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.

Allergy and Clinical Immunology Unit Centro Hospitalar e Universitário de Coimbra Coimbra and Institute of Immunology Faculty of Medicine University of Coimbra Coimbra Portugal

Allergy and Respiratory Diseases Ospedale Policlino San Martino University of Genoa Genoa Italy

Allergy Center CUF Descobertas Hospital Lisbon Portugal

Allergy Section Department of Internal Medicine Hospital Vall d'Hebron and ARADyAL Research Network Barcelona Spain

Allergy Unit 'D Kalogeromitros' 2nd Department of Dermatology and Venereology National and Kapodistrian University of Athens 'Attikon' University Hospital Athens Greece

Allergy Unit CUF Porto Porto Portugal

Allergy Unit Instituto CUF Porto and Hospital CUF Porto Porto Portugal

Argentine Association of Allergy and Clinical Immunology Buenos Aires Argentina

bFondazione Mediterranea GB Morgagni Catania Italy

Celal Bayar University Department of Pulmonology Manisa Turkey

Center for Research in Health Technologies and Information Systems CINTESIS University of Porto Porto Portugal

Center for Rhinology and Allergology Wiesbaden Germany

Center of Allergy and Immunology Georgian Association of Allergology and Clinical Immunology Tbilisi Georgia

Center of Allergy Immunology and Respiratory Diseases Santa Fe Argentina

Center of Excellence in Asthma and Allergy Médica Sur Clinical Foundation and Hospital México City Mexico

Children's Hospital Srebrnjak Zagreb School of Medicine University J J Strossmayer Osijek Croatia

CHU Clermont Ferrand Unité d'Allergologie de l'Enfant Pole pédiatrique Hopital Estaing Clermont Ferrand France

CINTESIS Center for Health Technology and Services Research Faculdade de Medicina Universidade do Porto Porto Portugal

Clinic of Children's Diseases Institute of Clinical Medicine Faculty of Medicine Vilnius University Vilnius Lithuania

Clinical Research Center for Allergy and Rheumatology NHO Sagamihara National Hospital Sagamihara Japan

Comprehensive Allergy Center Department of Dermatology and Allergy Charité Universitätsmedizin Berlin Humboldt Universität zu Berlin and Berlin Institute of Health Berlin Germany

CRI Clinical Research International Ltd Hamburg Germany

Croatian Pulmonary Society Zagreb Croatia

Department of Allergology Medical University of Gdańsk Gdansk Poland

Department of Allergy Immunology and Respiratory Medicine Alfred Hospital and Central Clinical School Monash University Melbourne Vic Australia

Department of Clinical Immunology Wrocław Medical University Wroclaw Poland

Department of Community Medicine Health Information and Decision MEDCIDsS Faculty of Medicina University of Porto Porto Portugal

Department of ENT Diseases Karolinska University Hospital Stockholm Sweden

Department of Family Medicine Medical University of Lodz Lodz Poland

Department of Immunology and Allergology Faculty of Medicine and Faculty Hospital in Pilsen Charles University Prague Pilsen Czech Republic

Department of Immunology Monash University Melbourne Vic Australia

Department of Internal Medicine and IRCCS Ospedale Policlinico San Martino University of Genoa Genoa Italy

Department of Lung Diseases and Clinical Immunology University of Turku and Terveystalo allergy clinic Turku Finland

Department of Medical Sciences and Public Health and Unit of Allergy and Clinical Immunology University Hospital 'Duilio Casula' University of Cagliari Cagliari Italy

Department of Medicine Surgery and Dentistry 'Scuola Medica Salernitana' University of Salerno Salerno Italy

Department of Otolaryngology Head and Neck Surgery Universitätsmedizin Mainz Mainz Germany

Department of Otolaryngology Nippon Medical School Tokyo Japan

Department of Otolaryngology Yong Loo Lin School of Medicine National University of Singapore Singapore Singapore

Department of Otorhinolaryngology Academic Medical Centers AMC Amsterdam The Netherlands

Department of Otorhinolaryngology Amsterdam University Medical Centres AMC Amsterdam The Netherlands

Department of Otorhinolaryngology Chiba University Hospital Chiba Japan

Department of Otorhinolaryngology Head and Neck Surgery Section of Rhinology and Allergy University Hospital Marburg Philipps Universität Marburg Marburg Germany

Department of Otorhinolaryngology University of Crete School of Medicine Heraklion Greece

Department of Pathology Faculty of Medicine Institute of Biomedical Sciences Vilnius University and Institute of Clinical Medicine Clinic of Chest Diseases and Allergology Faculty of Medicine Vilnius University Vilnius Lithuania

Department of Pediatrics Federal University of Minas Gerais Medical School Belo Horizonte Brazil

Department of Prevention of Environmental Hazards and Allergology Medical University of Warsaw Warsaw Poland

Department of Pulmonary Diseases Istanbul University Cerrahpasa Cerrahpasa Faculty of Medicine Istanbul Turkey

Department of Pulmonology Helsinki University Central Hospital Helsinki Department of Public Health University of Helsinki Helsinki Finland

Department of Respiratory Medicine Copenhagen University Hospital Hvidovre and Institute of Clinical Medicine University of Copenhagen Copenhagen Denmark

Department of Respiratory Medicine National Institute of Diseases of the Chest and Hospital Dhaka Bangladesh

Department of Respiratory Medicine University Hospital Olomouc Olomouc Czech Republic

Departments of Medicine and Health Research Methods Evidence and Impact McMaster University Hamilton ON Canada

Division of Allergy and Clinical Immunology Department of Medicine Agency of Health ASL Salerno 'Santa Maria della Speranza' Hospital Salerno Italy

Division of Allergy Asthma and Clinical Immunology Emek Medical Center Afula Israel

Division of Allergy Clinical Immunology and Rheumatology Department of Pediatrics Federal University of São Paulo São Paulo Brazil

Division of Allergy Department of Pediatric Medicine The Bambino Gesù Children's Research Hospital Holy see IRCCS Rome Italy

Division of Allergy immunology University of South Florida Tampa FL USA

Division of ENT Diseases CLINTEC Karolinska Institutet Stockholm Sweden

Division of Infection Immunity and Respiratory Medicine Royal Manchester Children's Hospital University of Manchester Manchester UK

Division of Internal Medicine Asthma and Allergy Barlicki University Hospital Medical University of Lodz Lodz Poland

ENT Department Medical Faculty Eskisehir Osmangazi University Eskisehir Turkey

EUFOREA Brussels Belgium

European Academy of Paediatrics Brussels Belgium

Filha Finnish Lung Health Association Helsinki Finland

Foundation for the Development of Medical and Biological Sciences Cartagena Colombia

Fundacion Ayre Instituto Medico ALAS Salta Argentina

Fundacion Jimenez Diaz CIBERES Faculty of Medicine Autonoma University of Madrid Madrid Spain

Health Planning Unit Department of Social Medicine Faculty of Medicine University of Crete Greece and International Primary Care Respiratory Group IPCRG Aberdeen Scotland

Hospital de Clinicas University of Parana Curitiba Brazil

Institute for Immunological Research University of Cartagena Campus de Zaragocilla Edificio Biblioteca Primer piso Cartagena Colombia

International Primary Care Respiratory Group IPCRG London UK

Johns Hopkins School of Medicine Baltimore MD USA

Life and Health Sciences Research Institute (ICVS School of Medicine University of Minho Braga Portugal

MACVIA France Montpellier France

MASK air Montpellier France

Medical Consulting Czarlewski Levallois France

National Center for Research in Chronic Respiratory Diseases Tishreen University School of Medicine Latakia and Syrian Private University Damascus Damascus Syria

National Hospital Organization Tokyo National Hospital Tokyo Japan

National Institute of Pneumology M Nasta Bucharest Romania

National Research Center Institute of Immunology Federal Medicobiological Agency Laboratory of Molecular Immunology Moscow Russian Federation

Nova Southeastern University Fort Lauderdale FL USA

Oasi Research Institute IRCCS Troina Italy

Pediatric Allergy and Asthma Unit Hacettepe University School of Medicine Ankara Turkey

Pediatric Allergy and Immunology Unit Children's hospital Ain Shams University Cairo Egypt

Personalized Medicine Clinic Asthma and Allergy Humanitas Clinical and Research Center IRCCS Rozzano and Department of Biomedical Sciences Humanitas University Pieve Emanuele Milan Italy

Pneumology and Allergy Department CIBERES and Clinical and Experimental Respiratory Immunoallergy IDIBAPS University of Barcelona Barcelona Spain

PT Government Associate Laboratory Braga Guimarães Portugal

Respiratory Physician Mater Dei Hospital Malta Medicine University of Malta Faculty of Medicine and Surgery University of Medicine La Valette Malta

Rhinology Unit and Smell Clinic ENT Department Hospital Clínic; Clinical and Experimental Respiratory Immunoallergy IDIBAPS CIBERES University of Barcelona Barcelona Spain

School of Medicine University CEU San Pablo Madrid Spain

Scottish Centre for Respiratory Research Cardiovascular and Diabetes Medicine Medical Research Institute Ninewells Hospital University of Dundee Dundee UK

Section of Allergy and Immunology Saint Louis University School of Medicine Saint Louis MO USA

Servicio de Alergia e Immunologia Clinica Santa Isabel Buenos Aires Argentina

Skin and Allergy Hospital Helsinki University Hospital Helsinki Finland

SOS Allergology and Clinical Immunology USL Toscana Centro Prato Italy

Sun Yat sen University International Airway Research Center 1st Affiliated Hospital Guangzou Guangzou China

Swiss Institute of Allergy and Asthma Research University of Zurich Davos Switzerland

The Allergy and Asthma Institute Pakistan Pakistan

Transylvania University Brasov Brasov Romania

Universidad Católica de Córdoba Universidad Nacional de Villa Maria Córdoba Argentina

University Clinic of Pulmology and Allergy Medical Faculty Skopje Skopje Republic of Macedonia

University Hospital 'Sv Ivan Rilski' Sofia Bulgaria

University Hospital Bielefeld Children's Center Bethel EvKB Bielefeld Germany

University Hospital Montpellier Montpellier France

University of Bari Medical School Unit of Geriatric Immunoallergology Bari Italy

University of Turku Turku Finland

Upper Airways Research Laboratory ENT Department Ghent University Hospital Ghent Belgium

Usher Institute University of Edinburgh Edinburgh UK

Vilnius University Faculty of Medicine Institute of Clinical Medicine and Institute of Health Sciences Vilnius Lithuania

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Zobrazit více v PubMed

Han E, Tan MMJ, Turk E, et al. Lessons learnt from easing COVID‐19 restrictions: an analysis of countries and regions in Asia Pacific and Europe. Lancet. 2020;396(10261):1525‐1534. PubMed PMC

Gao J, Quan L. Current status of diagnostic testing for SARS‐CoV‐2 infection and future developments: a review. Med Sci Monit. 2020;26. PubMed PMC

Mair M, Singhavi H, Pai A, et al. A meta‐analysis of 67 studies with presenting symptoms and laboratory tests of COVID‐19 patients. Laryngoscope. 2021;131(6):1254‐1265. PubMed

Goyal P, Choi JJ, Pinheiro LC, et al. Clinical characteristics of covid‐19 in New York City. N Engl J Med. 2020;382(24):2372‐2374. PubMed PMC

Rojas‐Lechuga MJ, Izquierdo‐Dominguez A, Chiesa‐Estomba C, et al. Chemosensory dysfunction in COVID‐19 out‐patients. Eur Arch Otorhinolaryngol. 2020;278(3):695‐702. PubMed PMC

Pang KW, Chee J, Subramaniam S, Ng CL. Frequency and clinical utility of olfactory dysfunction in COVID‐19: a systematic review and meta‐analysis. Curr Allergy Asthma Rep. 2020;20(12):76. PubMed PMC

Hoang MP, Kanjanaumporn J, Aeumjaturapat S, Chusakul S, Seresirikachorn K, Snidvongs K. Olfactory and gustatory dysfunctions in COVID‐19 patients: a systematic review and meta‐analysis. Asian Pac J Allergy Immunol. 2020;38(3):162‐169. PubMed

Liu X, Li X, Sun T, et al. East‐West differences in clinical manifestations of COVID‐19 patients: a systematic literature review and meta‐analysis. J Med Virol. 2021;93(5):2683‐2693. PubMed

Mullol J, Alobid I, Marino‐Sanchez F, et al. The loss of smell and taste in the COVID‐19 outbreak: a tale of many countries. Curr Allergy Asthma Rep. 2020;20(10):61. PubMed PMC

Venn AMR, Schmidt JM, Mullan PC. A case series of pediatric croup with COVID‐19. Am J Emerg Med. 2020. 10.1016/j.ajem.2020.09.034 PubMed DOI PMC

Bousquet J, Anto JM, Bachert C, et al. Allergic rhinitis. Nat Rev Dis Primers. 2020;6(1):95. PubMed

Bedard A, Basagana X, Anto JM, et al. Treatment of allergic rhinitis during and outside the pollen season using mobile technology. A MASK study. Clin Transl Allergy. 2020;10(1):62. PubMed PMC

Pormohammad A, Ghorbani S, Khatami A, et al. Comparison of influenza type A and B with COVID‐19: a global systematic review and meta‐analysis on clinical, laboratory and radiographic findings. Rev Med Virol. 2021;31(3):e2179. PubMed PMC

Courbis AL, Murray RB, Arnavielhe S, et al. Electronic clinical decision support system for allergic rhinitis management: MASK e‐CDSS. Clin Exp Allergy. 2018;48(12):1640‐1653. PubMed

Bousquet JJ, Schunemann HJ, Togias A, et al. Next‐generation ARIA care pathways for rhinitis and asthma: a model for multimorbid chronic diseases. Clin Transl Allergy. 2019;9:44. PubMed PMC

Bousquet J, Bedbrook A, Czarlewski W, et al. Guidance to 2018 good practice: ARIA digitally‐enabled, integrated, person‐centred care for rhinitis and asthma. Clin Transl Allergy. 2019;9:16. PubMed PMC

Bousquet J, Akdis C, Jutel M, et al. Intranasal corticosteroids in allergic rhinitis in COVID‐19 infected patients: an ARIA‐EAACI statement. Allergy. 2020;75(10):2440‐2444. PubMed

Bousquet J, Jutel M, Akdis CA, et al. ARIA‐EAACI statement on asthma and COVID‐19 (June 2, 2020). Allergy. 2020:76(3):689‐697. PubMed PMC

Klimek L, Jutel M, Akdis C, et al. Handling of allergen immunotherapy in the COVID‐19 pandemic: an ARIA‐EAACI statement. Allergy. 2020;75(7):1546‐1554. PubMed PMC

Klimek L, Pfaar O, Worm M, et al. Allergen immunotherapy in the current COVID‐19 pandemic: a position paper of AeDA, ARIA, EAACI, DGAKI and GPA: position paper of the German ARIA Group(A) in cooperation with the Austrian ARIA Group(B), the Swiss ARIA Group(C), German Society for Applied Allergology (AEDA)(D), German Society for Allergology and Clinical Immunology (DGAKI)(E), Society for Pediatric Allergology (GPA)(F) in cooperation with AG Clinical Immunology, Allergology and Environmental Medicine of the DGHNO‐KHC(G) and the European Academy of Allergy and Clinical Immunology (EAACI)(H). Allergol Select. 2020;4:44‐52. PubMed PMC

Pfaar O, Klimek L, Jutel M, et al. COVID‐19 pandemic: practical considerations on the organization of an allergy clinic ‐ an EAACI/ARIA position paper. Allergy. 2020;76(3):648‐676. PubMed PMC

Thompson M. Considering the implication of variations within Delphi research. Fam Pract. 2009;26(5):420‐424. PubMed

Varsavsky T, Graham MS, Canas LS, et al. Detecting COVID‐19 infection hotspots in England using large‐scale self‐reported data from a mobile application: a prospective, observational study. Lancet Public Health. 2021;6(1):21–29. PubMed PMC

Yu J, Zhang HW, Shao YK, et al. A smartphone‐based online tool for prehospital self‐triage of COVID‐19. Chin J Acad Radiol. 2020:16:1‐6. PubMed PMC

Antonelli M, Capdevila J, Chaudhari A, et al. Identification of optimal symptom combinations to trigger diagnostic work‐up of suspected COVID‐19 cases: analysis from a community‐based, prospective, observational cohort. medRxiv. 2020. 10.1101/2020.11.23.20237313 PubMed DOI PMC

Klimek L, Hoffmann HJ, Kalpaklioglu AF, et al. In‐vivo diagnostic test allergens in Europe: a call to action and proposal for recovery plan ‐ An EAACI position paper. Allergy. 2020;75(9):2161‐2169. PubMed

Tricco AC, Ashoor HM, Cardoso R, et al. Sustainability of knowledge translation interventions in healthcare decision‐making: a scoping review. Implement Sci. 2016;11:55. PubMed PMC

Stacey D, Hawker G, Dervin G, et al. Decision aid for patients considering total knee arthroplasty with preference report for surgeons: a pilot randomized controlled trial. BMC Musculoskelet Disord. 2014;15:54. PubMed PMC