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Is It Allergies or COVID? Expert Shows How to Tell the Difference

a man sneezing

MONDAY, April 19, 2021 (HealthDay News) -- Seasonal allergies are striking this year at the worst possible time, with the United States in the midst of a fourth wave of the global COVID-19 pandemic.

You've got an itchy nose and watery eyes. Or maybe you've got a fever and a sore throat. Or you've developed a cough and you have trouble breathing.

Is it COVID-19, or just your usual allergies?

Confusion is perfectly understandable because "a lot of the symptoms are overlapping for mild COVID and seasonal allergies," said Dr. Gregory Levitin, an otolaryngologist at the New York Eye and Ear Infirmary of Mount Sinai, in New York City.

And this allergy season already is shaping up to be pretty severe, according to Dr. Stanley Fineman, a past president of the American College of Allergy, Asthma & Immunology.

"We've had an unusually bad pollen season," said Fineman, an allergy specialist in Marietta, Ga. "This year we've already had 20 days with the pollen count over 1,000," about as many as during most full spring allergy seasons.

An itchy, runny nose or itchy, watery eyes are the best sign that you're suffering from seasonal allergies rather than COVID-19, Levitin said.

Seasonal allergies happen when your immune system mistakenly identifies pollen from trees, flowers or grass as a dangerous invader, like a bacterium or virus.

As part of its allergic response, your body releases chemicals called histamines. Itching and sneezing are major side effects of the inflammation caused by histamines, along with runny noses and watery eyes.

"That's almost always associated with allergies," Levitin said.

On the other hand, if you're suffering from a fever, get yourself tested for COVID-19.

"COVID can cause a fever. Allergies never cause a fever," Levitin said.

Other symptoms that are more common with COVID-19 include chills, muscle or body aches, nausea or vomiting, and diarrhea.

There also are a great many symptoms in common between COVID-19 and allergies.

For example, loss of taste or smell is now widely known as a COVID-19 symptom, but some folks with allergies might have trouble smelling as well, Levitin noted.

"Sometimes congestion can be so severe with allergies that it leads to a loss of smell, which is one of those symptoms we associate with COVID," he said.

Other common symptoms of both COVID-19 and allergies, according to the U.S. Centers for Disease Control and Prevention, include:

  • Cough
  • Shortness of breath or difficulty breathing
  • Fatigue
  • Headache
  • Sore throat

The amount of time you've been miserable provides a big clue as to whether you've got the novel coronavirus or are simply dealing with pollen allergies, Levitin said. A sudden onset of symptoms is more likely with COVID-19.

"You have to tease it out to see if it's part of a two- or three-week course of allergy or are these two or three days of symptoms that started suddenly and unexpectedly, even in the background of allergies," Levitin said.

People who want to protect themselves against seasonal allergies should consider closing their windows, running a HEPA air filter in their home, and putting allergy covers on their pillow cases and mattresses, he suggested.

Folks can treat seasonal allergies using over-the-counter remedies, including steroidal nasal sprays like Flonase or Nasonex, or oral antihistamines like Claritin, Allegra and Zyrtec, Levitin added. Doctors can provide stronger prescription drugs for harsher allergy symptoms.

And if you're truly not sure whether you have COVID-19 or allergies, don't hesitate to be tested.

"Because we are still in a COVID world, I would not want to come across as not suspicious for COVID," Levitin said. "Anyone with not two or three weeks but two or three days of symptoms should talk to a doctor about getting tested."

More information

The U.S. Centers for Disease Control and Prevention has more about allergies versus COVID.

SOURCES: Stanley Fineman, MD, past president, American College of Allergy, Asthma & Immunology, and allergy specialist, Marietta, Ga.; Gregory Levitin, MD, otolaryngologist, New York Eye and Ear Infirmary of Mount Sinai, New York City

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