Runny nose, sneezing unlikely signs of COVID-19

Cold, flu, and allergy all affect the respiratory system, which can make it hard to breathe. In this report by Sade Oguntola, experts say that each condition has key symptoms that set them apart from COVID-19.


When Mrs Adene Haruna returned home from the office, she immediately decided on self-isolation because she had been with a colleague with a cold and who was feeling unwell a few days back that was later confirmed to have COVID-19.

“There was someone I had close contact with who was coughing, and another patient, both of who were later found to have the infection. I just wanted to make sure that afterwards, I didn’t end up spreading the infection to my family,” said Mrs Haruna, a hospital attendant.

Mrs Haruna is one of the people that have expressed anxiety about the Wuhan coronavirus, which may have originated in one of the city’s wildlife markets. She had decided on self-isolation based on the advice of a doctor she talked to about her dilemma.

But is the fault totally that of Henry, her acquaintance, who was coughing at work? Henry had resorted to treating himself at home with cough mixtures for fear of being tagged “a COVID-19 patient” and left unattended to for hours at the primary health care facility next to his home.

Itunu Adeeko was also turned back from a nearby clinic when he had an asthmatic attack. Despite his difficulty breathing, the nurse at the hospital he went to turned him back for fear that it might be COVID-19.

Even after showing his inhaler medication that he is asthmatic, the doctor at the next hospital he went to seek medical assistance wanted proof that his difficulty to breathe was not due to coronavirus infection.

The Nigerian Institute of Medical Research (NIMR), Lagos has a diagnostic laboratory that is recognised by Nigeria Centre for Disease Control (NCDC) to offer free testing for COVID-19. It affords people the opportunity to drive in and out to have the test done.

These are people who have come in contact with a confirmed COVID-19 case or who have recently come from high-risk countries but who do not want to go to the other laboratories in the isolation area and are showing symptoms that are related to the virus.

Even during a pandemic, every little sneeze or cough should not cause panic. But “Experience since the beginning of our drive-through testing in NIMR has shown that some doctors are refusing to even assess their patients once their complaints are about the upper respiratory tract. Such patients have often been sent to go and get COVID-19 test done,” said NIMR’s director-general, Professor Babatunde Salako.

According to Professor Salako, “In some of the cases the results are negative. Patient probably has other medical issues which if not treated on time may lead to complications or death. Physicians should please review their patients before panicking to send them for COVID-19 test. It’s time for a call to duty.”

In many places, even a common cold or shortness of breath, also remarkably similar symptoms of the feared virus, is enough to set off the panic of contracting coronavirus by many people.

Howbeit, it can be difficult to distinguish the symptoms of a COVID-19 infection from the symptoms of the common cold, the flu (influenza) or allergy.

While fever is common with the flu and COVID-19, sneezing is typically only associated with colds. Though sore throats are typical with colds, they are uncommon with COVID-19 infections and the flu.

Typical symptoms of seasonal allergies include itchy eyes, itchy nose, sneezing, runny nose and post-nasal drip. Symptoms of COVID-19 include fever, cough, shortness of breath, fatigue, muscle aches, diarrhoea and, sometimes, sore throat.

Dr Ayotunde Fasunla, a consultant Ear, Nose and Throat expert at the University College Hospital (UCH), Ibadan, Oyo State said cold, flu and COVID-19 are all viral infections with few similar symptoms but these common symptoms progress at different rates.

“Coronavirus infection progresses so rapidly unlike the flu; it also overpowers the immune system of the body such that instead of the body being able to curtail it, it overpowers the body system. The progression is faster in those with other underlying diseases such as diabetes,” he added.

Dr Fasunla said a differentiating factor between allergies and COVID-19 are those itchy symptoms — itchy eyes, itchy nose and sneezing.

He stated that those itchy symptoms and a runny nose are most likely due to environmental allergies and not COVID-19.

The flu is also more likely to come with aches and pains than COVID-19. Also, flu usually doesn’t cause shortness of breath initially unless it has progressed to pneumonia.

Allergies should not cause a fever or body aches. Generally, there is no cough unless there is a lot of nasal drainage. Also, allergies also may cause wheezing, especially in people with asthma.

Moreover, allergy symptoms tend to vary with the environment: worsening with exposure to dust, pollen, or animal dander, whereas cold symptoms tend to persist regardless of time of day, weather, locality, or other environmental factors.

Although overlapping symptoms of these diseases include sore throat, fatigue and a dry cough, typically, people with COVID-19 don’t have runny or stuffy noses and sneezing, he declared.

He added, “In terms of differentiating between flu and COVID-19, it can be almost impossible to distinguish even though they are caused by different viruses. That is why we always say that once you see anybody with such symptoms, before you do anything, protect yourself. Also, treat the person in such a way that the person cannot infect others.”

Dr Fasunla said the best way to distinguish these viral infections with different severity is to run tests on such patients.

They take swabs from the back of the throat, a swab from the nose and the chest and quickly screen them to know the actual problem.

However, that health workers turn patients with respiratory problems such as cough and shortness of breath back from the hospital is because many hospitals have not imbibed the culture of ensuring that health workers have the appropriate equipment to protect themselves from being exposed to infections like coronavirus.

“The realization that they may die if they do anything without a PPE makes them keep such persons at an arm’s length. But it shouldn’t be so because they are the one that can help these patients out of their problems,” he added.

For people who worry about experiencing asthma, Dr Olumide Sogaolu, a consultant chest physician at the University College Hospital, Ibadan, said they should watch out against things that can trigger asthmatic attacks.

Such individuals, Dr Sogaolu said, should know their doctor’s number so that they can call in case of an asthmatic attack as well as use their inhaler medications, especially the controller drugs, to make sure that their background asthma is under excellent control.

“Even if exposed to coronavirus, it will not trigger any problem that will give the person any serious asthmatic attack,” he added.

Data from the World Health Organisation (WHO) and Center for Disease Control (CDC) also indicate diarrhoea (in 4 per cent of the cases studied), especially early on with COVID-19. Nasal congestion only occurs in 4.8 per cent of cases. About 14 per cent had a sore throat.

Much more common symptoms of the coronavirus include fever (in 87.9 per cent of the cases studied), dry cough (67.7 per cent of cases), and fatigue (38.1 per cent). Also, vomiting and eye symptoms are rare with COVID-19 patients.

In addition, allergies can be differentiated from cold based on the duration of the symptoms. A cold should get better in a week to 10 days. Allergies don’t go away unless they are treated or its trigger is avoided.

Still, the overlap between symptoms of COVID-19 and symptoms of other common conditions is in part why widespread testing is necessary. Also, someone could have both coronavirus and allergies simultaneously.


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