How long do COVID-19 symptoms last compared to seasonal allergies?

COVID-19 is an acute illness. Patients will develop symptoms between 2 to 14 days after being exposed to the virus. Those symptoms will then last 10 to 14 days. Although symptoms may differ from person to person, they will appear in most people within the 14-day exposure window. This is true whether you have a moderate case or a severe case. Allergies are more of chronic issue. They will generally manifest as mild symptoms and last for the allergy season, which is typically from April to mid-June. Compared to COVID-19, seasonal allergies, as well as allergies that occur perennially, have a much longer time course. In addition, patients will often be familiar with their typical seasonal allergy symptoms, as they often will be similar each spring.

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Q: Are there other symptoms that may indicate COVID-19?

Yes, in addition to cough and fever, some patient experience a loss of smell (anosmia). We don’t typically see a loss of smell with seasonal allergies, unless patients have significant congestion of the nasal passages or have polyps blocking their nasal passages. The loss of smell that is associated with COVID-19 is thought to be due to direct damage to the olfactory nerve and specialized olfactory neuroepithelium.

Q: I’m unsure if I am suffering from allergies or COVID-19. What should I do?

Telemedicine is making it easier—and safer—to get care. If you are concerned, I recommend using a telehealth service to find out what is causing your symptoms.

Did You Gain Weight During Quarantine? Here’s How to Lose it.

May 5, 2021 | COVID-19, Diet and Nutrition, Your Health

Have you gained any weight since the stay-at-home orders were issued in March of 2020? If so, you are not alone. The American Psychological Association’s “Stress in America” poll found that 61 percent of its 3,013 adult respondents experienced undesired weight changes during the COVID-19 pandemic, with 42 percent reporting they gained more weight than they intended. The median weight gain was 15 pounds.

Whether it is 15 pounds or the “Quarantine 19,” studies have found that stress, in this case generated by the health crisis, influences changes in eating patterns and increases the desire for foods high in fat and sugar. Excessive weight gain and obesity is a risk factor for developing potentially life-threatening health problems, including COVID-19.

You can begin to make changes in your lifestyle to lose this weight. Mary Graffagnino, Chief Dietitian at Mount Sinai South Nassau, offers these 10 simple steps:

Eat more veggies, fresh fruits, nuts, seeds, and whole grains.
Avoid processed foods, such as baked goods, ready-to-eat meals, and meat products, such as bacon, sausage, and salami.
Avoid sugary snacks and beverages.
Engage in regular physical exercise. Get at least 150 minutes each week.
Eat breakfast every day. Skipping the first meal of the day makes you hungrier for the next one.
Make sure you get enough sleep. Insufficient sleep is linked to a higher risk of obesity.
Do not be a member of the “clean-plate” club. Leave a few bites of food on your plate, especially when eating out.
Eat mindfully and savor your food. Consider putting away your phone at meal time.
Control your portion size. If you crave a chocolate bar, have a smaller size or half a bar. One serving of meat or poultry should fit in the palm of your hand, or no bigger than a deck of cards
Keep a food journal. Jot down all the meals and snacks you have eaten throughout the day.

Get some healthy snack ideas from Mount Sinai

Can COVID-19 Spread Faster in an Air Conditioned House?

May 3, 2021 | COVID-19, Health Hub, Your Health

As the weather begins to turn warmer and people spend more time at home, many will be thinking about cranking up the AC. Some might wonder whether COVID-19 can spread faster in an air conditioned home.

Waleed Javaid, MD, Associate Professor of Medicine (Infectious Diseases) at the Icahn School of Medicine at Mount Sinai in New York City, says it is possible, but not likely.

If someone in the house who is infected with the virus is coughing and sneezing and not being careful, then tiny virus particles in respiratory droplets could be circulated in the air. Anything that moves air currents around the room can spread these droplets, whether it is an air conditioning system, a window-mounted AC unit, a forced heating system, or even a fan, according to Dr. Javaid.

But he notes the added risk is limited and can be overcome with careful observance of the general rules for minimizing the spread of the virus. The most important point is that people with the virus should be very careful about covering their mouth and nose when they cough or sneeze. Anyone who is infected should stay in an out-of-the way part of the residence, away from others, he says. Those in the residence should treat others as if they could be infected with the virus by maintaining a safe distance and frequently washing their hands.

One thing you can do if you are a homeowner and have a forced air heating and cooling system is ensure that the air filter in your unit is replaced according to the filter instructions, he said. Some filters are designed to remove particles such as respiratory droplets.

Also, opening a window can help bring in fresh air from the outside and disperse stale air inside, and that could help reduce the possibility of the spread of the virus particles in the house.

Questions about the possible role of air conditioners in spreading the virus arose after the Centers for Disease Control and Prevention recently posted a paper to be published in the July 2020 issue of an agency publication. In the paper, Chinese researchers traced an outbreak of COVID-19 to the air flow in an air-conditioned restaurant and recommended increasing the distance between tables and improving ventilation.

Currently, one of the best ways to protect against COVID-19 is to get yourself, and all eligible household members, vaccinated. Vaccination has been proven to reduce the risk of contracting COVID-19 as well as transmitting the illness.

If you would like to get a COVID-19 vaccine, contact your state or local health department for scheduling information.

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How to Cope With Post-Pandemic Anxiety

Updated on Jun 30, 2022 | COVID-19, Mental Health, Psychiatry, Your Health

Young woman sits in window sill while looking at phone

With vaccination efforts ramping up across the United States, people are looking forward to a sense of normalcy. However, for many, the thought of things returning to normal brings a paralyzing sense of anxiety. Shannon O’Neill, PhD, licensed psychologist and Assistant Professor of Psychiatry at the Icahn School of Medicine at Mount Sinai, discusses the post-pandemic anxiety you may be experiencing and how to overcome those complicated feelings.

Why are people feeling anxious as we see signs of the pandemic easing?

It makes a lot of sense that people are feeling anxious and unsettled right now. Just when we were finally adjusting to a new normal with some predictability and flow, the world is preparing to change all over again. Future uncertainty and a sense of not knowing what to expect can fuel anticipatory anxiety. There is even a diagnosis for this feeling: adjustment disorder.

What does that mean?

Adjustment disorder is described as an emotional or behavioral reaction to stress or change in a person’s life. As vaccinations tick up and warmer weather approaches, there will likely be a significant readjustment of phasing normalcy back into our lives, similar to the adjustments made to social distancing or quarantining at home. This can, naturally, cause feelings of anxiety, as well as depression.

In most circumstances, beginning to reintegrate a ‘normal’ routine can enhance ones confidence. So, having the extra protection of the vaccine amongst ourselves and within our community may offer added physical and emotional security for those who are feeling anxious about things going back to normal.

How can I overcome the new feelings of anxiety I’ve developed during quarantine?

A classic treatment approach for an anxiety diagnosis is exposure. Rather than avoiding what is feared, it is important to lean into those activities.

Technology has been a wonderful and very helpful incentive for us to stay home when it was important to do so. Whether enabling us to receive a grocery or pharmacy delivery or attend a virtual happy hour, technology has allowed us to obtain resources and socialize from a distance. However, for some, this adaptation can turn into over accommodation and avoidance.

Thankfully, through repeated exposures to feared stimuli, while also following CDC guidelines, you should eventually become more comfortable. However, this may mean that you will need to ease in with smaller social commitments that have time limits before expanding out to larger outings. For instance, if attending an extended outing with your larger—hopefully fully vaccinated—social group sounds too much, try connecting with a friend you haven’t seen in a year with an hour-long picnic in the park. Once you feel comfortable with these smaller interactions, you can begin to safely expand your social network.

Another good rule of thumb is to know your boundaries and limits ahead of time as this will allow for some predictability and certainty. Ask yourself, what are you willing to tolerate? Is it the group size, rules around mask wearing, or the amount of time you are present? Acknowledging your boundaries and sticking to a plan can offer a good sense of confidence when you leave your home.

How can I tell if my anxiety about leaving the house is agoraphobia? What are the symptoms?

Agoraphobia is a clinical diagnosis under the umbrella of anxiety. This entails marked fear or anxiety across a number of situations whether that is going outside alone, using public transportation, standing in line, or being in large crowds or within closed spaces.

When there is fear of leaving the home, significant avoidance or behavioral modifications can develop. This can be turning down invitations, starting to self-medicate before leaving the home, or engaging in ‘safety behaviors’ such as only leaving the home with a trusted loved one.

How do I know if I should seek care for these feelings?

If current behaviors and emotions cause significant distress, impact daily functioning, or affect interpersonal relationships, it would be a good time to seek help from a trusted provider. Additionally, if self-medication—via drugs, alcohol, or even food—is necessary to white-knuckle your way through a task, seeking help would be important.

Telehealth services have expanded throughout the Mount Sinai Health System during the pandemic and this can be a wonderful way to begin psychotherapy for those with anxiety or agoraphobia. Working towards even just meeting in person with your provider is a great treatment goal at the start of these sessions.

Learn more about Behavioral Health at Mount Sinai

How Can I Tell the Difference Between Seasonal Allergies and COVID-19?

Updated on Jun 30, 2022 | Allergy, COVID-19, Your Health

Today, every sniffle, every cough, and every sneeze are a cause for concern. “Do I have COVID-19?” races through our minds. Madeleine R. Schaberg, MD, Director of Rhinology and Endoscopic Surgery, Mount Sinai Downtown, helps you tell the difference between allergies and COVID-19.

How do the symptoms of seasonal allergies differ from COVID-19?

The main symptoms of allergic rhinitis or seasonal allergies are itchy, watery eyes, runny nose, nasal congestion, and sneezing, while the symptoms of COVID-19 are fever, cough, body aches, sore throat, and shortness of breath. Many symptomatic patients with COVID-19 will have a fever which, in an adult, is a temperature above 99°F.

Other symptoms of seasonal allergies include post-nasal drip, facial pressure and sinus headaches, and mild fatigue. We generally do not see a significant amount of coughing with seasonal allergies, except in patients with significant post-nasal drip or allergy associated asthma. Sneezing is generally a prominent feature of seasonal allergies, but it has not been reported with COVID-19, although it may happen occasionally.

In general, the key differentiating factors between COVID-19 and allergies are fever and body aches (malaise). Typically, you do not see either symptom in allergy sufferers. While you may see some mild fatigue with allergies, the fatigue we are seeing with COVID-19 is more extreme.

Are there other symptoms that may indicate COVID-19?

Yes, in addition to cough and fever, many patients will experience a loss of smell (anosmia). We don’t typically see a loss of smell with seasonal allergies, unless patients have significant congestion of the nasal passages or have polyps blocking their nasal passages. The loss of smell that is associated with COVID-19 is thought to be due to direct damage to the olfactory nerve and specialized olfactory neuroepithelium.

It’s also worth noting that, for most people, COVID-19 is an acute illness. Patients will develop symptoms between 2 to 14 days after being exposed to the virus. Those symptoms will then last 10 to 14 days. Although symptoms may differ from person to person, they will appear in most people within the 14-day exposure window. This is true whether you have a moderate case or a severe case.

Allergies are more of a chronic issue. They will generally manifest as mild symptoms and last for the allergy season, which is typically from April to mid-June. Compared to COVID-19, seasonal allergies, as well as allergies that occur perennially, have a much longer time course. In addition, patients will often be familiar with their typical seasonal allergy symptoms, as they often will be similar each spring.

What is the treatment for allergies?

For allergies, the first line of treatment is over-the-counter antihistamines. The main inflammatory mediator of seasonal allergies is histamine. This would include such medications as, cetirizine, loratadine, fexofenadine, and levocetirizine. There are also many over-the-counter steroid nasal sprays, which are extremely effective for allergy relief, such as budesonide, fluticasone, and triamcinolone.

If patients don’t get relief with over-the-counter medication, then an appointment with a rhinologist would be appropriate to explore possible prescription medication.

There are many prescription medications that can be extremely helpful.

I’m unsure if I am suffering from allergies or COVID-19. What should I do?

If you are experiencing mild symptoms that you are concerned may be COVID-19, there are a number of testing options available.

In-person testing is available at all Mount Sinai Urgent Care locations for walk-in or scheduled appointment.

You can also have your symptoms assessed virtually throughout Mount Sinai Urgent Care. Physicians are available for online consultations, video calls, and via text from your mobile device. Additionally, you can contact your Mount Sinai primary care physician or use Mount Sinai’s Express Online Consult Click4Care to receive virtual assessment of your symptoms.

Make an appointment with Dr. Schaberg

How Do I Prevent—And Treat—A Muscle Strain?

Updated on Jun 30, 2022 | Sports Medicine, Your Health

Man running in park stops to check on injured ankle

During the pandemic, more people have been exercising on their own rather than with intramural teams or at the gym. That means if you run into trouble, you’re also on your own. If you have a muscle strain or sprain, you may want to know what to do—and when you really need to seek professional help. Melissa Leber, MD, Director of Emergency Department Sports Medicine at The Mount Sinai Hospital, answers some of your questions.

How do you strain a muscle?

A muscle strain happens when you pull, tear, or stretch a muscle. Strains sometimes happen from overuse, but often they’re caused by an injury. Muscle strains and sprains can trigger pain, swelling, and even bruising. You can strain or sprain almost any muscle in the body, but the ones we see most often affect the calf muscle (called the gastrocnemius), the ankle, or the lower back. We also see a lot of strained rotator cuffs, quads, and hamstrings.

How should I treat a muscle strain?

If you think you have strained or sprained a muscle, you should immediately stop what you are doing. Then, plan to rest the injured area and apply ice. Ice should not be applied directly to the skin, but rather wrapped in a towel. It should be held in place for about 20 minutes and then taken off. This can be repeated for the first 24 hours after an injury. After an injury you can also take an anti-inflammatory medication such as ibuprofen or naproxen, if you are allowed. If you can’t bear weight or if you can’t use your affected muscle at all, you should seek emergency care by at the nearest emergency room or urgent care facility. Otherwise, give it a day or two to see if the muscle gets better.

I have not worked out in six months. How can I prevent straining a muscle when restarting my fitness regimen?

Muscle strains and sprains are common—but they aren’t inevitable. To prevent straining your muscles, vary the frequency and variety of your workout. You don’t want to do the same thing over and over again because that can ask too much of the muscle. While you might not feel any pain in the moment, you could still be damaging the muscle. Then, later on, you could start to feel pain seemingly out of nowhere.

You’ll also want to vary the intensity of your workout. You can’t go hard day after day after day. Give your body at least one day off a week. One way to vary the intensity of your exercise is to practice interval training. This means performing a series of high intensity workouts interspersed with rest periods.

When should I see a doctor about my injury?

If you are still in pain after treating at home for two to three days, you should make an appointment with a physician who might take an x-ray or perform a musculoskeletal ultrasound to gauge the severity of your injury.

Also, in addition to strains and sprains, a torn muscle can develop a hematoma. This happens when blood collects at the site of the torn muscle causing pain, swelling, and discoloration of the area. While many hematomas can be treated at home with RICE (rest, ice, compression, elevation), more severe injuries will need a medical intervention. If you suspect that you have a hematoma and have severe pain and/or your injury expands over one to two days, seek medical attention.

Make an appointment with Dr. Leber

Pregnancy and Antidepressants: Should You Avoid Taking Them?

Updated on Jun 30, 2022 | Featured, Mental Health, OB/GYN, Psychiatry, Research, Women's Health, Your Health

Approximately half of women who use antidepressants before pregnancy decide to discontinue use either before or during pregnancy due to concerns about the negative consequences for their child.

Those who are pregnant or who may be thinking of getting pregnant may wonder if taking antidepressants could affect the heath of the child. New research from Mount Sinai offers some potentially important findings and shows that the underlying mental health of the parents is more of a concern than the medication itself.

The study shows that while there is a link between maternal antidepressant use during pregnancy and affective disorders in the child later in life, the link also exists between paternal antidepressant use during pregnancy and child mental health.

The data suggest the observed link is most likely due to the underlying mental illness of the parents rather than any “intrauterine effect,” which means any effect the medication could have on the fetus developing inside the uterus. These affective disorders include depression and anxiety.

“Our study does not provide evidence for a causal relationship between in-utero exposure to antidepressants and affective disorders in the child,” says Anna-Sophie Rommel, PhD, an instructor in the Department of Psychiatry at Icahn Mount Sinai and first author of the paper. “So, while other long-term effects of intrauterine exposure to antidepressants remain to be investigated, our work supports antidepressant continuation for women who would like to continue taking their medication, for example because of severe symptoms or a high risk of relapse. It is important to note that untreated psychiatric illness during pregnancy can also have negative consequences on the health and development of the child. Women and their health care providers should carefully weigh all of the treatment options and jointly decide on the best course of action.”

Anna-Sophie Rommel, PhD

Approximately half of women who use antidepressants before pregnancy decide to discontinue use either before or during pregnancy due to concerns about the negative consequences for their child, according to Dr. Rommel, who is also an expert in epidemiology and has been studying how the COVID-19 pandemic disproportionately affects pregnant women in underserved communities.

Major depressive disorder is highly prevalent, with one in five people experiencing an episode at some point in their life, and is almost twice as common in women than in men. Antidepressants are usually given as a first-line treatment, including during pregnancy, either to prevent the recurrence of depression, or as acute treatment in newly depressed patients. Antidepressant use during pregnancy is widespread and since antidepressants cross the placenta and the blood-brain barrier, concern exists about potential long-term effects of intrauterine antidepressant exposure in the unborn child.

Using the Danish National Registers to follow more than 42,000 babies born during 1998-2011 for up to 18 years, researchers at the Icahn School of Medicine at Mount Sinai investigated whether exposure to antidepressants in the womb would increase the risk of developing affective disorder like depression and anxiety in the child.

In a study published April 5 in Neuropsychopharmacology, the scientists found that children whose mothers continued antidepressants during pregnancy had a higher risk of affective disorders than children whose mothers stopped taking antidepressants before pregnancy.

However, to understand whether the underlying disorder for which the antidepressant was given or the medication itself was linked to the child’s risk of developing an affective disorder, they also studied the effect of paternal antidepressant use during pregnancy and similarly, found that children of fathers who took antidepressants throughout pregnancy had a higher risk for affective disorders. Thus, the research team speculates that rather than being an intrauterine effect, the observed link is most likely due to the parental mental illness underlying the antidepressant use.