Allergies, Cold, Flu or COVID-19? How to Tell the Difference

By Sara Narayan, MD, of Allergy West
Reviewed by Scott Paparello, DO, Emerson Health Director of Infectious Disease, and Rand Nashi, MD, of Emerson Health Primary Care Bedford

In today's world, with every sneeze, cough or tickle in the throat, many people wonder: Do I have COVID-19? For the millions of allergy suffers around the country, this question becomes a little more complex — allergies or COVID-19 (also known as the coronavirus), or perhaps a cold or the flu? Following are ways to tell if you are suffering from allergies, a cold or the flu, or if you should call you physician and get tested for COVID-19.

Also, below is a podcast with Sara Narayan, MD, allergy and immunology specialist, discussing how to tell the difference between allergies and COVID-19.

The range of symptoms for COVID-19 is quite broad, based on different variants. In addition, people who are vaccinated but have a breakthrough infection, may experience different symptoms than those who are not vaccinated. Symptoms of COVID-19 infections can now range from asymptomatic to mild upper or lower respiratory symptoms, to severe pneumonia.

Early testing is advised if there is any suspicion of SARS Cov2/COVID-19 infection. Monoclonal antibody treatment can be effective, but only if COVID-19 is detected early through a COVID-19 test. Most of the PCR tests for COVID-19 available in our community, as well as the rapid antigen tests, will detect the current circulating variants, including omicron.

For any non-emergency health concern, contact your physician or visit an urgent care center where doctors can examine you and determine the best treatment. COVID-19 symptoms vary broadly and can range from mild to severe.


Allergy symptoms range from mild to severe and can occur seasonally or be present year-long. In patients with asthma, allergies can cause a cough, wheeze and shortness of breath. Allergies are caused by your immune system overreacting to normal things in your environment — such as pollen, dust, mold, pet dander — and are not contagious. Medications can typically treat your symptoms and allergy immunotherapy (allergy shots) can often help patients find long-term relief.

Common Allergy Symptoms

  • Sneezing
  • Runny or stuffy nose
  • Itchy or watery eyes
  • Itchy nose or ears
  • Post-nasal drip (which can sometimes cause a mild sore throat)
  • Mild fatigue


The coronavirus (COVID-19) is a viral illness that can be spread in ways that include coughing, sneezing, and close personal contact. Symptoms typically start between 2-14 days after exposure and usually resolve within ~14 days after onset, whether the symptoms are mild, moderate or severe. It is important to note that if you have received the COVID-19 vaccine, it is still possible you can get COVID-19. If you are vaccinated and test positive for COVID-19, your symptoms are expected to be milder.

Common COVID-19 Symptoms


In General

  • Fever
  • Dry cough
  • Shortness of breath
  • Intense fatigue, body aches
  • Loss of smell

Common Omicron Variant COVID-19 Symptoms

  • Runny nose
  • Headache
  • Fatigue
  • Sneezing
  • Sore throat

Is Sneezing Really a Symptom of COVID?

Although initially not thought to be a prominent COVID-19 symptom, it is often found in people with the omicron variant.

The ZOE COVID Study found that sneezing is an increasingly common symptom of COVID-19. The study found that sneezing is the fourth most common reported symptom associated with omicron. The ZOE COVID Study is a joint effort created by researchers at Massachusetts General Hospital, the Harvard T.H. Chan School of Public Health, King’s College London, Stanford University School of Medicine and the health app ZOE.

What is a Sneeze?

Now you might be wondering: what exactly is a sneeze? Sneezing is a forceful expulsion of air from the lungs through the nose and mouth. It is typically caused by foreign particles that irritate the nasal mucosa. The function of a sneeze is to expel mucous containing foreign particles or irritants and cleanse the nasal cavity.

Possible causes can include exposure to allergens, viral infections, exposure to bright light, sudden change in temperature, exposure to a breeze of cold air. Sneezes can spread disease, including COVID-19, through infectious aerosol droplets.

Key Points to Determine Allergies or COVID-19 Infection

  1. Timeline and past history.
    • Often people with allergies have a history of seasonal allergies.
    • Allergy symptoms tend to be more long-lasting than viral symptoms.
  2. Allergy symptoms often respond to allergy medications.
  3. Allergies typically make people itchy. Itchiness is not a symptom of viral illness.
  4. Patients with allergies do not develop a fever. Often, people with COVID-19 do.
  5. Patients with allergies may also have asthma, which can cause coughing, shortness of breath, chest tightness and wheezing. COVID-19 typically does not cause wheezing.

Allergies, Cold, Flu, or COVID-19 Checklist

Use this handy chart to identify your symptoms and help determine what health issue you may be suffering from.


Body Aches Rarely
Chills No No
Fever No Rarely
Headache Sometimes Sometimes
Nasal Congestion Sometimes
Runny Nose Sometimes
Sneezing Sometimes Sometimes
Itchy/Watery Eyes No No No
Dry Cough Sometimes
Shortness of Breath Sometimes Sometimes Sometimes Sometimes
Wheezing Sometimes Sometimes Sometimes Sometimes
Loss of Smell Mild Rarely Rarely Less Common
Sore Throat Sometimes
Nausea, Vomiting, Diarrhea No Sometimes Sometimes Sometimes
Itchy, Scratchy Throat No No No
Fatigue Sometimes Sometimes

If you have symptoms, please call your primary care provider's office or an urgent care center to alert them of your symptoms and the need for testing. Test results are usually returned within 48 hours. Many primary care offices can test for COVID as well as flu and RSV. Learn more about COVID-19 testing through Emerson Hospital.

This information was provided by Dr. Sara Narayan, an allergist with Allergy West, and reviewed by Scott Paparello, DO, Emerson Health Director of Infectious Disease, and Rand Nashi, MD, of Emerson Health Primary Care Bedford.

Emerson Podcast: Allergies or COVID-19? How to Tell the Difference

Dr. Sara Narayan, an allergist with Allergy West and affiliated with Emerson Hospital, explains the difference between allergies and COVID-19.

Visit our podcast page to find the latest episode or subscribe to the Health Works Here Podcast.

Support Emerson Hospital

Thank you for reading our article on COVID-19 symptoms. As a community hospital we rely on the support of our community to continue to provide our local health care needs. We welcome your help in fostering a healthy community. If this content has helped you in an way, please consider making an online gift to Emerson Hospital so that we can continue to support our community’s health needs.

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