Cold, flu, hay fever, or COVID - Which one do I have?

Medically reviewed by Leigh Ann Anderson, PharmD. Last updated on Oct 23, 2024.

Official Answer by Drugs.com

Maybe you’ve developed a mild cough, sore throat and a runny nose, and you are panicking. That’s understandable, especially now, with COVID-19 still causing illness. It’s important to remember that as concerning as COVID-19 is, most people recover from the disease without needing special treatment. Some people never even have symptoms.

In fact, many of the most common COVID-19 symptoms are commonly seen in other illnesses, like the flu, the common cold or seasonal allergies such as hay fever (see Table 1).

Cough and cold, flu and allergy seasons often all occur at the same time which can make working out your symptoms even more challenging. You may end up with mixed symptoms (such as allergy and COVID-19 symptoms), so it can get complicated.

Comparing the most common features of COVID-19 with other viruses and allergies that circulate throughout the year might be a helpful start.

The initial COVID-19 symptoms tended to appear within the first 2 to 14 days, usually around day 5 to 6, but may be sooner with the more recent variants. The most common ones -- fever, cough and shortness of breath -- are well-known and expected features.

With the newer variants, a sore throat and nasal congestion, occurring more in the upper respiratory tract system, also seem to be common. Symptoms may appear more quickly than previous variants, around day 2 to 3 after exposure.

Omicron variants seem to cause less severe illness than earlier types of COVID-19. The variants circulating as of September 2023 are all of Omicron lineage.

Symptoms of COVID-19 are usually mild and start gradually. Although fever, cough, shortness of breath and fatigue are frequent symptoms, not everyone exhibits the same side effects. Some features, like diarrhea and headache, may occur less frequently. Children may exhibit a different set of symptoms or no symptoms at all.

The CDC states that anyone with can spread the virus to others, even if they are vaccinated or don’t have symptoms.

Table 1: Symptoms of COVID-19, the Flu, a Cold and Allergies

This list is not all-inclusive and you should contact your health care provider for any symptoms that are severe or concerning to you. Not all (or any) symptoms may occur. Also, remember that the virus that causes COVID-19 may spread from person-to-person before symptoms appear. Symptoms in unvaccinated or unboosted patients may be more common or severe.

Symptoms	COVID-19	Flu	Common Cold	Allergies (hay fever)
Fever, chills	Common (may be less common with Omicron variants)	Common	Not usually	None
Cough	Common (dry cough, may be more mild with Omicron variants)	Common (dry cough)	Sometimes	Sometimes (from post nasal drip)
Fatigue, tiredness	Common	Common	Sometimes	Sometimes
Muscle / Body Aches	Common	Common	Sometimes	Not usually
Diarrhea, nausea, vomiting or other GI symptoms	Sometimes	Sometimes	Not usually	None
Headache	Sometimes (may be more common with Omicron variants)	Common	Sometimes	Sometimes
Shortness of breath, difficulty breathing	Sometimes (with more severe symptoms). May be less common with Omicron variants, but can be severe in people with high risk factors.	Sometimes (with more severe symptoms)	Not usually	Not usually
Sore throat	Sometimes (may be more common with Omicron variants)	Sometimes	Common	Sometimes
Stuffy or runny nose	Sometimes (may be more common with Omicron variants)	Sometimes	Common	Common
Sneezing	Not usually (may be more common with Omicron variants)	Not usually	Common	Common
Itchy eyes, throat, nose	Not usually	Not usually	Not usually	Common
Pink eye (conjunctivitis)	Possibly (based on limited reports)	Sometimes (usually viral conjunctivitis)	Sometimes (usually viral conjunctivitis)	Common (allergic conjunctivitis)
Loss of smell, change in taste	Possibly (much less common with Omicron variants)	Sometimes	Rare or none	Rare or none

Does everyone show COVID-19 symptoms if they have this virus?

No, you can still be infected with COVID-19 and may not know it. While most people today usually get at least mild cold- or flu-like symptoms, you may not have any symptoms at all.

Staying at home, social distancing, using a good face mask, and frequent and thorough hand washing are so important if you are infected.

When to seek emergency care

It’s important to know your symptoms and seek advice when needed. If you develop emergency warning signs for COVID-19, contact emergency care immediately. Severe cases can lead to pneumonia and acute respiratory distress syndrome and can be fatal. Emergency warning signs include:

Trouble breathing
Persistent pain or pressure in the chest
New confusion
Inability to wake or stay awake
Pale, gray, or blue-colored skin, lips, or nail beds, depending on skin tone

If someone is showing any of these signs, call 911 or call ahead to your local emergency facility. Notify the operator that you are seeking care for someone who has or may have COVID-19.

Call your doctor

If you think you have been exposed to COVID-19, or test positive, and develop a fever and symptoms like a cough or difficulty breathing, call your health care provider for medical advice. Antiviral treatments like Paxlovid are now available but need to be started within 5 days of symptom onset.

If you have symptoms consistent with COVID-19 and you are aged 50 years or older OR are at high risk of getting very sick, you may be eligible for treatment. Treatment can reduce your risk of hospitalization by over 50% and reduce the risk of death.

Learn more: When should I test for COVID?

Who is at high risk for COVID-19 complications?

Older adults (age over 50) and people who have severe underlying medical conditions are especially vulnerable and should take special precautions to avoid contact with the virus. According to the CDC, more than 81% of COVID-19 deaths occur in people over age 65.

Higher risk groups for severe illness with COVID-19, as noted by the CDC, include:

Heart diseases (heart failure, coronary artery disease, cardiomyopathies, and possibly high blood pressure (hypertension)
Kidney and / or liver disease
Overweight and obesity
HIV infection
Sickle cell disease or thalassemia
Lung diseases such as asthma or chronic obstructive pulmonary disease (COPD)
Type 1 or type 2 diabetes
Cystic fibrosis
Substance use disorders
Certain types of disabilities (i.e., birth defects, Down syndrome, ADHD, cerebral palsy)
Pregnancy
Stroke
Tuberculosis
Organ or blood stem cell transplant
Smoking (current or former)
Weakened immune system (immunocompromised)
Dementia or other neurological disorders
Mental health disorders (mood disorders, including depression, and schizophrenia)
Little or no physical activity

It is important that you talk with your healthcare provider about your risk for severe disease or death if you should contract COVID-19. Understand what kind of action plan you initiate if you have symptoms or test positive for COVID-19. Learn if you are eligible for antiviral treatment.

This is not all the information you need to know about COVID-19 treatment for safe and effective use and does not take the place of your doctor’s directions. Review any treatment information and discuss this information and any questions you have with your doctor or other health care provider.

References

People with Certain Medical Conditions and COVID-19 Risk Factors. S Centers for Disease Control and Prevention (CDC). Accessed Oct 23, 2024 at https://www.cdc.gov/covid/risk-factors/
COVID-19 US Centers for Disease Control and Prevention (CDC). Accessed Oct 23, 2024 at https://www.cdc.gov/covid/
What we know about the symptoms — and the severity — of the omicron variant. NPR. Jan. 6, 2022. https://www.npr.org/sections/health-shots/2022/01/06/1070622880/what-we-know-about-the-symptoms-and-the-severity-of-the-omicron-variant
Gane SB, Kelly C, Hopkins C. Isolated sudden onset anosmia in COVID-19 infection. A novel syndrome? Rhinology. April 2, 2020. doi:10.4193/Rhin20.114
Centers for Disease Control and Prevention (CDC). Symptoms of COVID-19. Updated Oct. 26, 2022. Accessed Sep 14, 2023 at https://www.cdc.gov/covid/
Seah I, Agrawal R. Can the Coronavirus Disease 2019 (COVID-19) Affect the Eyes? A Review of Coronaviruses and Ocular Implications in Humans and Animals. Ocul Immunol Inflamm. 28 (3), 391-395 2020 Apr 2. DOI: 10.1080/09273948.2020.1738501
World Health Organization (WHO). Coronaviruse disease (COVID-19). https://www.who.int/health-topics/coronavirus#tab=tab_3

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Cold, flu, hay fever, or COVID - Which one do I have?

Table 1: Symptoms of COVID-19, the Flu, a Cold and Allergies

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