Is it allergies or a cold — or COVID-19?

Have you developed an annoying cough? Having a sore throat? It’s spring and with spring comes lots of allergy and cold symptoms. It can be hard to distinguish between the two at times, and now it becomes a little more complicated with the current COVID pandemic. It is easy to be confused about what is going on.

While there is a good deal of overlap between seasonal allergies and a cold, there are several ways to tell them apart. Allergies often cause itchy watery eyes, scratchy throat, nasal congestion, and runny nose. People who have allergic asthma may also notice a dry cough or wheezing. Those with allergies often sneeze as well. For most people, allergies occur seasonally so they almost know when to expect them. Allergies can cause sinus type headaches, puffy eyes, fatigue, and generally make a person feel bad.  

Allergies do not cause a fever. This is one big area where it becomes easier to tell the difference between a cold and allergies. Colds don’t always cause a fever in adults, but they frequently do in children.  Colds can cause achy muscles, nasal congestion, runny nose, sneezing or sinus headaches, if a person has not had allergy issues in the past, it is likely these symptoms are a viral infection.

Allergies and cold do have many common symptoms. They can both cause congestion, runny nose, sinus headaches, sneezing, hoarse voice, and fatigue. While allergies usually cause a clear runny nose, colds frequently give people yellow or greenish mucous. A cold will typically last 3-14 days, but allergies usually last weeks or months until the season has changed.

As far a COVID goes, there are many overlapping symptoms.  COVID often causes a dry cough and occasionally difficulty breathing. COVID can also cause sore throat, loss of taste and smell, headache, body aches, fever, fatigue, nausea, or diarrhea. There are a few more rare symptoms that can be associated with COIVD such as confusion, tingling, and “covid toes”. While some of the symptoms of COVID occur in many illnesses there are a few which are quite characteristic and should be considered suspicious for infection with the virus. Loss of taste and smell has become a very well-known symptom. Most patients with COVID will have a dry cough too and this should be considered a strong indication of COVID.

The treatment for these three conditions is quite a bit different. The common cold has no great treatment except for over-the-counter symptom relief. Tylenol or ibuprofen for body aches, headaches, or fever, and other cold remedies like decongestants may be helpful for some people. There are no great approved therapies for COVID at this time either except tylenol. Both of these illnesses have to run their course. Antibiotics are not recommended for a cold and are rarely indicated in COVID.

Luckily, there are some treatments for allergies. Most people who do well with allergy treatments need to use several different medications to keep things under control. These include prescription medications such as leukotriene inhibitors or nasal steroid sprays. There are antihistamines available over the counter in many forms including pills, eye drops, and nasal sprays. Some people who don’t get relief by using all of these treatments end of getting desensitization treatments like drops that go under the tongue or allergy injections.  There are some new medications that have recently come out for those with serious allergies that have not been successfully controlled with other medications or treatments. Of course, allergen avoidance is good if that is possible.

It can be really difficult to tell the difference between allergies and a cold, much less COVID. If you aren’t sure which one you have, your doctor’s office can help. By asking a few questions and doing an exam is it much more likely to find the right diagnosis and treatment and get you on your feet feeling great again.