Allergies or COVID? Here’s How to Tell the Difference

If you have seasonal allergies, you know how uncomfortable it can be when your symptoms flare up. Allergies can cause a stuffy nose, cough, and fatigue. These symptoms are very similar to those of a COVID-19 infection. So it’s common to wonder whether your symptoms are due to COVID or allergies. 

Let’s take a closer look at how you can tell the difference between COVID and allergy symptoms — and what you can do to feel better.

COVID vs. allergies

Seasonal allergies flare in the spring and fall. Perennial allergies (such as those to dust and mold) are around all year. The tricky thing is that allergies can behave like COVID. 

Both COVID and allergies can cause symptoms like: 

• Runny nose

• Nasal congestion

• Postnasal drip

• Sore throat

• Irritated eyes

• Fatigue

Differences between COVID symptoms and allergies

The major differences between allergy and COVID symptoms are:

• Fever: Allergies shouldn’t cause any increase in temperature. If you detect a fever of 100°F or higher, this points to an infection and not allergies. Not everyone with COVID gets a fever, but it occurs in many people with the infection.

• Itching: Itching is a characteristic symptom of allergies but not COVID. Allergies can cause itchy eyes, nose, throat, and skin. 

• Length of symptoms: Allergy symptoms last much longer than viral infections. COVID symptoms usually clear up within 1 to 2 weeks. Pollen seasons can last for a couple of months, and perennial allergies are around all year.

COVID can also cause symptoms that affect other organs. These are uncommon with allergies. Examples include: 

• Chest tightness, shortness of breath, cough, or wheeze

• Loss of smell and taste 

• Muscle and joint pain 

• Headache

• Nausea, vomiting, and diarrhea 

• Skin symptoms, such as rashes and other skin changes

Is it allergies or COVID?

Sometimes, it can be hard to tell the difference between allergies and COVID. This is especially true when symptoms are just starting. But subtle clues, like fever or symptoms beyond the upper respiratory system, can help tell them apart. 

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• The telltale symptoms of allergies: Allergies can bring on many different symptoms. These are the most common. 

• Rapid COVID testing: If you have symptoms of COVID but aren’t sure that’s the cause, an at-home COVID test can give you quick results.

• COVID vs. sinus infection: Sore throat, headache, and cough can occur with both COVID and sinus infections. Here’s how to tell them apart.

If you know you’ve been exposed to COVID, it’s best to be safe and take a COVID test. Err on the side of caution, assume you’re contagious, and take steps to prevent the spread. 

Sore throat: Allergies or COVID?

Sore throat is a common symptom of COVID. It may occur along with other symptoms, such as fever and congestion. Or it may be the first symptom to develop. 

Many people with allergies also complain of a sore throat due to postnasal drainage — when mucus drips down the back of the throat. This can be worse in the early morning after lying down at night. 

Sore throats from allergies usually occur with other allergy symptoms and not on their own. In other words, your sore throat could be due to either COVID or allergies. Your other symptoms can help point to a cause. But the only way to know for sure is to take a COVID test. 

Cough: Allergies or COVID?

Both COVID and allergies can make you cough. With allergies, increased mucus and postnasal drainage that irritates the throat also cause coughing. It can also feel like a tickle or itch in your throat. Allergies can also cause chest symptoms if you have allergic asthma.

On the other hand, a cough due to COVID develops when the lungs are affected. The cough is usually dry, meaning that it doesn’t produce any mucus or phlegm. You may have other chest symptoms with your cough, such as shortness of breath, chest discomfort, and wheeze. 

Hoarse voice: Allergies or COVID?

Both COVID and allergies can cause voice changes, including hoarseness. Hoarseness can happen with allergies due to irritation from postnasal drip. The drainage and mucus can lead to inflammation in the throat and voice changes. Laryngitis (irritation of the voice box) is also possible with upper respiratory tract infections, like COVID and the flu.

It’s also fairly common to have a hoarse voice with COVID. In one study looking at over 13,000 people, about 1 in 4 people with COVID reported voice changes. And some even reported long-lasting changes. 

Sinus pressure: Allergies or COVID?

Sinus pressure can occur with both allergies and COVID. Sinus pressure is a familiar hallmark of allergy season, and it’s pretty common with COVID too. 

There’s not a lot of data about sinus pressure as a symptom of COVID infection. But one small study found that about half of people with COVID infection reported sinus inflammation. 

See a healthcare professional if allergy medications don’t relieve your sinus pressure, or if you develop a fever. Allergies and viral infections (like COVID) can lead to sinus infections, which may need antibiotics.

Headache: Allergies or COVID?

A headache can happen with both allergies and COVID. Headache is one of the most common symptoms of COVID infection — second only to respiratory symptoms. And sinus pressure with allergies can often trigger a sinus headache as well. 

If you have a headache and you think you may have a COVID infection, a quick COVID test can point you in the right direction. Always let your primary care provider know if you have unexplained headaches.

Can you have COVID and allergies at the same time?

Yes, you can have COVID and allergies at the same time. Interestingly, some research suggests that people with allergies may be at lower risk of getting COVID. This may be because allergic airways have a reduced expression of ACE2, the receptor for COVID. But more research is needed to better understand the relationship between COVID risk and allergies. 

In another study, nasal steroid sprays — a common treatment for allergies — seemed to decrease the severity of COVID. 

What to do if you aren’t sure it’s allergies or COVID

A good way to tell the difference between COVID and allergies is checking your temperature at home. If you have a fever, then you most likely have some kind of infection.

And consider your response to allergy treatments. You can manage most of your allergy symptoms with over-the-counter (OTC) antihistamines and nasal steroid sprays. If your symptoms go away with these medications, then you probably don’t have a serious illness. 

When should you get a COVID test?

If you aren’t sure what’s causing your symptoms, a healthcare professional can help figure it out. Consider a telemedicine visit so that you can speak with a healthcare professional in the comfort of your own home. 

While you’re waiting to figure out the cause of your symptoms, it’s best to err on the side of caution. That means avoiding contact with others, washing your hands frequently, and wearing a mask. 

At the end of the day, only a COVID test can definitively tell the difference between COVID and allergies. Getting tested is important to prevent the spread of COVID. 

Types of COVID tests

There are two main types of tests to see if you’re infected with COVID. Both are done by swabbing the nose and/or throat for the virus:

• Rapid tests: You can do rapid tests at home or testing sites. You’ll get results within 15 minutes. Rapid tests are convenient, but they have a higher chance of missing an active infection. 

• Laboratory tests (PCR tests): Results take longer, but they’re the most reliable at identifying an infection. 

Here’s a helpful tool to find a testing site close to you. 

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Written by:

Merin Kuruvilla, MD

Merin Kuruvilla, MD, is a board-certified allergist/immunologist at Emory University in Atlanta. She has authored several peer-reviewed publications in the field.

Edited by:

Alex Eastman, PhD, RN

Alex Eastman, PhD, RN, is a California-based registered nurse and staff medical editor at GoodRx, where he focuses on clinical updates and Latino health.

Reviewed by:

Farzon A. Nahvi, MD

Dr. Nahvi is an emergency medicine physician and author of “Code Gray: Death, Life, and Uncertainty in the ER.” He works clinically at Concord Hospital in Concord, New Hampshire, and is a clinical assistant professor of emergency medicine at the Geisel School of Medicine at Dartmouth. Prior to this, he worked as an ER physician and clinical assistant professor of emergency medicine at the Mount Sinai Health System, NYU Langone Health, NYC Health + Hospitals/Bellevue, and the Manhattan VA. He is a graduate of Cornell University and NYU School of Medicine.

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