Allergies vs. COVID-19: how to tell the difference

Since the start of the pandemic, sneezing in public has become more dramatic than ever before.

People have spent so long living in the shadow of the COVID-19 pandemic that we can sometimes forget that sneezing can be caused by something other than the coronavirus.

Now that spring has sprung, we’re left with an important question: is it allergies or COVID? We’ve covered the symptoms of seasonal allergies and the symptoms of  COVID—and how to tell the difference. 

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Common COVID symptoms 

As the weather gets warmer and we get outside more and more, the blossoming trees and flowers can provide a perfect backdrop for an afternoon picnic. But with wonderful weather comes seasonal allergies, the symptoms of which might be confused for COVID-19.

A long and varied list of COVID symptoms has been reported, but the most common are fever, dry cough, and fatigue (Jiang, 2019).

Less common symptoms include shortness of breath, muscle aches, loss of sense of smell and taste, sore throat, red or irritated eyes, runny nose, and sneezing. You’ll notice some of these (along with one we’ll look at below) have a lot in common with allergy symptoms (Jiang, 2019).

Research is ongoing, so it’s difficult to provide a complete list of COVID symptoms. Here are the most common COVID symptoms so far (Rauf, 2020, Meng, 2020):

• Fever
• Dry cough
• Shortness of breath or difficulty breathing 
• Fatigue
• Muscle pain
• Coughing with mucus or blood
• Headache
• Diarrhea
• Sneezing
• Confusion
• Stuffy or runny nose
• Chest pain
• Nausea and vomiting
• Loss of appetite
• Dizziness
• Abdominal pain
• Conjunctivitis

Common seasonal allergy symptoms 

While allergies pale in comparison to COVID, the reactions can have a significant impact on your quality of life.

Sneezing, stuffed up sinuses, and a runny, itchy nose are common symptoms of seasonal allergies. These reactions are typically caused by inhaling allergens in the air like pollen, animal dander, and mold. Even changes in humidity can trigger seasonal allergies.

Similar to COVID, allergies can also cause coughing, sore throat, red or itchy eyes, and even loss of smell or taste. Here are a few more symptoms allergies and COVID share (Akhouri, 2021):

• Stuffy or itchy nose
• Runny nose (clear)
• Sneezing
• Coughing
• Postnasal drip
• Red, itchy, or watery eyes
• Sore throat
• Ears that are painful or feel clogged
• Loss of smell and taste

While there is a good deal of overlap between symptoms, sneezing, runny nose, and red, itchy eyes are seen less with COVID (Jiang, 2020). 

Which COVID symptoms aren’t caused by allergies? 

COVID and allergies share some similar symptoms, but there are indicators of COVID that are distinct and highly unlikely to be caused by allergies. 

Fever and shortness of breath are serious symptoms of COVID that are rarely related to allergies. One study reported that 98% of participants with COVID had a fever, and 55% experienced shortness of breath (Jiang, 2019). 

Here are other signs of COVID that shouldn’t be mistaken for seasonal allergies (Loffredo 2020):

• Difficulty breathing
• Fever
• Muscle soreness
• Coughing up blood
• Diarrhea
• Chest pain
• Nausea or vomiting
• Abdominal pain

What to do if you have COVID symptoms 

Here’s what to do if you see signs of COVID, according to the Centers for Disease Control (CDC, 2021):

• Stay home. Don’t go out in public, except to get medical care.
• Get tested. If you have symptoms or have been in close contact with someone who has COVID, get a test to learn if you have an active infection.
• Practice social distancing. Stay away from other people, including those you live with, to avoid spreading the virus.
• Know when to seek help. Get medical attention immediately if you experience serious symptoms like trouble breathing, fever, or cough.
• Keep informed. Get information from trusted sources about COVID symptoms, treatments, and vaccines.

COVID vaccines are also widely available if you haven’t gotten one yet.

If you’re worried about being vaccinated, know that it’s safe, and any side effects are typically mild. Getting vaccinated prevents you and others from getting sick—and can help stop the virus from spreading. 

If you want to get back to some semblance of normal life, getting vaccinated is a vital step.

How to manage allergy symptoms

If you’re experiencing allergies, there are several over-the-counter and prescription allergy medications that can help improve your symptoms.

In general, your first line of defense should be corticosteroid nasal sprays, which have been found effective for treating allergies without the drowsiness caused by antihistamines, another common and effective treatment. 

If over-the-counter solutions aren’t cutting it, prescription options or immunotherapy may be a long-term solution for some patients.

Can COVID be more dangerous during allergy season?

Interestingly, there is some evidence to suggest COVID could be worse during allergy season.

Exposure to pollen can weaken the immune system’s response to viruses—even in people without allergies (Gilles, 2019). Another study suggests that higher pollen concentrations in the air are linked to a higher number of COVID infections, although that doesn’t prove one caused the other (Damialis, 2021).

If you’re at high risk of complications from COVID, it may be better to limit your outdoor activities during peak pollen season (Gilles 2019).
Wearing masks can help with COVID and allergy symptoms

Not only does wearing a mask protect yourself and others from COVID, but it may also help with allergy symptoms.

In a recent study, nurses in Israel with allergies and who wore surgical masks or N95 respirators reported a significant reduction in mild and severe allergy symptoms (Dror, 2020).

Overall, there’s plenty of reasons to be hopeful about COVID—especially with vaccines now available. Even if you’re vaccinated, it’s important to remain careful and be on the lookout for COVID symptoms.

If you’re experiencing fever, shortness of breath, or anything else that doesn’t feel like typical springtime allergies, consider staying away from others until you can get tested for COVID.

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Disclaimer

If you have any medical questions or concerns, please talk to your healthcare provider. The articles on Health Guide are underpinned by peer-reviewed research and information drawn from medical societies and governmental agencies. However, they are not a substitute for professional medical advice, diagnosis, or treatment.

References

1. Centers for Disease Control and Prevention. (n.d.). What to Do If You Are Sick. Centers for Disease Control and Prevention. https://www.cdc.gov/coronavirus/2019-ncov/if-you-are-sick/steps-when-sick.html
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7. Meng X, Deng Y, Dai Z, Meng Z. COVID-19 and anosmia: A review based on up-to-date knowledge. American Journal of Otolaryngology, 41(5), 102581. doi:10.1016/j.amjoto.2020.102581. https://pubmed.ncbi.nlm.nih.gov/32563019/
8. Rauf A, Abu-Izneid T, Olatunde A, et al. (2020). COVID-19 Pandemic: Epidemiology, Etiology, Conventional and Non-Conventional Therapies. International Journal of Environmental Research and Public Health, 17(21), 8155. doi:10.3390/ijerph17218155. https://pubmed.ncbi.nlm.nih.gov/33158234/
9. Akhouri S, House SA. Allergic Rhinitis. In: StatPearls. Treasure Island (FL): StatPearls Publishing; January 19, 2021. https://pubmed.ncbi.nlm.nih.gov/30844213/
10. Seidman MD, Gurgel RK, Lin SY, et al. (2015). Clinical practice guideline: Allergic rhinitis. Otolaryngoly-Head Neck Surgery, 152, S1-S43. doi:10.1177/0194599814561600. https://pubmed.ncbi.nlm.nih.gov/25644617/
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12. World Health Organization. (n.d.). Advice for the public on COVID-19. World Health Organization. https://www.who.int/emergencies/diseases/novel-coronavirus-2019/advice-for-public

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