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As the fall allergy season gets underway, theÌýmore typicalÌýsymptomsÌýthat allergy-sufferers feel may beÌý²õ´Ç³¾±ð·É³ó²¹³ÙÌýheightened byÌýawareness ofÌýthe COVID-19 pandemic.Ìý

Aaron N. Pearlman, M.D., FACS, attending otolaryngologistÌýat ÎåÔÂÌìÊÓƵ,Ìýhelps sort outÌýwhat to expect this season,Ìýthe signs andÌýsymptoms, and what options patients with allergies may want toÌýdiscuss with their specialists.ÌýÌý

How would you describe the current fall allergy season?Ìý

In the fall, the most typical seasonal allergies are to pollens from some grasses and weeds--theyÌýmay note increased sneezing, itchy eyes, runny nose and nasal congestion.ÌýPatients with more severe allergies may feel lower respiratory symptoms such as shortness of breath, cough, and wheezing.Ìý(ThoseÌýwho suffer from indoor allergies to molds, dust, and animal dander will continue to be affected in all seasons.)Ìý

Can symptoms of allergies overlap with COVID-19 symptoms? What are the key differences that patients need to know?ÌýÌý

COVID-19 is a complex disease caused by the SARS Covalent 2 (SARS-CoV-2) virus. The spectrum of symptoms of those infected with SARS-CoV-2 can be none (asymptomatic carrier) to severe respiratory compromise and death.  Ìý

Patients with seasonal allergies usuallyÌýareÌýaware that they have a history of temporarily associated symptoms of sneezing, itchy eyes, clear runny nose, nasal congestion, and sometimesÌýwheezing and mild cough.ÌýTaking over the counter medications,Ìýsuch as oral antihistamines,Ìýcan help alleviate symptoms.  ÌýÌý

People suffering from symptomatic COVID-19 most commonly have cough, fever,Ìýand shortness of breath. These symptoms typically begin to worsen over time,Ìýand may be most severe during the second week of infection.  Ìý

ThoughÌýsymptomsÌýsuch as cough, wheezing, and loss of smell and taste may overlap inÌýCOVID-19Ìýand allergy patients, in thoseÌýwith COVID-19, the acute loss of smell and taste isÌýnotÌýassociated with nasal congestion. The allergyÌýpatient isÌýmoreÌýlikely to have nasal congestion andÌýaÌýsecondary difficulty with smell.

At what point should a patient managing allergy symptoms get tested for COVID-19?Ìý

Patients who suffer from seasonal allergies should monitor their symptoms for changes that are inconsistent with their prior experiences in past seasons.  If theyÌýexperience aÌýfever, significant cough, or worsening shortness of breath,Ìýthey should consider getting tested for COVID-19.  Ìý

Additionally, a patient with an acute loss of smell and tasteÌýwithoutÌýnasal congestion should be suspicious for COVID-19 and should considerÌýgettingÌýtestedÌýforÌýit.Ìý

AreÌýseasonal allergy sufferers more likely to contract COVID-19?Ìý

At this time, thereÌýis no reason to think thatÌýpatients with seasonalÌýallergies are more likely to be infected with COVID-19.  More data is needed to make any association.Ìý

What, if any, impact might be seen for allergy patients wearing masks this year?ÌýCanÌýwearing a mask reduce the chance of suffering from fall allergies?

Mask wearing may help people with allergies protect from allergic exacerbations by decreasing the amount of pollen particles that are inhaled andÌýcontact the respiratory system. In the past, it’s beenÌýrecommended that people with dust allergies wear a mask when cleaning their homes. So, it’s not hard to extrapolate that recommendation to the outside world in the current environment. Of course, the patient should wear the mask appropriately overÌýbothÌýtheir mouth and nose.Ìý

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There also has been discussion ofÌýair filters helping prevent COVID-19? How, if at all, does this relate to allergy sufferers?Ìý

High-efficiency particulate air (HEPA) filters and purifiers are used to decrease the amount of free air particles down to about 0.3 micrometers in diameter. Though these filters are often recommended for patients who suffer from allergies, the subjective and objective improvement in symptoms have been mixed.ÌýÌý

In COVID-19, it is still unclearÌýwhetherÌýthey’re helpful. ItÌýmayÌýbe possible that aerosolized particles could be less than 0.3 microns and not captured by the filter.ÌýÌý

Most important,Ìýthough, isÌýto properly clear SARS-CoV-2ÌýbyÌýventilating the purifierÌýto the outside world. If the purifier returnsÌýair back into the same space, this is not adequate. But if air can be moved outside through a HEPA filtration system, this may be beneficial to clear a room of particles,Ìýincluding the virus that causes COVID-19.Ìý

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What additional measuresÌýcanÌýpatients takeÌýatÌýhomeÌýand outdoors to ease allergy symptoms this season?Ìý

PatientsÌýshould manage allergies with a medical professional.ÌýSeasonal allergyÌýsufferers can keep the windows closed and use air conditioning to decrease allergens entering the home.ÌýTheyÌýalsoÌýshould be diligent about cleaning household surfacesÌýandÌýlinens.  

If lifestyle modifications areÌýnot enough to manage symptoms, they may need to consider medical therapy, including oral antihistamines, nasal steroid sprays, nasal antihistamines, leukotriene inhibitors,ÌýcromolynÌýsodium,ÌýorÌýeven oral steroids.  Long-term therapies,Ìýincluding allergy shots,ÌýalsoÌýmayÌýbe considered.ÌýÌý