Boston Children's Health Physicians | Understanding the Differences Between Allergies and COVID-19

If your child has a cough, a sore throat, and a runny nose, you probably wonder: Is it allergies or could it be COVID-19?

Allergy season has kicked off earlier this year than usual. This means that all of the time families are spending outdoors while social distancing could be leading to symptoms that look similar to COVID-19, the coronavirus that is making so many people sick in the area. But in many cases, these symptoms are actually triggered by a reaction to pollen or grass. 

Dr. Subhadra Siegel the director of the Allergy and Immunology Program at Boston Children's Health Physicians, says it’s important for parents to know how to tell the difference between allergies and illnesses, such as the flu and COVID-19, so they can respond appropriately.

Listening to the symptoms 

“Right now many people are anxious and concerned with COVID-19 being so widespread,” Dr. Siegel says. “But I tell parents that while the symptoms of allergies and COVID-19 can be similar, there are some concrete ways to tell which one their child is experiencing so they will know how to treat it.”

Here are several differences that can be important clues: 

• An illness like COVID-19 causes a system-wide response, while an allergy, which is an overreaction of the immune system in response to exposure to a trigger, is usually more localized. For instance, a child with a flu or COVID-19 may have a fever, body aches, chills, a sore throat, weakness, and respiratory symptoms. Someone with allergies will be more likely to have the symptoms centered on the nose, eyes, and throat, and they usually won’t have a fever.
  
  
• “Allergies cause itchiness: itchy eyes, itchy nose and sneezing, and a tickle in the throat,” she says.  Itchiness is usually not a symptom of illness.
  
  
• COVID-19 doesn’t seem to cause much in the way of nasal symptoms, Dr. Siegel says. That means if your child is sneezing a lot, it’s more likely allergies, a cold, the flu, or another illness that isn’t related to COVID-19.
  
  
• Children with allergies may also have asthma, which can cause wheezing, coughing, and chest tightness. While many people with COVID-19 also have a cough and chest tightness or difficulty breathing, most of the time this isn’t accompanied by wheezing, Dr. Siegel says.

Managing allergies with medication

For a child with allergies, your doctor may recommend using allergy medications to prevent or manage the symptoms. This can include antihistamines (a medication that blocks histamine, a chemical your body releases when exposed to a trigger), nasal corticosteroids (prescription medications that relieve symptoms by reducing inflammation in your nasal passages), and if your child also has asthma, a rescue asthma inhaler (this contains a medication that opens airway passages) and inhaled corticosteroids (this reduces the inflammation in your airways).

Ways to manage seasonal allergies at home

• Have your child wear a hat and sunglasses to prevent pollen from getting in their eyes.
  
  
• Remove your child’s clothes as soon as they come indoors and wash them to remove allergens.
  
  
• Leave shoes at the door so your family doesn’t track allergens through your home.
  
  
• Wash your child’s hands and face as soon as they come in from the outdoors. 

When allergies and illness co-exist 

Remember that children with seasonal allergies can still get sick. “With chronic nasal congestion, people don’t clear germs as well from the nose. Therefore, they can get more viruses and those viruses can linger longer,” Dr. Siegel. This means that if your child has allergies and then gets new symptoms that don’t respond to allergy medications, it’s important to check with your pediatrician. 

Anyone who has any illness symptoms must make sure to quarantine at home to avoid spreading the germs.

Schedule a telehealth visit

Most BCHP pediatricians are now seeing patients remotely using telehealth visits to assess symptoms. In some cases, your child may need to go get a flu or strep test to rule out these other illnesses. COVID-19 tests are still limited, so your pediatrician will advise you on whether your child needs testing. BCHP physicians can also prescribe allergy medications remotely.

Learn more about our telehealth visits.