How do I know if it is allergies or COVID-19?

Rapid tests are convenient but have a higher chance of missing an active infection. | Unsplash/Annie Spratt

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With springtime around the corner, and the winds blowing through the Kern River Valley, for those who suffer from allergies, many of us can have stuffy nose, cough and fatigue – very similar to the symptoms of COVID-19. So those with allergies might wonder whether their symptoms are due to COVID-19 or if their allergies are acting up.

Here we’ll review the similarities and differences in the symptoms of COVID-19 and allergies. We’ll also discuss what you can do if you have these symptoms.

What’s the difference between allergy and COVID-19 symptoms?

Allergic rhinitis is the type of allergy that causes nasal symptoms. Seasonal allergies, also called “hay fever,” flare up in the spring and fall. Perennial allergies (such as those to dust and mold) are around all year.

Allergies can behave like COVID-19. They can both cause runny nose, nasal congestion, postnasal drip, sore throat, irritated eyes and fatigue. Early variants of COVID-19 only caused minimal nasal symptoms. According to early reports from the World Health Organization, only 5% of people had nasal congestion. But the more recent variant – omicron – tends to cause more nasal symptoms. It also causes more upper respiratory symptoms, such as sore throat. So on the surface, both conditions can look the same.

The major differences between allergy and COVID-19 symptoms are:

• Fever: Allergies shouldn’t cause any increase in temperature. If you detect a fever of 100°F or higher, these points to an infection and not allergies. Although not all people with COVID-19 have a fever, it occurs in many people with the infection.

• Itching: Itching is one characteristic symptom of allergies but not COVID-19. Allergies can cause itchy eyes, nose, throat and skin.

• Duration of symptoms: Allergy symptoms last much longer than viral infections. COVID-19 symptoms usually clear up within 1 to 2 weeks. Pollen seasons can last for a couple of months, and perennial allergies are around all year.

COVID-19 can also cause symptoms that affect other organs. These are uncommon with allergies. Examples include:

  • Chest tightness, shortness of breath, cough, wheeze
  • Loss of smell and taste
  • Muscle and joint pain
  • Headache
  • Nausea, vomiting, diarrhea
  • Skin symptoms, such as rashes and other skin changes

Is my sore throat from COVID-19 or allergies?

Sore throat is a common symptom of COVID-19. It may go hand-in-hand with other symptoms, such as fever and congestion, or it may be the very first symptom to develop. In fact, a sore or scratchy throat is a common early symptom of the omicron variant of COVID-19. One small study suggests that this strain may first infect the throat instead of the nose.

Many people with allergies also complain of a sore throat due to postnasal drainage – when mucus drips down the back of the throat. This can be worse in the early morning after lying down at night. Sore throats from allergies usually occur with other allergy symptoms and don’t occur in isolation.

In other words, your sore throat could be due to either COVID-19 or allergies. Your other symptoms can help point to a cause, but the only way to know for sure is to take a COVID-19 test (more below).

Is my cough from COVID-19 or allergies?

Both COVID-19 and allergies can make you cough. With allergies, increased mucus and postnasal drainage that irritates the throat also cause this. It can also feel like a tickle or itch in your throat.

On the other hand, a cough due to COVID-19 develops when the lungs are affected. The cough is usually dry, meaning that it doesn’t produce any mucus or phlegm. You may have other chest symptoms with your cough, such as shortness of breath, chest discomfort and wheeze. The omicron variant is less likely to cause chest symptoms, especially in those who are vaccinated. Allergies can cause chest symptoms only if you also have allergic asthma.

Again, either COVID-19 or allergies might be causing your symptoms. The only way to know for sure is to take a test.

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

Yes, you can have COVID-19 and allergies at the same time. Interestingly, people with allergies may be at a lower risk of contracting COVID-19. This may be because allergic airways have a reduced expression of ACE2, the receptor for COVID-19.

In another recent study, nasal steroid sprays — a common treatment for allergies — seemed to decrease the severity of COVID-19.

What to do if you aren’t sure it’s allergies or COVID-19

A good start to telling the difference between COVID-19 and allergies is checking your temperature at home. If you have a fever, then most likely you have some kind of infection.

Another thing to consider is your response to allergy treatments. You can manage most of your allergy symptoms with over-the-counter antihistamines and nasal steroid sprays. If your symptoms go away with these medications, then you likely had allergies and not anything more serious. COVID-19 symptoms don’t respond to or get better with allergy medication.

When should I get a COVID-19 test?

If you aren’t sure what’s causing your symptoms, your provider can help figure it out. Consider a telemedicine visit so that you can speak with your provider without leaving your house. While waiting to talk to your provider, it’s better to err on the side of caution. That means you should isolate yourself, sanitize surfaces and wear a mask. You shouldn’t engage in social settings until you are sure that it’s only allergies.

At the end of the day, we can’t definitively tell the difference between COVID-19 and allergies without a formal COVID-19 test. Getting tested is important to prevent the spread of COVID-19.

There are two main types of tests to see if you are infected with COVID-19. Both are done by swabbing the nose and/or throat for the virus:

1) Rapid tests: You can do these at home or testing sites. You’ll get results within 15 minutes. Rapid tests are convenient but have a higher chance of missing an active infection.

2) Laboratory tests (PCR tests): These take longer to produce results but are the most reliable at identifying an infection.

Written by Merin Kuruvilla, MD | Reviewed by Mandy Armitage, MD

Published on Feb. 7, 2022

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