As winter slowly turns to spring, seasonal allergy sufferers are starting to think about their springtime allergy routine. Symptoms like coughing, sneezing, and sore throats are common. Still, most people with allergies can successfully keep them at bay with allergy medications.

Unfortunately, the same symptoms people with allergies regularly deal with have taken on a different meaning in the last two years. Instead of accepting a runny nose or a sore throat as seasonal allergy concerns, everyone’s mind now turns immediately to COVID-19 as a possible culprit. 

Those concerns can be nerve-racking. Understanding the difference between recognizing a sore throat from allergies or COVID can bring a lot of peace of mind, and can help give some guidance on next steps. 

Below are some keys to telling the difference!

What are seasonal allergies?

Allergies happen when the body overreacts to a trigger, usually something that’s generally common and generally harmless, like pet dander or mold. When someone with allergies encounters that trigger (referred to as an allergen), their immune system responds by throwing everything it can into removing that allergen from the body. With that, the body creates a chemical called histamine to help.

Histamines are the cause behind most allergy symptoms, including sneezing, runny nose, and itching. Seasonal allergies work the same way, except the triggers occur for only part of the year. In many cases of seasonal allergies, pollen is the leading allergen behind most symptoms. 

One of the main differences between seasonal allergies and COVID-19 is that the virus is contagious but allergies are not.

Seasonal allergies are not contagious, so sneezing out an allergen that is then breathed in by someone else won’t “infect” them with allergy symptoms. However, if someone with COVID-19 sneezes out viral particles that are then breathed in by someone else, they are likely to contract COVID-19 and experience similar symptoms. 

What is COVID-19?

COVID-19 is a respiratory disease that is highly infectious, meaning it’s easily passed from person to person through the air. While the infection rate in the U.S. is going down (thanks to more people getting vaccinated and wearing masks), getting sick with COVID is still a huge concern. 

The disease spreads most often either through close contact with an infected person, or by touching an infected surface and touching the mouth, eyes, or nose. COVID cases can range from mild to severe.

COVID-19 is also relatively unpredictable. While certain risk factors may make someone more likely to develop severe side effects, even the young and healthy can sometimes have significant complications. Like the flu, a serious COVID-19 infection can lead to hospitalization or can even be fatal. 

What symptoms do COVID-19 and seasonal allergies have in common?

Unfortunately, there is an overlap between COVID-19 and seasonal allergy symptoms. This overlap can make it difficult for even experienced allergy sufferers to know the difference, creating a lot of anxiety. 

Those overlapping symptoms include:

• Congestion (stuffy nose);

• Cough;

• Runny nose;

• Sore throat.

While there are differences in the way people experience those symptoms with either health issue, the symptoms don’t point directly to one or the other. Developing any of the above symptoms requires further evaluation and diagnosis, even if the person has a previous history of seasonal allergies.

How to tell the difference between allergies and COVID

Even though allergies and COVID-19 share many of the same symptoms, there are a few distinctions that can provide some guidance.

Co-occurring symptoms that strongly suggest a possible COVID-19 infection instead of seasonal allergies include:

• A fever over 100.4 ℉ / 38 ℃;

• A new sudden loss of taste;

• Muscle aches;

• Sudden shortness of breath or difficulty breathing.

On the other hand, symptoms more common to seasonal allergies include:

• Itchy, watery eyes;

• Sneezing.

Another difference between seasonal allergies and COVID-19 is how long it takes for symptoms to show up. People with seasonal allergies will often develop symptoms within 48 hours of exposure, while COVID-19 symptoms can take anywhere from 5 to 14 days to show since initial exposure to the virus.

The only way for people with the above symptoms to know whether they have been infected with a virus or are experiencing typical allergies is to do a COVID viral test and talk with a doctor. 

Most often, especially for those with a known exposure, the provider will recommend a COVID test to help confirm infection and guide treatment. Although COVID-19 does not yet have a cure, treating and managing symptoms can help reduce the length and severity of the illness.

How long does a sore throat from allergies last?

The big question for people with seasonal allergy-related sore throats is how long symptoms last. Unfortunately, even with the best allergy medicine for sore throats, this specific symptom can stick around for a long time (sometimes for the entirety of allergy season). 

The length of throat allergy symptoms often relates to something called postnasal drip. Postnasal drip happens when the mucus from a stuffy or runny nose drips down the back of the throat. Because it isn’t supposed to be there, the mucus causes the throat to be irritated and sore. Some people also describe postnasal drip as a constant tickling or scratchy feeling.

There is one factor for allergy sufferers to keep in mind, though. While they can expect a sore throat during allergy season, a sore throat combined with difficulty breathing or swelling in the throat or neck can indicate an anaphylactic reaction. These reactions are always an emergency, and anyone experiencing those symptoms should seek medical attention immediately. 

Allergy prevention

For people with allergies, the proper prevention techniques are crucial. Unfortunately, prevention can be more difficult for those who suffer from only seasonal allergies. 

Doctors recommend avoiding allergy triggers as one of the best ways to prevent symptoms. However, to avoid allergens altogether, people with seasonal allergies would typically have to stay in the house for the entire pollen season. For obvious reasons, this is not an option for most people.

It is also essential for those with seasonal allergies to monitor their local pollen count (cellphone apps can display pollen levels). On days where the pollen count is higher, they can take additional precautions such as keeping the doors and windows shut, taking a shower after being exposed to pollen outside, and wearing a mask such as a COVID-19 face mask.

In addition, pollen levels are often highest in the early morning and late evening. It may be helpful for seasonal allergy sufferers to alter their plans to avoid being out and about during those specific times of the day.

Allergy management

Unfortunately, even with proper planning, people can not avoid seasonal allergens entirely. That is why it is crucial for anyone who believes they may be dealing with allergies to see a doctor for an official diagnosis.    

An official diagnosis can help doctors find the best allergy medication for sore throat, cough, and runny nose symptoms. Having a doctor prescribe a targeted allergy medication can make a big difference for people who have relied only on over-the-counter allergy medications.

Medications for seasonal allergies are most commonly available in oral, nasal, and inhaled forms. There are many allergy medications on the market that allow doctors to customize treatment to help with specific symptoms. 

Some of the allergy medications that doctors prescribe or recommend most frequently to help with seasonal allergies include:

• Zyrtec (cetirizine);

• Xyzal (levocetirizine);

• Allegra (fexofenadine);

• Claritin (loratadine);

• Clarinex (desloratadine);

• Singulair (montelukast);

• Flonase (fluticasone);

• Nasonex (mometasone);

• Zaditor (ketotifen).

Some options also combine antihistamines with a decongestant, like Allegra-D, Claritin-D, and Zyrtec-D. These allergy medications can help reduce inflammation while blocking the effects of histamines. The benefit of using combination medications to treat seasonal allergies is that they can work more quickly to reduce the severity of symptoms and they can target multiple symptoms for greater overall relief. 

When to talk to a doctor

Anyone who develops a sore throat and fever should talk to a doctor. In addition to the potential for COVID-19, a sore throat can also mean strep throat, which a doctor will need to treat with an antibiotic. Treatment is different for these health issues, so proper diagnosis is crucial.

People with recent, known exposure to COVID-19 should also speak with a doctor, regardless of whether or not they are experiencing any symptoms. In most cases, they will recommend being tested for COVID to confirm either way. 

Even though seasonal allergies are generally not life-threatening, doctors generally urge anyone suffering from new or changing symptoms to schedule an appointment for further evaluation. They may require an adjustment to or change in allergy medication, or a different management approach altogether.

In addition, if the usual allergy medications don’t take care of a sore throat, or symptoms begin to worsen, patients should consult a medical professional. There is always the possibility that there is more than one health issue going on, and each may need different treatment. A patient may have a combination of four common illnesses: allergies, strep throat, the flu, or COVID-19.

In summary

While there are differences between a sore throat from allergies or COVID-caused discomfort, the only way to know for sure is to do a COVID viral test and see a doctor. 

HealthTap offers 24/7 urgent care appointments, done virtually by video with our team of doctors. They can advise on symptoms, including sore throat, and guide patients toward the recommended next steps, all at an affordable price without leaving the safety of home. However, a patient sometimes will need to seek in-person care to do a nasal swab test or a throat swab test.

Schedule your visit with a HealthTap doctor today here.