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Is It Seasonal Allergies ... or Coronavirus Symptoms?

How to decide if you need to get tested for COVID-19

spinner image woman with pollen allergies standing outdoors under blossoming trees sneezing into a tissue
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| Warmer days don’t just mean the arrival of spring. If you have seasonal allergies, warm weather may also signal the arrival of watery eyes, sneezing, congestion, headache and maybe even a cough.

With the continuing pandemic and allergy season starting earlier than usual in many parts of the country, there may be times when you’re not sure if your symptoms are due to allergies or to COVID-19.

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It’s an understandable concern because they share many symptoms, says Panagis Galiatsatos, M.D., a physician in the Division of Pulmonary and Critical Care Medicine at Johns Hopkins Medicine. Overlapping symptoms include headache, sore throat, congestion, runny nose and cough.

The U.S. Centers for Disease Control and Prevention (CDC) offers this Venn diagram that shows the symptoms unique to each condition, and which symptoms they share:

Coronavirus vs. allergy symptoms

spinner image Venn diagram comparing symptoms of COVID-19 and seasonal allergies

How can you tell the difference between seasonal allergies and COVID-19 symptoms? If you have a fever and chills, that can indicate an infection, so you should definitely get a coronavirus test, Galiatsatos says. The same goes if you lose your sense of taste or smell.

Allergies are rarely associated with a fever. They usually affect your upper respiratory system, Galiatsatos says, so you’re more likely to have itchy, watery eyes and a runny nose.

“Most people with seasonal allergies know their symptoms; it’s almost like a Spidey sense,” Galiatsatos adds. “If it’s what you feel every year, it’s probably not COVID.”

Milwaukee allergist Gary Steven, M.D., recommends paying attention to what makes your symptoms worse. “If you're fine when you're indoors and the windows are closed, but then you go out on a dry, windy day and start sneezing your head off, yes, that's an allergy.”

If you’re still uncertain, though, there’s no downside to getting a COVID-19 test.

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Why your allergies may seem worse

Spring arrived early this year in many parts of the U.S. For California and Arizona, it arrived earlier in 2021 than at any point in the past 40 years, which is how long such records have been kept, according to the USA National Phenology Network, funded primarily by the U.S. Geological Survey.

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It's part of a continuing trend in recent years of longer and more intense allergy seasons caused by climate change, explains Ronald Saff, M.D., an allergist in Tallahassee, Florida. A 2019 study, reported in the journal Lancet Planetary Health, found that airborne pollen counts increase as average temperatures climb.

"Warmer weather tricks the trees into thinking it's an early spring, so they start pollinating,” Saff says. Because tree pollen is so fine, wind can carry it for miles. For allergy sufferers, it can cause itchy, swollen eyes, a dry cough, congestion, sneezing and wheezing. From 10 to 30 percent of the adult population suffers from seasonal allergies (also called allergic rhinitis).

Older adults are not immune. In one study about 15 percent of women and 13 percent of men over age 60 reported they have some type of seasonal allergy. After age 70, however, allergies tend to decrease, along with the responsiveness of your immune system.

If you're experiencing symptoms, doctors recommend the following steps.

Reduce your exposure

  • Keep windows closed and filter indoor air. When driving, set the controls to “recirculate” so your car isn't pulling in outside air that's filled with pollen.

  • When outside, wear glasses and a hat, as they keep pollen from striking your face and eyes.

  • Reduce pollen cling. Change your clothes after being outside, and take a shower if you can, to wash the pollen grains off your hair and body. Leave your shoes outside the door.

Try over-the-counter remedies

  • Nasal steroids: The American Academy of Allergy, Asthma and Immunology considers these sprays (such as Flonase, Nasonex and Nasacort) “the mainstay of treatment” for seasonal allergies. They have few side effects, and just a spritz or two dramatically relieves symptoms in most people, Saff says. The sprays are most effective if you start them before the beginning of allergy season and use them every day.

  • Oral antihistamines: These drugs are designed to counter the effects of histamine, the chemical your body releases during an allergic reaction. To prevent drowsiness, Steven recommends “second-generation” antihistamines, such as Allegra, Claritin and Zyrtec, rather than a first-generation medication like Benadryl. “The first-generation antihistamines slow down reaction times, especially in older adults,” he notes. “They can have an impact on your driving."

  • Antihistamine eye drops: Drops made with an antihistamine called ketotifen will help relieve itchiness, redness and puffiness, Saff says. These drops last for up to 12 hours.

  • Sinus rinse: A rinse at the end of the day can “wash out all of the allergens and gunk that accumulates in your nostrils and sinuses during the day so you feel better,” Saff advises. Make sure you use distilled water, sterilized water or tap water that has been boiled, and then cool when used; in a few rare cases, regular tap water that wasn't boiled caused dangerous infections.
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See an allergy doctor

Whether your symptoms are severe or not, it's a good idea to consult an allergy specialist before you self-treat, Saff and Steven suggest. Allergists can do tests to find out what you're allergic to and offer access to stronger prescription medications, such as antihistamine sprays, which Steven says are extremely effective.

If you have a severe case, an allergist may recommend “allergen immunotherapy,” which exposes you to increasing amounts of an allergen, usually through a series of shots, to build up your immune system.

Michelle Crouch is a contributing writer who has covered health and personal finance for some of the nation's top consumer publications. Her work has appeared in Reader's Digest, Real Simple, Prevention, The Washington Post and The New York Times.

Editor’s note: This story was updated to reflect 2021 information.

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