Differentiation of COVID‐19 signs and symptoms from allergic rhinitis and common cold: An ARIA‐EAACI‐GA²LEN consensus

Abstract

Background: Although there are many asymptomatic patients, one of the problems of COVID-19 is early recognition of the disease. COVID-19 symptoms are polymorphic and may include upper respiratory symptoms. However, COVID-19 symptoms may be mistaken with the common cold or allergic rhinitis. An ARIA-EAACI study group attempted to differentiate upper respiratory symptoms between the three diseases.Methods: A modified Delphi process was used. The ARIA members who were seeing COVID-19 patients were asked to fill in a questionnaire on the upper airway symptoms of COVID-19, common cold and allergic rhinitis.Results: Among the 192 ARIA members who were invited to respond to the questionnaire, 89 responded and 87 questionnaires were analysed. The consensus was then reported. A two-way ANOVA revealed significant differences in the symptom intensity between the three diseases (p < .001). Conclusions:This modified Delphi approach enabled the differentiation of upper respiratory symptoms between COVID-19, the common cold and allergic rhinitis. An electronic algorithm will be devised using the questionnaire.

The effect of allergy and asthma as a comorbidity on the susceptibility and outcomes of COVID-19

“…Nasal symptoms in COVID-19 present similarities to those of AR during the pollen season, increasing the complexity of the diagnosis ( 97 ). Moreover, the prevalence of the common cold in winter will further complicate the differentiation between perennial AR and COVID-19 ( 98 ). Seasonal AR had a higher sino-nasal outcome test-22 score.…”

Increasing incidence of parosmia and phantosmia in patients recovering from COVID-19 smell loss

“…Classically, patient complaints of smell loss with the common cold arise from a blocked or stuffy nose that prevents volatile odorants from reaching olfactory receptors near the top of the nasal cavity, and gustation is not affected 9 . However, with COVID-19, sudden smell loss was commonly observed without nasal blockage [10][11][12] , and direct assessment with odor-free tastants (e.g., sugar) indicated taste was also affected 13 .…”

School Asthma Care During COVID-19: What We Have Learned and What We Are Learning

“…39 A modified Delphi process has been used by the ARIA (Allergic Rhinitis and its Impact on Asthma)-EAACI (European Academy of Allergy and Clinical Immunology)-GA 2 LEN (Global Allergy and Asthma European Network) initiative to establish a set of questions aimed at distinguishing COVID-19 from allergic conditions. 40 However, in the interim, it is very difficult to distinguish these conditions from COVID-19. 37,41 As a result, if there are upper or lower respiratory symptoms, especially if atypical from a child's standard allergic symptoms, COVID-19 testing is the only way to differentiate infection from allergic symptoms including asthma and rhinitis at the present time.…”