

  • Trouble breathing
  • Persistent pain or pressure in the chest
  • New confusion
  • Inability to wake or stay awake
  • Pale, gray, or blue-colored skin, lips, or nail beds, depending on skin tone

RELATED: How to tell if your coronavirus symptoms are mild, moderate, or severe

Early in the pandemic, congestion and runny nose were not considered COVID-19 symptoms; however, with the emergence of new variants, like the Omicron variant, sinus symptoms became a more common indicator. Eye irritation is even considered a less common symptom by the World Health Organization (WHO). One study found that COVID symptoms commonly occur in this order: fever, cough and muscle pain, nausea or vomiting, then diarrhea; however, symptoms vary from person to person and variant to variant. 

And what about if you have a fever? “You can have a very low-grade fever of, for example, 99 degrees, with severe allergies,” says Anne Marie Ditto, MD, an associate professor of medicine in the division of allergy and immunology at Northwestern University Feinberg School of Medicine in Chicago. “But a fever is usually more indicative of a viral infection, including this coronavirus.” 

RELATED: How are symptoms of COVID-19 different from the flu?

You can “catch” the coronavirus, but not allergies

Coronavirus transmission occurs much like other respiratory infections do—from the droplets of infected people. You can pick up the virus when an infected person sneezes or coughs on you, you touch a surface, or you are in close proximity to someone for 15 minutes or more. This is why it’s so important, experts say, that you regularly and thoroughly wash your hands, disinfect surfaces, distance yourself from sick people when possible, wear a mask in crowded places, and avoid touching your face with your hands.

Allergies, on the other hand, are not contagious. They’re triggered when your immune system—for reasons that aren’t fully understood—mistakes a harmless substance (such as sprouting trees, grasses, weeds, etc.) as a foreign invader and launches a campaign to protect your body. Cue the sneezing, coughing, itching, and general misery allergies bring.

One way to help determine if you’re suffering with symptoms of allergies or coronavirus is to take a trip down memory lane. Think back to last spring and the spring before and the spring before that. Do you typically have a runny nose and itchy eyes when the calendar flips from March to April? That’s a good indication you have seasonal allergies and not the coronavirus. According to Dr. Ditto, allergies typically don’t develop later in life. So, if you’re an adult and are suddenly experiencing symptoms like a runny nose or a cough, it’s unlikely they’re due to allergies if you never had them before. However, because the symptoms overlap, the best way to know for sure is to get a COVID-19 test.

One’s riskier than the other

People can die from severe allergic reactions to certain foods (think nuts or eggs), medications (like penicillin), or materials (such as latex). “Allergic rhinitis [aka, a runny, stuffy nose and itchy watery eyes], while uncomfortable, is not fatal,” Dr. Ditto says. But some of the complications of allergies, such as asthma, can be. 

According to the CDC, most cases of COVID-19 are mild, but cases can turn severe, especially if you’re older or have other health issues like diabetes or heart disease. Other things to note:

  • It can take two to 14 days for COVID-19 symptoms to appear after exposure to the virus. This is called the incubation period.
  • COVID-19 is very contagious. It has the ability to spread widely, even in vaccinated people or those without symptoms.
  • Interestingly, the number of people affected by seasonal allergies also seem to be on the upswing, due, at least in part, say experts at the American Academy of Allergy, Asthma and Immunology (ACAAI), to climate change.

Can you have allergies and COVID-19 at the same time?

If you have allergies and are also experiencing coronavirus symptoms, treat both conditions. “Other diseases will still occur during this pandemic,” cautions Shuhan He, MD, an emergency physician in Boston and the founder of Conduct Science. “Having allergies and COVID-19 at the same time will probably make you more uncomfortable, but your treatment plan shouldn’t change.”

What’s the treatment?

Treatment for seasonal allergies includes:

  • Over-the-counter nasal sprays and eye drops
  • Antihistamines
  • Decongestants
  • Allergen immunotherapy (allergy shots), which involves receiving tiny amounts of the thing(s) you’re allergic to (often via injection) until you become desensitized to it and your immune system stops fighting it.

The following treatments for COVID-19 are available and supported by safety and efficacy data:

Healthcare providers also advise a fever reducer like Tylenol, resting, and fluids. 

Prevention

Preventing allergies means avoiding the things that trigger them. For seasonal allergy sufferers, that means the great outdoors.

  • Stay inside when possible.
  • Close windows.
  • Use air conditioning when possible.
  • Use (and maintain) high-efficiency air filters.
  • Monitor allergen counts in your community and take allergy medication when the readings are high, even before symptoms start. 

The way to prevent COVID-19 infection is to get a COVID-19 vaccine. For people who cannot receive the vaccine, Evusheld, a preventive antibody therapy, is now available. Additionally, you can take steps to avoid the coronavirus with the following strategies:

  • Wash your hands frequently (and especially before eating) with soap and water for a full 20 seconds. Be sure to wash under nails and between webbing in your fingers.
  • Use a hand sanitizer with at least 60% alcohol when soap and water aren’t available.
  • Stay 6 feet away from sick people, and wear a mask when in public, crowded spaces.
  • Disinfect surfaces regularly.
  • Avoid touching your face.
  • Take care of yourself—rest, eat well, and stay hydrated.