Is it Seasonal Allergies or Coronavirus?

Loss of smell can happen with seasonal allergy, but may also be an early sign of COVID-19 disease. Doctors weigh in for the answers.

One of the stranger possible early-symptoms of COVID-19 appears to be a loss of smell or taste. Although the evidence has not been rigorously collected yet, physicians treating the disease have reported that some patients experience these symptoms in the early stages of the disease. But seasonal allergies, which are also kicking up this time of year, can also make people lose their sense of smell. Is it COVID-19 or is it allergies? Jefferson allergist, John Cohn, MD, helps straighten out the answers.

“Many of the early symptoms of COVID-19 are similar to other illnesses and allergies, which can make it difficult to tell early coronavirus symptoms from typical allergies, especially this time of year. Making the correct diagnosis is a particular problem since those infected vary so greatly in the severity of their illness. If your symptoms are mild, that is a good thing, but it’s difficult to exclude infection or the need for isolation and other avoidance measures. With the shortage of testing supplies, it gets even more complex.

Current recommendations are to limit testing to those with significant symptoms. “A stuffy nose or a tight chest can be common in Philadelphia in April and testing everyone with such symptoms would jeopardize scarce supplies,” says Dr. Cohn.

coronavirus or allergies infographic

Dr. Cohn helps us tease apart which is which, and the appropriate steps we can take.

I have a sore throat, a cough, a headache, and some muscle aches as well, but no fever. Could it be COVID-19?

Many seasonal allergies cause sore throat, some can aggravate a cough or underlying asthma, sinus headaches aren’t uncommon. Body aches are typically something that accompanies fevers, including the flu or COVID-19. But as many people transition to less ergonomic work-from-home offices, such as a couch or kitchen table, minor muscle injuries and fatigue can happen, which can feel achy. Add the stress and difficulty of this historic moment, and you may have many people who aren’t feeling their best.

What can I do to ease allergy symptoms? 

Keep the windows closed at home to keep pollen out. There are several once-daily non-sedating antihistamines on the market, as well as nasal steroids. They are all over the counter, so you don’t need a prescription.

If you still need help, JeffConnect can put you in touch with a Jefferson doctor. Allergists and other Jefferson providers are available through telehealth.

But could it be early or mild symptoms of COVID-19?

We know a lot about the cases that land in our hospital, but we know less about mild cases. Our health system has been mobilized to treat the enormous and growing influx of serious to severe cases of COVID-19. We’ve had less opportunity to study and track mild cases. So we have less definitive data about what the majority of people who contract a mild case of COVID-19 look like. Think back to three months ago, when all but a few research scientists had ever really thought much about coronavirus. We don’t know for certain how long a person might have the disease before they develop a fever.

Estimates have shown that those with mild illness can make up over 80% of cases, most of which will go unreported until we have broader testing available including for serum antibodies reflecting prior infection.

The classic symptoms of COVID-19 are persistent fever and dry cough. Most people will get better on their own. The most important thing you can do today is to minimize your contact with others in order to prevent spreading it before you know you have it.

What about loss of smell and taste that we’ve heard about? Is that a sign of COVID-19?

We’ve heard some reports of people who seem to temporarily lose their sense of smell or taste a few days before developing the more classic symptoms of COVID-19. And the American Academy of Otolaryngology — Head and Neck Surgery has asked the medical community to begin to track these symptoms. They recommended that loss of smell/taste be added to the list of screening criteria.

The organization also encourages ear, nose, throat doctors to use personal protective gear when assessing patients for these symptoms, as a precaution, but that will be hard to do in May in Philadelphia.

Loss of smell can also be a symptom of allergy or other illnesses. That may be why we haven’t seen these recommendations filter into national guidelines yet. We still need to see these anecdotes confirmed with more data, but it’s a possibility.

Cohn allergies and coronavirus

If temporary loss of smell or taste does, in fact, turn out to be an early symptom of the disease, would that change medical experts such as yourself handle the illness?

It depends on just how helpful it can be.  We can only hope that COVID-19 is long gone well before we have had a chance to study the similarities with seasonal allergies.

Bottom line, what should we do if we show symptoms of allergy or something that might be COVID-19?

Stay at home. If you have mild symptoms, the most important thing you can do – for yourself and others – is to stay home, and take precautions to prevent potential spread. Then, monitor your symptoms. If you have the same symptoms every day, it’s probably allergies. You’ll want to get in touch with a doctor via phone or telehealth if your symptoms get worse, or you’re having trouble breathing. If you have a mobile testing unit near you, you can consider getting tested if you meet testing guidelines and CDC recommendations.

It can be a scary time, but it’s important to remember that most people with COVID-19 will be fine waiting out the disease in their homes. For guidance on how to quarantine, while keeping other members of your home safe, known as “home isolation,” read this useful guide from the CDC.

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