Is It COVID-19, Cold, Allergies or Flu?

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A young man with closed eyes wearing a face protective mask and coughing in his arm

You feel ill with nasal congestion, scratchy throat and fatigue. Is it a cold or is it COVID-19? Could it be allergies?

It’s become increasingly difficult to distinguish illnesses based on symptoms, as the predominant COVID-19 variant – BA.2 and its subvariants – produces cold-like symptoms in many people.

Earlier versions of the virus attacked the lungs and often produced fevers, shortness of breath and loss of taste and smell.

“The changed COVID-19 virus has greater propensity to infect the upper respiratory tract and cause less severe symptoms,” says UH infectious disease specialist Robert Salata, MD. “Based on this, it’s very difficult to ascertain if an infection is due to COVID-19 or other cold viruses.

Here are some tips that can help distinguish between cold, flu, allergies and COVID-19:

  • Seasonal allergy symptoms can be similar to cold symptoms, but allergies tend to produce red, itchy eyes and don’t usually cause sore throat or body aches. Time of season and past experience are good indicators of allergies, Dr. Salata says.
  • Telltale signs of flu are fever, chills, headache, sore throat, dry cough and fatigue.
  • If you have symptoms such as nasal congestion and cough, Dr. Salata suggests isolating regardless whether it’s COVID-19 or a cold. You can do an at-home rapid test for COVID-19.

How Important Is to Know Whether You Have a Cold or COVID-19?

It may not be critical to test if you have mild symptoms and are at low risk for complications, as long as you stay away from others, especially others who may be at risk because of advanced age or underlying health problems.

“In folks who are vulnerable – people over 65, those with chronic diseases such as lung disease, diabetes and hypertension, or those who are immunocompromised – it’s good to know for sure if you have COVID-19 because it could progress and there is antiviral therapy to mitigate that possibility,” Dr. Salata says.

The antiviral drug Paxlovid, granted emergency use authorization by the Food and Drug Administration in December, can be taken at home by high-risk patients. The drug was shown to be 90 percent effective at preventing serious illness and deaths.

However, the best way to avoid serious illness and death is to be fully vaccinated.

High-risk patients who develop symptoms should consider a PCR test because they are more reliable than home tests, Dr. Salata says. PCR tests are administered at testing sites and medical facilities.

If you have symptoms that don’t go away or become worse, you should see a doctor.

Related Links

The ear, nose and throat specialists at University Hospitals provide comprehensive ear, nose and throat care for children and adults. We have the advanced medical and surgical expertise to diagnose and treat a full spectrum of conditions that range from allergies, sinus problems and hearing loss to complex head, neck and skull-based tumors. Learn more about ear, nose and throat services at University Hospitals.

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