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Is it COVID-19 or seasonal allergies?

April 10: Are you suddenly coughing, noticing an unusual “tickle” in your throat, or dabbing at a runny nose? With the COVID-19 pandemic raging around us, virtually any upper respiratory symptom may be worrying. But it’s also spring — a particularly early spring in the Boston area and many other places — complete with budding trees, flowers, and pollen. 

Diagram showing similarities & differences between COVID-19 symptoms &  seasonal allergy symptoms

So, what’s causing your symptoms? How can you tell the difference between symptoms of seasonal allergy and symptoms of possible COVID-19 infection? Let’s start by looking at the table below:

Symptom COVID-19 Seasonal allergies
Fever above 100.4°F/38.0°C Often Never
Dry cough Often Often
Fatigue Often Sometimes
Shortness of breath Often Never
Body aches Sometimes Never
Sore throat Sometimes Sometimes
Diarrhea Sometimes Never
Loss of smell or taste Often Never
Runny nose Sometimes Often
Nasal congestion Sometimes Often
Itchy throat Never Often
Itchy eyes Never Often
Sneezing Never Often

While a dry cough is common in both seasonal allergies and COVID-19, a cough related to an “itch” or “tickle” in your throat is most likely due to seasonal allergies. Itchy eyes or sneezing are another sign that you are most likely suffering from seasonal allergies. A fever, on the other hand, would be cause for concern; as would shortness of breath, body aches, and extreme fatigue. And we now know that loss of the sense of smell, often accompanied by loss of taste, is the symptom most predictive of a positive PCR test and the most prevalent overall (at least in Europe and North America, particularly in individuals with mild cases).

“But it’s not about any one symptom,” emphasizes Dr. Shawn Ferullo, MIT Medical’s chief of student health. “You need to realistically evaluate all your symptoms as a whole.” And, unfortunately, it’s not necessarily an either/or situation. “Even if you have classic allergy symptoms like itchy eyes and a runny nose, you shouldn’t ignore potentially worrying symptoms like fever and severe fatigue,” he adds.

Several types of over-the-counter medications can help ease allergy symptoms. These include oral antihistamines such as loratadine (Claritin, Alavert) or cetirizine (Zyrtec), nasal sprays such as fluticasone propionate (Flonase), or medications that combine an antihistamine with a decongestant. 

For symptoms of COVID-19, such as fever, dry cough, fatigue, and shortness of breath, call MIT Medical’s COVID-19 hotline at 617-253-4865 to talk with a clinician and get advice about what to do next. (MIT only)


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