little girl kleenex

Ask The Nurse: Do I have allergies? A cold? The flu? Or COVID-19? How to tell the difference.

In ALDA Archives Newsletter, Ask The Nurse by ALDA News

by Anne Marie Killilea, MSN, RN

little girl kleenex

My little granddaughter came over the other day with red blurry eyes and a cough that, when heard, could have gagged a moose. Before she came, she was playing with some other children in her neighborhood, and they were sick. Being young “nose pickers”, every smaller person shares everything with every other small person. She obviously got this from the other kids, but kids will get sick. Their immune system is new and because they are young, children cannot fight off simple viral infections as adults can. But, of course, the nurse in me kicked in…..OK, I have got to get her to drink fluids, eat small simple meals, take a nap, and go outside to be in the fresh air. I had accomplished all of that by dinnertime. After dinner, my granddaughter’s eyes looked droopy again and all she wanted to do was to sit and rest.

She finally went to bed around 8:00 pm after having some fluids and two small meals. I checked her temperature, and it was a little elevated: 99.2 degrees. She was still sick, and I felt bad. We put her into her crib, and I began to panic. “What if this is the beginning of the flu? Or, does she have Covid? She is not vaccinated,” I said to myself. I grabbed a blanket and slept on the floor next to her all night just in case her breathing changed. 

By 4:30 am, I couldn’t stay awake anymore and drifted off to sleep. I woke up at 5:15 and sprung over to her to make sure she was breathing. I clasped both of my hands and said to myself, “Oh! How could I be so uncaring! I fell asleep!” But there in the middle of her crib she lay sleeping soundly while cuddling her stuffed animal held close towards her body.

Relieved, I sat back on the floor, put my head in my hands, and thought to myself, “We made it through one night. How many other parents, or grandparents, are not as lucky as me? Wait a minute! This is probably just a cold. She is not wheezing, her nose is runny, but the secretions are clear. She is eating and does not have diarrhea. She will be fine.” But how many other people know this?

Comparing Allergies, the common Cold, the Flu, and COVID-19

Even though all four of these respiratory diseases have some similar symptoms, each one starts off very differently.

  1. Allergies are caused from particles in the air that are irritants to the body. 
  2. The common cold is caused by Rhinoviruses. 
  3. The flu is caused by the influenza A and B virus.
  4. COVID-19 is caused by the SARS-CoV-2 virus.

Below is a grid comparing the symptoms of the four respiratory diseases:  

Allergies The common Cold The Flu COVID-19
Cough Sometimes Usually Usually Usually (dry) 
Muscle aches Never Sometimes Usually Usually
Tiredness Sometimes Sometimes Usually  Usually
Sneezing Usually Sometimes Sometimes Rarely
Sore throat Rarely Usually Usually Usually
Runny or stuffy nose Usually Usually Usually Usually
Fever Never Sometimes Usually-not always Usually
Diarrhea Never Never Sometimes-more common in children Sometimes
Nausea or vomiting Never Never Sometimes-more common in children Sometimes
New loss of taste or smell Sometimes with a stuffy nose Sometimes with a stuffy nose Usually Usually (early-often without a runny or stuffy nose)
Pink Eye Sometimes * * Sometimes
Shortness of Breath-difficulty breathing * Can happen if “Cold” lasts longer than 2 weeks, or if person has asthma.  Rarely

Can happen if the person has asthma. 

Usually- early often without a runny nose or stuffy nose

( * – No Data)

I looked at this grid and surmised that my granddaughter just had the common cold. Her symptoms were tiredness, a cough, runny nose, and a low-grade fever. Drinking fluids, eating small meals, and rest were going to help her get better. For me, as a nurse and grandmother, I was lucky, and I knew it. I don’t mind the tired days after being awake all night, as long as my granddaughter gets better. To see her smile and hear her laugh is far beyond what words can describe. It is pure joy!

It is always good to learn something about these four respiratory diseases especially now when the winter months are upon us. There can be some confusion as to what respiratory disease you or someone else may have. If you or someone else is sick, you can use this grid to figure out what type of disease is present.  As a word of caution, even though this grid which compares the four types of respiratory disease is brief, it does not take the place of common sense. If you feel that the respiratory condition is worsening DO NOT WAIT. Call the doctor or go to the ER and be checked out! It is better to always go and get checked out rather than wait and become extremely sick.

Please remember that none of us are out of the woods yet! We are still living in the midst of the pandemic. Viruses linger around us and take advantage of our health if we are not careful. We still need to take extra precautions to keep ourselves healthy and our loved ones safe. Knowing the differences between allergies, the common cold, the flu, and Covid-19 are important as we go through our daily lives. This knowledge will help us to learn how to care for ourselves and others.

As we head towards the end of the year, please continue to be safe, wash your hands, keep away from crowded areas, and rest!

Have a wonderfully safe, healthy, and happy holiday season!

ALDA cares about you! 



Mayo Foundation for Medical Education and Research (MFMER) (1998-2021). COVID-19, cold, allergies, and the flu: What are the differences? Retrieved from: