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

Medically reviewed by Leigh Ann Anderson, PharmD. Last updated on Jan 7, 2022.

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 and Omicron a constant worry. 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).

Around many parts of the world, the cough and cold, flu and allergy seasons are all happening now -- all at the same time -- which can make deciphering 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 tend to appear within the first 2 to 14 days, usually around day 5 to 6. The most common ones -- fever, cough and shortness of breath -- are well-known and expected features,. With Omicron, a sore throat and nose congestion, occurring more in the upper respiratory system, also seem to be common. Omicron symptoms may appear more quickly than previous variants, around day 3 after exposure.

Symptoms of COVID-19 are usually mild and start gradually. Although fever, cough, shortness of breath and fatigue are frequent symptoms, not everyone is painting the same picture. 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 Omicron infection, now the primary variant in the US, 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 Common (may be less common with Omicron) Common Not usually none
Cough Common (dry cough, may be more mild with Omicron) Common (dry cough) Sometimes Sometimes (from post nasal drip)
Fatigue, tiredness Common Common Sometimes Sometimes
Body Aches Common Common Sometimes Not usually
Diarrhea, nausea or other GI symptoms Sometimes Sometimes Not usually none
Headache Sometimes (may be more common with Omicron) Common Sometimes Sometimes
Shortness of breath Sometimes (with more severe symptoms). May be less common with Omicron, but can be severe if risk factors. Sometimes (with more severe symptoms) Not usually Not usually
Sore throat Sometimes (may be more common with Omicron) Sometimes Common Sometimes
Stuffy or runny nose Sometimes (may be more common with Omicron) Sometimes Common Common
Sneezing Not usually (may be more common with Omicron) 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 (may be less common with Omicron) Sometimes Rare or none Rare or none

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

No, it seems not everyone who is infected with coronavirus is exhibiting symptoms, especially with Omicron, which might make it hard to control this outbreak. Those without symptoms may be able to transmit COVID-19 disease to others, and that’s another reason why staying at home, keeping at least 6 feet of social distancing, using an upgraded face mask in public (N95, KN95), and frequent and thorough hand washing are so important. This can’t be overstated enough.

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 or inability to arouse
  • bluish lips or face

Call your doctor

If you think you have been exposed to COVID-19 and develop a fever and symptoms like a cough or difficulty breathing, call your health care provider for medical and testing advice. You may need to shelter in place, undergo testing, and seek medical care.

Learn more: When should I test for COVID?

Those at high risk for COVID-19 complications

Older adults and people who have severe underlying medical conditions are especially vulnerable and should take special precautions to avoid contact with the virus. These higher risk groups include those with chronic conditions such as:

  • heart disease
  • high blood pressure
  • lung diseases such as asthma or chronic obstructive pulmonary disease (COPD)
  • diabetes.
References
  • Omicron Variant: What You Need to Know. US Centers for Disease Control and Prevention (CDC). Dec. 20, 2021. https://www.cdc.gov/coronavirus/2019-ncov/variants/omicron-variant.html
  • 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 Coronavirus. https://www.cdc.gov/coronavirus/2019-ncov/symptoms-testing/symptoms.html
  • 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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