COVID sore throat vs “regular” sore throat

Every year, 11 million patients in the U.S. seek medical care for pharyngitis, a sore throat caused by viruses such as COVID-19, the flu, and the common cold. Since a sore throat is one of the hallmark symptoms of COVID-19, it’s worth taking a moment to learn about the differences between pharyngitis caused by viruses, such as COVID, the flu and the common cold, and pharyngitis caused by bacteria, including strep throat.

Is sore throat a sign of COVID?

With the multiple strains that have developed since the beginning of the COVID-19 pandemic, keeping up with symptoms can be confusing. You may wonder if a sore throat is still a symptom of COVID-19 or if there are other more prevalent symptoms to look out for.

Yes, sore throat and COVID are still closely associated, and a painful throat is often one of the first symptoms. However, COVID-19 is certainly not the only cause of sore throat, and it’s not typically the primary complaint of people with COVID. Sometimes, the accompanying symptoms can offer some clues to what’s causing the sore throat.

COVID sore throat vs. viral sore throat

Because COVID-19 is an illness caused by a virus, a COVID sore throat may look and feel like other viral sore throats. One clue that you have viral pharyngitis is that it is often accompanied by other common symptoms. For example, people with influenza will probably also have a runny nose, cough, body aches, fever, and fatigue in addition to a sore throat.

If you think these accompanying flu symptoms sound a lot like COVID-19 symptoms, you’re right. Without proper testing, it’s hard to know which virus is causing the pain.

COVID sore throat vs. strep throat: How to tell them apart

Sometimes sore throats are caused by bacterial infections. Bacterial pharyngitis generally comes with symptoms different from those of a sore throat with COVID-19. While a fever is common with bacterial throat infections, they don’t cause a cough or runny nose.

Patients with bacterial infections often have swollen lymph nodes in their necks. A physical exam may also reveal white spots known as exudate on their tonsils.

The most concerning cause of bacterial pharyngitis is group A streptococcus bacteria, or Group A Strep for short. If a patient tests positive for this form of strep, antibiotics are imperative.

Contrary to common belief, antibiotics aren’t necessary for the throat infection strep causes; they’re given because if left untreated, Group A Strep can spread to other parts of the body and cause damage to vital organs, including the heart and kidneys.

Approximately 10% of pharyngitis cases are due to Group A Strep, which means 1 in 10 patients require antibiotics. However, antibiotics are given to 70% of patients with pharyngitis, which means pharyngitis is one of the most common causes of antibiotic overuse. Antibiotics have no effect on viruses, and they can cause unnecessary side effects and lead to antibiotic resistance.

One final thing to note is that the virus does not cause strep throat. But a COVID or viral infection can suppress your immune system putting you at risk for bacterial infections like strep.

When to get tested for a sore throat and COVID symptoms

An accurate diagnosis of pharyngitis is important because it identifies which patients will benefit from an antibiotic and which patients will recover from pharyngitis without any intervention.

If you do develop a sore throat with COVID-19 or any other reason, it’s important to seek medical attention, especially if the pain gets worse or doesn’t clear up within 48 hours. Seeking medical care will help you receive an accurate diagnosis and determine which treatment is best for you.

If a patient has symptoms that suggest a specific viral cause—including mono, influenza, and COVID-19—tests for those infections can be performed, and the proper treatment plan can be put in place. If no other signs of infection are present, at-home care such as rest, hydration and soothing cough drops may be recommended.

Rapid strep tests

Because overuse of antibiotics is unsafe, skilled providers offer rapid strep tests if they suspect a bacterial infection. To determine if a patient’s symptoms warrant the test, clinicians use the Centor Criteria, a four-point scoring system that indicates the likelihood of a bacterial infection.

The four criteria are:

Fever
Exudate on the tonsils
Swollen lymph nodes in the neck
Absence of a cough

If a patient meets these criteria, a strep test is warranted. If a patient does not meet these criteria, the likelihood of a bacterial infection is low, and a strep test is not indicated.

A rapid strep test is quick and easy. A provider obtains an infection sample by gently wiping the patient’s tonsils with a soft cotton swab. The swab is then immediately placed in a testing container to obtain results.

On average, rapid strep tests produce a result in less than 10 minutes, and they’re 95% accurate. If a rapid strep test is negative but the suspicion of a bacterial infection is high, a clinician can send a throat culture to the lab, which produces a result in a few days.

Visit urgent care for COVID sore throat symptoms and testing

Now that you know sore throat is a sign of COVID-19 infection but can also be a sign of other illnesses, we are here to help. Urgent care offers both COVID-19 testing and provider visits for the whole family. Proactive patients who are diagnosed early can often receive treatment that reduces the severity of the illness.

Urgent care centers also offer Virtual Visits for patients who prefer to stay in the comfort of their homes. With Virtual Visits, patients can see skilled providers any day of the week simply by using their smartphone, laptop, or tablet.

If you need help assessing and treating any illness, come see our network of health system partners. You can walk in or save your spot online. We’ll have you back to feeling better in no time.

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Written by Sarah Thebarge, Physician Assistant