How to tell the difference between COVID and allergies in kids

This spring, kids with allergies are scratching their noses, and parents are scratching their heads. With the overlap of allergy symptoms and COVID symptoms, many parents wonder how to tell the difference between COVID and allergies. While there is an overlap in symptoms between allergies and viruses (COVID or otherwise), there are a few distinguishing features:

Allergies Itch

Itchy nose, itchy eyes, itchy throat. If your child is doing a lot of facial rubbing or throat clearing, you can more confidently blame allergies. If needed, treat these annoying itches with allergy medicine such as cetirizine (brand name Zyrtec), loratadine (brand name Claritin), or fexofenadine (Brand name Allegra). You can also read our prior post about spring allergies. Allergy medicine does not improve these symptoms if your child has a virus. 

Fever: Viruses can cause fever. Allergies do not.

If your child has a fever along with their runny or stuffy nose, coughing, sore throat, and watery eyes, think VIRUS. Also, think “contagious.” In contrast, allergies do not trigger fevers. So if your child has sudden onset of respiratory symptoms WITH FEVER, you can’t blame it on allergies. 

Age 

If your child is younger than a year, it is unlikely that they will show signs of spring allergies because they have never been exposed to spring pollen. A person needs to be sensitized to something before they can be allergic to it. If it is your child’s first spring,  they will not usually show signs of allergies. Usually, cold symptoms in a child this young means that your child does, in fact, have a cold virus. 

History

Sensitive noses, sensitive airways, sensitive skin, sensitive gut… they all tend to go together. If your child has ever had eczema, there is a good chance that they may have environmental allergies, asthma or food allergies.

If two parents have nasal allergies, there is about an 80 percent chance that their child has allergies.

A year ago, COVID -19 testing wasn’t readily available. Now that we have more access to testing, with any uncertainty, go ahead and test. You can always call your pediatrician to guide you through figuring out whether your kid has COVID versus allergies.

In the meantime, at least take heart that masks not only protect against COVID from spreading, but scientists discovered that masks decrease allergies!

Julie Kardos, MD and Naline Lai, MD
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