Key takeaways:
Allergies and COVID-19 can cause similar respiratory symptoms, making it difficult to tell them apart.
The main difference between allergies and COVID symptoms is that COVID can cause fever, whereas allergies don’t.
The only way to tell for sure whether your symptoms are from a COVID infection rather than allergies is a positive COVID test.
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 generally flare in the spring, summer, and early fall. Perennial allergies (such as those to dust and mold) are around all year. The tricky thing is that allergies can behave like COVID.
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Both COVID and allergies can cause symptoms like:
Runny nose
Nasal congestion
Postnasal drip
Sore throat
Irritated eyes
Fatigue
Cold, flu, allergies, or COVID? How to tell which one you have
This chart can help you visualize the difference between COVID and allergy symptoms. The chart also includes symptoms of the flu and COVID, which can also overlap.
Differences between COVID symptoms and allergies
The major differences between allergy and COVID symptoms are:
Fever: Allergies shouldn’t cause your temperature to rise. If you have a fever of 100°F (37.7°C) or higher, this points to an infection, 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
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.
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 all night.
One key difference is that allergy-related sore throats almost always come with other allergy symptoms, such as sneezing, itchy eyes, or a runny nose. COVID-related sore throats may occur with a wider range of cold-like symptoms or even on their own early on.
Because symptoms can overlap, the only way to know for sure whether COVID is the cause is to take a COVID test.
Cough: Allergies or COVID?
Both COVID and allergies can make you cough, but the reason behind each cough is different.
With allergies, coughing is often triggered by postnasal drip. Extra mucus irritates the throat and can cause a dry, tickly, or itchy cough. 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 directly affected. The cough is usually dry, which means that you don’t produce any mucus or phlegm. You may have other chest symptoms as well, 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 your voice box) is also possible with upper respiratory tract infections, like COVID.
It’s also fairly common to have a hoarse voice with COVID. In one study looking at nearly 14,000 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 study found that about a quarter of people with COVID infection reported sinus inflammation.
Take a COVID test if allergy medications don’t relieve your sinus pressure, or if you develop a fever. Allergies and viral infections (like COVID) can lead to bacterial sinus infections, which may need antibiotics.
Headache: Allergies or COVID?
A headache can happen with both allergies and COVID. In fact, headache is one of the most common symptoms of COVID, second only to respiratory symptoms.
Allergies can also cause headaches, usually from sinus congestion and pressure. This type of headache often comes with other allergy symptoms, such as a stuffy or runny nose.
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 severe or 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 other studies are less clear, so more research is needed to better understand the relationship between COVID risk and allergies.
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 should be able to 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 COVID.
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.
A COVID test can also be very helpful. If you are symptomatic and your COVID test is positive, your symptoms are probably caused by COVID. If you feel symptoms but your COVID test is negative, it’s probably something else, like allergies.
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.
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 in a doctor’s office. 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 to run, but they’re the most reliable at identifying an infection.
Frequently asked questions
Yes, it can be easy to confuse a COVID infection and allergies, especially when you first notice symptoms. Mild COVID infections and allergies share many of the same symptoms, including runny or stuffy nose, postnasal drip, and sore throat.
But keep in mind that allergy symptoms can last a lot longer than a viral infection like COVID. And allergies don’t cause a fever, while COVID can.
Yes, COVID infection can prompt your body to make more mucus. Mucus is a natural part of your body’s immune response when it’s fighting off illness. But the presence of mucus — and what it looks like — isn’t a great way to tell what’s causing your symptoms. Paying attention to your other symptoms, and testing for COVID, can help you figure out what’s going on.
Allergies can cause irritation and inflammation in your throat. And this can lead to change in your voice. While losing your voice from allergies doesn’t seem to be very common, it can happen. More research is needed to better understand the relationship between allergies and voice changes.
Be sure to get medical attention if you have trouble breathing. Some types of allergies can cause anaphylaxis, a severe allergic reaction that affects the entire body. This is a medical emergency and requires immediate attention.
Since COVID affects your immune system, it’s possible that COVID could lead to new allergies. One study found that people had a higher risk of developing new allergic conditions, like allergic rhinitis and asthma, in the months after a COVID infection. The risk was higher among people with more severe COVID illness. Vaccination lowered the likelihood of new allergies.
Sneezing can be a symptom of both allergies and COVID. By itself, sneezing isn’t the most helpful clue to help you figure out what’s causing your illness. That said, if you’re sneezing and have other COVID symptoms, like fever, it’s a good idea to test for COVID. Keep in mind that sneezing can spread the virus that causes COVID.
Chills aren’t a common symptom of allergies. You’re more likely to have chills with an infection, like COVID or the flu. Chills often occur along with a fever, which is a sign that your body is trying to fight off an infection.
Yes, it can be easy to confuse a COVID infection and allergies, especially when you first notice symptoms. Mild COVID infections and allergies share many of the same symptoms, including runny or stuffy nose, postnasal drip, and sore throat.
But keep in mind that allergy symptoms can last a lot longer than a viral infection like COVID. And allergies don’t cause a fever, while COVID can.
Yes, COVID infection can prompt your body to make more mucus. Mucus is a natural part of your body’s immune response when it’s fighting off illness. But the presence of mucus — and what it looks like — isn’t a great way to tell what’s causing your symptoms. Paying attention to your other symptoms, and testing for COVID, can help you figure out what’s going on.
Allergies can cause irritation and inflammation in your throat. And this can lead to change in your voice. While losing your voice from allergies doesn’t seem to be very common, it can happen. More research is needed to better understand the relationship between allergies and voice changes.
Be sure to get medical attention if you have trouble breathing. Some types of allergies can cause anaphylaxis, a severe allergic reaction that affects the entire body. This is a medical emergency and requires immediate attention.
Since COVID affects your immune system, it’s possible that COVID could lead to new allergies. One study found that people had a higher risk of developing new allergic conditions, like allergic rhinitis and asthma, in the months after a COVID infection. The risk was higher among people with more severe COVID illness. Vaccination lowered the likelihood of new allergies.
Sneezing can be a symptom of both allergies and COVID. By itself, sneezing isn’t the most helpful clue to help you figure out what’s causing your illness. That said, if you’re sneezing and have other COVID symptoms, like fever, it’s a good idea to test for COVID. Keep in mind that sneezing can spread the virus that causes COVID.
Chills aren’t a common symptom of allergies. You’re more likely to have chills with an infection, like COVID or the flu. Chills often occur along with a fever, which is a sign that your body is trying to fight off an infection.
The bottom line
COVID can be hard to tell apart from other conditions with similar symptoms. Allergies and COVID can be easy to confuse, but there are some subtle differences. Fever is the key symptom that helps to tell the difference between COVID and allergies.
If you think you may have a COVID infection, talk with a healthcare professional about your symptoms and get tested. It’s always best to be extra cautious and to limit contact with others until you know for sure what’s causing your symptoms.
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References
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Genovese, G., et al. (2020). Skin manifestations associated with COVID-19: Current knowledge and future perspectives. Dermatology.
Holt, H., et al. (2022). Risk factors for developing COVID-19: a population-based longitudinal study (COVIDENCE UK). Thorax.
Jackson, D. J., et al. (2020). Association of respiratory allergy, asthma, and expression of the SARS-CoV-2 receptor ACE2. The Journal of Allergy and Clinical Immunology.
Lin, C-W., et al. (2023). COVID-related dysphonia and persistent long-COVID voice sequelae: A systematic review and meta-analysis. American Journal of Otolaryngology.
Meenakshi, M., et al. (2021). Incidence of sino-nasal symptoms in COVID-19 patients. Indian Journal of Otolaryngology and Head & Neck Surgery.
Oh, J., et al. (2024). Incident allergic diseases in post-COVID-19 condition: multinational cohort studies from South Korea, Japan and the UK. Nature Communications.
Stachler, R. J., et al. (2017). Allergic laryngitis: Unraveling the myths. Current Opinion in Otolaryngology & Head and Neck Surgery.
Togha, M., et al. (2022). A review on headaches due to COVID-19 infection. Frontiers in Neurology.
