Seven months ago we had never even heard about the novel Corona Virus or COVID-19. Fast-forward to today; COVID-19 forms part of our daily conversation, it impacts on every decision we take from whether or not we should go to work, send our kids to school, restock our fridge or visit our parents. Who could have thought that something as microscopically-tiny as this could cause such enormous levels of anxiety as well as total devastation! For patients who suffer from allergies, there is much conflicting discussion and opinions in the medical world, as well as in the media, regarding the risk level that COVID-19 poses to this population. Our knowledge of COVID-19 is continuously growing and evolving, and I’d like to address COVID-19 in allergy sufferers as we understand it today, by examining five C’s.
COVID – 19, common cold or allergies?
Allergies, the common cold and other viral flu-like illnesses share many features that are also common to COVID-19. For example, coughing or shortness of breath is associated with many viral illnesses as well as asthma. A runny nose occurs in both allergic rhinitis (hayfever) and the common cold. However, high temperatures, muscle pains and fatigue, which are common to COVID-19 and influenza, do not form part of the presentation asthma or hayfever. Another important clue to remember is that seasonal allergies tend to wax and wane, whereas in a viral illness, such as flu or COVID-19, symptoms steadily worsen.
Most common presenting symptoms
|Shortness of breath||Runny nose and sneezing||Runny nose and sneezing||High temperature||High temperature|
|Cough||Itchy and watery eyes||Sore throat||Cough||Cough|
|Wheezing||Post-nasal drip|| ||Fatigue||Fatigue|
| ||Coughing|| ||Headaches||Shortness of breath|
| ||Congestion|| ||Muscle pains||Muscle pains|
| || || ||Diarrhoea||Sore throat|
| || || || ||Headache|
| || || || ||Nausea, vomiting, diarrhoea|
Control any underlying allergic conditions and continue chronic prescribed medication
Asthma too, needs to be well under control during this period. Although research has shown that mild to moderate asthma does not put one into a higher COVID risk category, poorly controlled asthma may lead to certain COVID-related complications. For this reason, good asthma control to prevent asthma exacerbations is key. According to numerous international allergy societies, regular asthma medications required for asthma control such as inhaled glucocorticoids, and montelukasts should not be discontinued during the COVID-19 pandemic.
Because allergic rhinitis (hayfever) presents with sneezing, a runny nose, post-nasal drip and associated itchy eyes, it may be easy to mistake these symptoms for COVID. For this reason, it is important to control allergies, perhaps even to take anti-histamine and nasal steroid medication ahead of allergy season to prevent mistaking COVID-19 for allergies. Further incentive to good allergy control during the COVID epidemic is that nasal and eye itchiness will present a challenge to mask-wearing and not touching ones’ face.
In summary, as stated by the American College of Allergy, Asthma and Immunology: “There is no data that continuing these allergy and asthma medications will have any effect on increasing your risk of getting the COVID-19 infection or if you get the infection, lead to a worse outcome. It is important to control your allergy and asthma symptoms’’.
Caution needs to be exercised when using a nebuliser
The use of nebulisers is not recommended during the COVID pandemic as they have been found to increase the risk of aerosol spread of the virus particles. Alternative options to nebulisers are asthma pumps, in young children with a spacer attached, to deliver bronchodilator medication.
Consult your doctor if you have concerns
If you or your child experiences any symptoms of chest tightness, difficulty breathing or wheezing, please consult your GP. Doctors are still seeing the ‘usual’ winter respiratory illnesses, and so any worrying symptoms should please be discussed with your healthcare provider. Should you develop symptoms suggestive of COVID, or have a positive COVID result, it is imperative that you make your doctor is aware so that the appropriate management steps can be taken.
Cover your nose and mouth with a mask, observe social distancing and wash your hands
At this stage, these simple measures are our most effective defence against COVID-19!
Take care and stay safe!