How is COVID-19 Different from Allergies, the Common Cold and the Flu? “When Should I Call the Doctor?”

Joseph R. Anticaglia MD
Medical Advisory Board

Some questions people ask about COVID-19 are: What are the symptoms? How does it spread? Should I be tested for this coronavirus? How is it treated?

COVID-19 patients have a typical triad of symptoms. A U. S. congressman, infected with the disease, put it this way: “I was coughing, had a temperature of 103F and ‘I had trouble breathing.’ It was getting worse and the test came back positive for the virus.”

Allergy patients don’t complain of having a fever or shortness of breath. They’re bothered by itchy eyes, runny nose, nasal congestion, sneezing and sometimes a cough and feeling tired. Often patients say, “My allergies are terrible this time of the year”

The common cold is more frequent during the fall and winter seasons. People with this viral disease also complain of a stuffy, runny nose, often with a cough and sore throat. They sometimes get a low grade fever but there’s neither a history of allergies nor shortness of breath. “I caught a cold and it’s getting worse.”

Flu symptoms can be dramatic. Patients tell the story of a sudden onset of fever, chills, headache along with muscle aches and pain. They have a nonproductive cough and in severe cases, it can land them in bed with loss of appetite, dehydration, complaining of nausea and vomiting. “This Flu landed me on my tail.”

Virus Yes X yes yes
Fever Yes X sometimes yes
Cough Yes sometimes usually yes
Shortness of breath Yes X X X
History of Allergies X yes X X
Sneezing X yes yes X
Nasal Congestion X yes yes X
Watery, runny nose X yes yes X
Itchy eyes & nose X yes rarely X
Watery eyes X yes yes X
Fever Yes X sometimes yes
Headache X sometimes sometimes yes
Sore throat X rarely usually yes
Chills X X X yes
Muscle aches & pain X X X yes
Vomiting X X X yes
Diarrhea X X X yes

A history of allergy sets it apart from the common cold and other upper respiratory infections. The FLU’s abrupt onset with the symptoms as depicted in green above aid in distinguishing it from COVID-19, the common cold and allergies.

COVID-19, a respiratory virus, is transmitted from person to person when droplets from an infected person (sneezing, coughing) come in contact with another person. The virus can also be transmitted when a healthy person touches a surface infected with COVID-19. Shortness of breath is a characteristic and worrisome symptom of this disease.

Approximately 80% of the symptoms of COVID-19 are mild and many do not know they were infected with the virus. Approximately 15% have severe symptoms and 5% require hospitalization. The symptom table above highlights the complaints of individuals with four different conditions.

At present, there is no vaccine available and no effective, approved drug treatment for COVID- 19. You’ve heard this before, wash your hands for at least 20 seconds, keep your distance (6 feet) from other people, and avoid gatherings of more than 10 people.

The symptom table emphasizes the essentials of diagnosis. Call your doctor particularly if you have COVID-19 triad symptoms as noted. We all need to be socially responsible to “flatten the curve” of this pandemic.


The American Academy of Otolaryngology-Head and Neck Surgery on March 22, 2020, issued a statement indicating that the loss of the sense of smell (“anosmia”) and a decrease or altered sense of taste (“dysgeusia”) may be early symptoms of CIVID-19. These patients may have no other symptoms but are able to transmit the infection to other people.

The Academy said, “We propose that these symptoms be added to the list of screening tools for possible COVID-19 infection.” A significant percentage of these patients have tested positive for COVID-19, especially those with anosmia; and consideration should be given to selfisolation.


  1. Joseph R. Anticaglia, MD; Allergic Rhinitis; Doctor’s Column, HC Smart, 2015
  2. Joseph R. Anticaglia, MD; Influenza It’s more Than a Cold; Doctor’s Column, HC Smart, 2016
  3. Joseph R. Anticaglia, MD; The New Coronavirus Outbreak What You Need to Know? What to Do? Doctor’s Column, HC Smart. 2020
  4. AAO-HNS: Anosmia, Hyposmia, and Dysgeusia Symptoms of Coronavirus Disease March 22, 2020 — 2:19pm

This article is intended solely as a learning experience. Please consult your physician for diagnostic and treatment options.