How to Tell the Difference Between Coronavirus Symptoms and Allergies

Your head hurts, your chest feels tight, your throat itches, and you keep coughing. It all begs the anxiety-inducing question: Is it coronavirus —  or just the same allergies that sneak in every spring?

The answer is complicated by the fact that we're living through such a unique time when it comes to respiratory issues. "The good news is COVID cases are decreasing in most places. However, as people go out and socialize more, we do risk seeing an emergence of other upper respiratory viruses, like the cold or flu," says Arizona-based family physician Natasha Bhuyan, M.D., regional medical director for One Medical. "Luckily, mask-wearing has kept these to a minimum, but as many places are lifting mask mandates, I expect an emergence in circulating viruses — at the same time that we're going to be seeing a surge in allergy cases." And, a reminder: You can have both seasonal allergies and a cold, or seasonal allergies and Covid-19 simultaneously.

Now, let's be clear: If you have any respiratory symptoms (coughing, wheezing, trouble breathing), you should self-isolate and call your primary care doctor ASAP in case they are indeed markers of COVID-19, says Dr. Bhuyan. They can review your symptoms and history, then determine the next best steps. "Your PCP might advise trying something for allergies or they may even advise a COVID test if they are concerned."

But there's a good chance you could simply be one of the more than 50 million Americans who suffer from seasonal allergies every year, according to the American College of Allergy, Asthma & Immunology (ACAAI). Last year, as people started spending more time indoors during lockdowns, surrounded by pets, dust mites, mold, and other potential allergens, many people were experiencing allergies that were worse than normal — or even for the first time, points out Purvi Parikh, M.D., allergist and immunologist with Allergy and Asthma Associates in New York. This year, however, as people are starting to go out more, it's very possible you're bringing allergens into your home — for example, pollen can stick to your clothing and linger in the tracks of your shoes, says Dr. Bhuyan. "We've also seen an increase in pet ownership during the pandemic, which of course, means more pet dander."

Climate change is another major factor. "We are seeing a trend of longer allergy seasons due to climate change and worsened air quality. I often have patients who previously were not allergy sufferers with new spring allergy symptoms. I also have patients who, every year, say their allergies are worsening compared to prior years," says Dr. Bhuyan.

If you already battled the whole 'is it Covid or just allergies' debate last year, you probably have a good idea of the overlapping symptoms and key differences between Covid-19 and spring allergies. But if you're new to this not-so-fun Venn diagram, here's a quick checklist that can help you decipher between the two.

Do you have a temperature? COVID-19 generally runs a fever over 100.4°F, while allergies rarely cause high temperatures, Dr. Parikh says.

Are you congested? Both COVID-19 and allergies can cause a cough, but corona's is usually dry whereas one from allergies is the direct result of post-nasal drainage. Coronavirus can definitely cause nasal congestion or a scratchy throat, but it's more rare.

Are you itchy? Anywhere — your skin, throat, nose, eyes. This is a hallmark sign of allergies and not associated with coronavirus.

Do your symptoms change throughout the day? If so, it's probably just allergies: Pollen peaks in the morning, which is when most allergy sufferers find their symptoms to be the worst, Dr. Bhuyan says. (Even if you haven't been outside today, it can get into your house on your pet's coat, through open windows, or just from poor insulation.) COVID-19 symptoms stay consistent throughout the day.

Take an allergy pill. Long-acting antihistamines like Allegra, Zyrtec, and Claritin are helpful for both allergies as well as a cold, Dr. Parikh points out. If you pop one and your symptoms get better, that's a good sign you're fighting something other than COVID-19.

Clean house. Limiting allergens in your home can go a long way in symptom control. Brush and bathe your pets regularly, and change your sheets and pillowcases weekly, Dr. Bhuyan advises. Investing in an air purifier can also help those with severe allergies by preventing allergens from lingering in the air.

Call your doc. It's worth repeating: Right now, any breathing symptom like a cough, wheeze, or shortness of breath should be treated by a physician, regardless of cause. If your respiratory symptoms are really bad, call them ASAP. But if they're mild, it's helpful to take the above steps first and rule out some of the key hallmarks of allergies before discussing next steps with your doc.

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