Fabio Ferreli, Francesca Gaino, Elena Russo, Matteo Di Bari, Francesca Pirola, Andrea Costantino, Luca Malvezzi, Armando De Virgilio, Giovanni Colombo, Giovanni Paoletti, Emanuela Morenghi, Giorgio Walter Canonica, Giuseppe Spriano, Enrico Heffler, Giuseppe Mercante

J Allergy Clin Immunol Pract . 2020 Aug 18;S2213-2198(20)30823-0. doi: 10.1016/j.jaip.2020.08.009. Online ahead of print.

COVID-19 is characterized by various clinical conditions, from mild symptoms to pneumonia and death. Mild symptoms, such as nasal and ocular manifestations, can be confused with allergic rhinoconjunctivitis at the onset. This article describes the differences that let one distinguish COVID-19 and allergic rhinoconjunctivitis.

This study included 204 patients that were infected with coronavirus were included. They were retrospectively studied via telephone interview, where they were requested to complete a validated questionnaire, The Mini Rhinoconjunctivitis Quality of Life Questionnaire (MiniRQLQ), which evaluated a series of 14 signs and symptoms on a scale from 0 to 6, indicating “not troubled” and “extremely troubled”, respectively. Patients were also asked to compare the manifestations of their last allergic symptomatic period with COVID-19 manifestations and to evaluate their sense of taste and/or smell.

Among all 204 participants, 22 were also affected by allergic rhinoconjunctivitis. Clinical manifestations of allergic rhinoconjunctivitis compared with those at the onset of COVID-19 were defined as “completely different” by 15 patients (68,2%), “different” by 3 (13.6%), and “similar” by 4 (18,2%). The two clinical presentations were never reported as “identical”.

Although COVID-19 may present some overlap in symptoms with seasonal allergies, the MiniRQLQ scored significantly different between allergic rhinoconjunctivitis and COVID-19. Also, in this study, there were no differences in taste and smell dysfunction reported. Patients with allergic rhinoconjunctivitis are familiar with its symptoms and were able to distinguish them from COVID-19 rhinoconjunctival manifestations.

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