Allergies or COVID? How to tell spring symptoms apart

It’s a confusing time for pollen-sensitive Southern Californians.

Spring is here and it brings with it the sneezing, coughing and wheezing brought on by seasonal allergies. The Santa Ana winds expected this week will also cause their share of stuffy noses and itchy eyes.

But at the same time, a coronavirus subvariant called BA.2 is gaining momentum, reversing the steady decline in COVID-19 cases we’ve seen since the Omicron variant caused a huge winter spike.

So as you work your way through a box of tissues, you might be wondering – is that pollen or something worse? (And I don’t mean dust mites.)

Experts say it can be harder to distinguish an allergic reaction from coronavirus infection when you’re fully vaccinated, given the protection you have against a more severe case of COVID. Still, they do point to some telltale signs that will help you decide whether you should get tested or see a doctor.

It’s helpful to start by looking at what allergies are and how the body reacts to them.

An allergy is an overreaction by your immune system to an otherwise harmless substance, like tree pollen or cat dander, that you breathe in, swallow, or touch. The immune system interprets the substance as a threat and creates (or mobilizes one if the antibody is already present) an antibody specific to it.

At a very high level, this is also how the body reacts to the coronavirus that causes COVID-19. However, in the case of an allergy, the antibodies stimulate the cells in the affected area to release an excessive amount of histamine, a chemical that (among other things) causes your nose to run and your eyes to itch when the body tries to expel the unwanted ones Substance. Left untreated, a runny nose can also cause mucus to flow from your sinuses into your throat (“postnasal drip”), which can make your sneezing and coughing worse.

Coughing, like congestion, is a sign of COVID-19 infection, said Dr. Rita Kachru, Department Chair in Clinical Immunology and Allergy at UCLA. However, this is not due to histamines; There is a completely different mechanism when the coronavirus enters your airways. Nonetheless, it is part of the overlap in symptoms that the Centers for Disease Control and Prevention has illustrated with this chart on twitter:

As the CDC notes, there are at least four differences that could differentiate your allergies from COVID. Fever, body aches, and loss of taste or smell are common in COVID patients but not in those with allergies. Also, people with COVID may feel short of breath, but you wouldn’t typically experience that with allergies unless you have asthma, the CDC says.

Just as a fever is usually a telltale sign of infection, an itchy nose is usually an indication of allergies. “You will never get an itch from a virus or bacteria,” Kachru said.

But not every coronavirus infection is created equal, so a lack of a fever, body aches, or disrupted taste buds isn’t a surefire sign you don’t have COVID.

Because of this, the first thing you should do is put your symptoms in context, said Dr. Dean Metcalfe, a senior investigator in allergic diseases at the National Institute of Allergy and Infectious Diseases. Do your allergies usually increase around this time of year? Do you have symptoms beyond the usual sniffles and sneezes? Have you been around someone who has the flu or COVID-19?

“Broadly speaking, when you get the flu or COVID-19, the predominant problems aren’t this intense itching that you get with allergies,” Metcalfe said, adding, “The things that indicate a broader inflammatory response outside of the upper Airways are what you have to watch out for.”

Another test: if you have allergies that plague you year-round, such as What you’re looking for, Kachru said, is “an increase in symptoms or a shift in symptoms.” Maybe there’s more coughing, a lot more drainage, or discoloration in the drainage, she said.

If you have asthma and your symptoms are getting worse, “you really need to see your doctor,” even if you’re not sure if it’s COVID, Metcalfe said.

However, the differences become blurred once you are fully vaccinated. On the plus side, Metcalfe said, “You’re not at high risk of anything serious.” He added, “Don’t worry too much unless you get a fever or chills [or] Myalgia,” the muscle pain that can accompany COVID.

Kachru this weekend pointed to another potential source of non-COVID hardship in Southern California: the high winds expected to blow through the area. People who are sensitive to the onslaught of airborne particles, diesel exhaust, and barometric pressure changes will suffer from vasomotor rhinitis, which she described as a more nerve-related problem resulting in an irritated, runny, and stuffy nose.

Here’s another reminder: “Always err on the side of testing,” said Kachru. If you suspect your tormentor is COVID and not the flowers blooming in your yard or the morning glory of Santa Ana, you can still get tested for free, order a free test kit from the federal government, or get a paid-for home test kit receive from your insurer. Allergies or COVID? How to tell spring symptoms apart

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