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 and 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. 87 questionnaires were analysed. The consensus was then reported. A two-way ANOVA analysis revealed significant differences in the symptom intensity between the three diseases (p<0.001).

Conclusions: This modified Delphi approach enabled the differentiation of upper respiratory symptoms betweenCOVID-19, common cold and allergic rhinitis. An electronic algorithm will be devised using the questionnaire.


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Hagemann, J., Onorato, G., Jutel, M., Akdis, C., Agache, I., Zuberbier, T., Czarlewski, W., Mullol, J., Bedbrook, A., Bachert, C., Bennoor, K., Bergmann, K., Braido, F., Camargos, P., Caraballo, L., Cardona, V., Casale, T., Cecchi, L., Chivato, T., Chu, D., Cingi, C., Correia-de-Sousa, J., Del Giacco, S., Dokic, D., Dykewicz, M., Ebisawa, M., El-Gamal, Y., Emuzyte, R., Fauquert, J., Fiocchi, A., Fokkens, W., Fonseca, J., Gemicioğlu, B., Gomez, M., Gotua, M., Haahtela, T., Hamelmann, E., Iinuma, T., Ivancevich, J., Jassem, E., Kalayci, O., Kardas, P., Khaitov, M., Kuna, P., Kvedariene, V., Larenas-Linnemann, D., Lipworth, B., Makris, M., Maspero, J., Miculinic, N., Mihaltan, F., Mohammad, Y., Montefort, S., Morais-Almeida, M., Mösges, R., Naclerio, R., Neffen, H., Niedoszytko, M., O'Hehir, R., Ohta, K., Okamoto, Y., Okubo, K., Panzner, P., Papadopoulos, N., Passalacqua, G., Patella, V., Pereira, A., Pfaar, O., Plavec, D., Popov, T., Prokopakis, E., Puggioni, F., Raciborski, F., Reijula, J., Regateiro, F., Reitsma, S., Romano, A., Rosario, N., Rottem, M., Ryan, D., Samolinski, B., Sastre, J., Solé, D., Sova, M., Stellato, C., Suppli-Ulrik, C., Tsiligianni, I., Valero, A., Valiulis, A., Valovirta, E., Vasankari, T., Ventura, M., Wallace, D., Wang, D., Williams, I., Yorgancioglu, A., Yusuf, O., Zernotti, M., Bousquet, J. & Klimek, L. 2021, 'Differentiation of COVID-19 signs and symptoms from allergic rhinitis and common cold- An ARIA-EAACI-GA2 LENconsensus', Allergy. https://doi.org/10.1111/all.14815

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Last updated: 28 June 2023
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