Around 60 million Americans suffer from itching, coughing, and sneezing caused by seasonal allergies each spring, according to the CDC. And while these symptoms aren’t typically a cause for concern, a runny nose and sore throat are also key symptoms of the now-dominant omicron subvariant of COVID-19, BA.2, leaving many people to wonder if their symptoms are simply allergies, or COVID-19.
Why Are These Symptoms So Similar?
The similarities in symptoms can be confusing, even frustrating, to some people, especially when they are worried about infecting other people, and determining if they should be isolating.
Scott Feldman, MD, PhD, an assistant professor of Clinical Medicine in the division of Allergy and Immunology in the Perelman School of Medicine, explains that producing mucus, sneezing, and coughing are all part of how the immune system keeps threats from entering the body and making us very ill.
Feldman explains how the immune system has two parts that work together to keep threats out of our bodies. The first part evolved to destroy or get rid of things that are ‘foreign,’ like viruses or parasites, before they can make us sick. “Many people who have been vaccinated are familiar with these side effects from the inflammation that this part of the immune system causes,” he said.
“The other, more advanced part of the immune system has a lot more specificity,” Feldman explained. This part of the immune system is responsible for remembering and distinguishing between different “invaders,” and eliminate them based on their specific profiles.
“Allergies are an over-response to pollen (or animal dander, dust mites, or molds), where the immune system is responding to environmental airborne proteins,” Feldman added.
Knowing the Difference in Symptoms
Feldman says that many patients who suffer with allergies regularly will be familiar with their pattern of symptoms and triggers. For instance, if someone has experienced seasonal allergies their whole life and knows pollen is a trigger, they might not worry about a sore throat and runny nose after spending the day gardening.
Conversely, if a patient has never been diagnosed with asthma, and they are experiencing shortness of breath, or other difficulty breathing, “infection is the more likely cause,” Feldman said. “There are still other viral infections going around, so not all infections are COVID, but depending on COVID rates in your area, COVID certainly can be the most likely infectious cause,” he added.
Allergies often involve itching and sneezing, but fever is rarely a symptom of allergies, which Feldman suggests might be a way to differentiate between COVID and seasonal allergies.
While loss of taste and smell was a widespread symptom of the earlier strains of COVID, it appears to be less common with omicron. However, Feldman cautions patients, “an abrupt loss of smell without nasal congestion or other allergy symptoms, especially if associated with other infectious symptoms of COVID-19 like fever, would make COVID-19 more likely.”
Feldman also acknowledges that it’s possible to have both allergies and COVID at the same time. “The combination of symptoms may suggest both,” he added. If a patient typically experiences a sore throat from allergies in the spring and summer, but develops a fever, that could be an indicator of an infection.
He urges patients to utilize rapid testing for COVID-19 when in doubt. “If you’re not sure and you may be exposing others unintentionally, the safer route is a rapid test,” he said. He also reminds patients that eight more rapid tests are available for free via the U.S. government.
When to See a Doctor
“Any severe symptoms like shortness of breath or difficulty breathing warrant seeking medical care,” Feldman said.
In less-acute scenarios, providers can also help manage allergy symptoms. “Allergists can help offer allergy testing, counsel on good medication, or consider immunotherapy, also known as ‘allergy shots,’ as another treatment option.”
Finally, Feldman reminds patients that getting the COVID vaccine and boosters are the best way to prevent severe illness and death from COVID, and if you think you may be sick, stay home.