Spring allergies vs. COVID-19: What you should know

Is it spring allergies or is it COVID-19? Even doctors sometimes have a hard time distinguishing the two, because the symptoms can be so similar: sinus congestion, runny nose, sore throat and changes in breathing, headache and fatigue.

“The overlap between the symptoms of environmental allergies and COVID-19 is pretty substantial, which is why it’s sometimes difficult to tell one from the other, ” Dr. Nate Wood, a Yale Medicine internal medicine physician tells Yahoo Life. Making a correct diagnosis is also difficult because COVID-19 affects people differently, he says.

COVID-19 can make allergies confusing

Dr. Katie Sharff, chief of Infectious Disease for Kaiser Permanente in Oregon and Southwest Washington tells Yahoo Life that it can get even more confusing if someone has had COVID-19 more than once. “We are starting to see individuals presenting with their second or third COVID-19 illness, and the prior immunity often results in milder illness that may be more likely to be confused with seasonal allergies,” she says.

Here are seven clues to bear in mind when trying to figure out if you are suffering from spring allergies, COVID-19 or both, according to six top allergists and infectious disease specialists.

1. Know which symptoms aren’t allergy-related

Muscle aches, chills and gastrointestinal symptoms such as nausea, vomiting and diarrhea are more likely to be caused by COVID-19 than allergies, according to Sharff. While a mild sore throat might be a sign of allergies, a severe sore throat that limits someone’s ability to eat or drink would be an “unusual presentation” of allergies and is more likely to be COVID-19, she says.

Do you have a fever? If someone develops a fever, COVID-19 is almost always to blame. “Allergies do not cause fever. Full stop. If there is a fever, there is an infection,” says Dr. Allen J. Dozor, professor of pediatrics and division chief of pulmonology, allergy and sleep medicine at New York Medical College.

If you have lost your sense of taste and smell, you are more likely to have COVID-19 than spring allergies. At the beginning of the pandemic, people with COVID-19 lost their sense of taste and smell, Dr. Roberto Garcia-Ibá?ez, a board-certified allergist with the AllergiGroup, tells Yahoo Life. “These symptoms seem to be abating, however, leading to a far more significant overlap of symptoms between COVID-19 and allergies,” he says.

2. Are your eyes itchy and watery?

Symptoms that are more likely to indicate that someone is suffering from allergies rather than COVID-19 include itchy, watery eyes, a runny nose and sneezing, Dr. Shruti Gohil, associate medical director, epidemiology and infection prevention and assistant professor, infectious diseases at the University of California, Irvine School of Medicine, tells Yahoo Life.

“Itchy, watery eyes are unique to seasonal allergies,” says Sharff. “Furthermore, allergy symptoms tend to wax and wane and may be worse when you are outside,” she says.

3. Do your symptoms get worse as the day goes on?

As for spring allergies, many patients tend to feel better in the morning. Because pollen tends to peak in the morning, after a night of not being exposed to this allergen, patients with seasonal allergies “often wake up feeling pretty good, and then their allergy symptoms worsen as the day goes on,” says Dozor.

With allergies, many patients “have times when their nose is clear, and then suddenly they become more congested," he says. “With any respiratory infection, including COVID-19, nasal symptoms and cough would not suddenly go away, and then return, all within hours.”

4. What time of year are you experiencing symptoms?

“Allergy symptoms often come back around the same time every year, and generally do not come as a surprise,” Garcia-Ibá?ez tells Yahoo Life. However, if symptoms appear at random, especially if combined with “symptoms like malaise, chills, chills and a headache," they are probably not related to allergies and are more likely to be COVID-19, he says.

He notes that “allergy symptoms are mainly seasonal or perennial, meaning that they are present during certain seasons and worse in some geographical locations.” If symptoms appear at a time of year or in a place that is not typical, they are more likely to be from COVID-19, he says.

5. How long have you had symptoms?

How long symptoms last is also a clue. “Seasonal allergy symptoms can last for weeks, compared to acute COVID-19 symptoms that typically last for days,” Dr. Ruth Kanthula with MedStar Health, who specializes in infectious diseases and pediatrics, tells Yahoo Life. If your symptoms linger, it’s more likely that you have spring allergies and should see an allergist. If you feel better in a few days, COVID-19 is the more likely culprit.

Sharff adds that symptoms from COVID-19 tend to get progressively worse over a period of days before someone feels better. Symptoms from allergies tend to stay consistent day-to-day during the spring.

6. How are your symptoms overlapping?

Much of the confusion surrounding COVID-19 and spring allergies stems from the multitude of overlapping symptoms. This is especially true in the early stages of COVID-19, when symptoms tend to be milder, says Gohil.

Many people don’t realize that allergies can cause a cough and sore throat, Wood says. Although these symptoms are more commonly associated with COVID-19, “allergies almost always cause a runny nose, resulting in fluid that drips both out of the nostrils and down the back of the throat. This fluid dripping down the back of the throat causes irritation, which can lead to both a sore throat and a cough,” he says.

7. Could you have COVID-19 and spring allergies?

Figuring out if you have COVID-19 or spring allergies is also complicated by the fact that people “can catch COVID-19 or other infections at the same time as they are suffering from allergies,” says Dozor. Taking a COVID-19 test may be the only way to know for sure if you have COVID-19, even if you also have traditional spring allergy symptoms.

“Many symptoms can overlap with many different diseases. People should recognize that at the end of the day, they know their bodies best. It's important to listen to your body,” says Gohil.

If you aren’t sure, determine if you could’ve been exposed to COVID-19. Wood recommends asking yourself if you have recently been around someone with COVID-19 and whether you have been “spending a lot of time in public, unmasked, in an area where COVID-19 is prevalent.”

Also, consider whether COVID-19 is circulating in high numbers in your community. “If the rates of COVID-19 in the community are low, then the likelihood of a patient having a positive COVID-19 test is low,” says Dozer. He notes that COVID-19 “keeps surprising us,” and that it’s important to check whether COVID-19 is circulating rather than relying on a seasonal spread, and test accordingly.

Why it’s important to know whether you have COVID-19 or allergies

Knowing whether you have COVID-19 or allergies is important, because both can lead to long-term complications if they are not treated early.

With COVID-19, high-risk individuals may be eligible to take an antiviral, which can reduce their likelihood of developing severe COVID-19, Sharff says. Because COVID-19 is so contagious, it’s also important to know if you have the virus so that you can take preventative measures to protect others. “Even someone with mild disease can transmit their infection to someone who is at high risk for severe disease, including the elderly or anyone who might be immunocompromised," including those who are pregnant, Dozor says.

Allergies can also lead to long-term medical problems if not treated. Patients who suffer ongoing allergies can develop complications, such as sinus infections or even ear infections.

Furthermore, “untreated allergies can contribute to fatigue, headaches and even shortness of breath,” says Sharff. Untreated allergies can start “snowballing into real asthma attacks, emergency room and urgent care visits, and hospitalizations,” Dozor adds. He recommends that anyone who suspects they have allergies meet with their health care provider to come up with a plan.