Is it allergies or COVID?

By: Joseph Mechak, MD


Each year Spring marks the end of the viral respiratory season and the start of allergy season. During this time of year it can be very difficult to determine if sniffles are from a virus or from environmental allergies. This year, the importance of this distinction is amplified with the presence of COVID-19 and kids getting back to school.

There is a large overlap in viral and allergic symptoms. Even for us, it can sometimes be difficult to distinguish between allergies and viral infections this time of year. Here are a few rules of thumb that can hopefully help make this distinction:

  1. Allergies DO NOT cause fever– The presence of fever points strongly towards an infectious cause, including COVID-19.
  2. Look out for COVID specific symptoms – Symptoms like muscle aches, loss of taste or smell, shortness of breath are all typical of COVID-19 and are not expected with seasonal allergies. If your child has any of these symptoms they should be tested for COVID.
  3. Contact tracing – If you child has any known exposure to COVID they need to be tested and quarantined per the CDC guidelines. This is true regardless of their underlying symptoms.
  4. Itchy eyes – Viruses do not typically cause itchy eyes. Red eyes can be a result of allergic or viral conjunctivitis but itchiness is fairly unique to seasonal allergies.
  5. Sneezing – Sneezing can occur with some colds, but is not typical for COVID. Sneezing and itchy noses point away from COVID and toward seasonal allergies.
  6. History is key – Seasonal allergies are, well, seasonal. If your child gets allergy symptoms every spring this year will be no different.
  7. Duration of symptoms – Viruses, even COVID, typically have a finite time course. If symptoms linger through the spring it’s far more likely to be seasonal allergies.
  8. Antihistamine trial – Allergies should respond to antihistamines like Diphenhydramine (Benadryl)l, Loratadine (Claritin), or Cetirizine (Zyrtec). Sometimes assessing response to these medications can be a helpful diagnostic tool!


CDC: COVID vs. Seasonal allergies infographic


All of this being said, during this pandemic it is always better to be safe than sorry. If you are not sure about the cause of your child’s symptoms we encourage you to come into the office. We can assess you child, help make this allergy vs. viral distinction, and/or perform COVID-19 testing if needed.

Schools, daycares, and camps all have algorithms they follow to keep everyone safe. If they request that your child be evaluated for their symptoms or that they have a COVID-19 test before return you should bring them in. We cannot override their protocols. Remember, they are just trying to keep everyone safe!

As always, if you want to chat more please give us a call at 301-279-6750, chat with us on our website, or send an email to

For more on seasonal allergies and treatments, check these older blogs from Potomac Pediatrics:

A few other helpful links: