Every year, 11 million patients in the U.S. seek medical care for a sore throat (which is called pharyngitis.) 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 that’s caused by viruses (including sore throat with COVID-19, the flu, and the common cold) and pharyngitis that’s 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 sign of COVID-19, and does COVID start with a sore throat?
Yes, sore throat and COVID-19 are still closely associated, and it’s often one of the first symptoms. But COVID-19 is certainly not the only cause of sore throat, and it’s not typically the primary symptom COVID-19 patients have. Sometimes accompanying symptoms offer clues that help indicate what is causing a patient’s pharyngitis.
COVID sore throat vs. viral sore throat
Because COVID-19 is an illness caused by a virus, a COVID-19 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 pharyngitis.
COVID sore throat vs. strep throat
Sometimes sore throats are caused by bacterial infections. Bacterial pharyngitis generally comes with different symptoms than 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 and they may find white spots known as exudate on their tonsils.
The most concerning the 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.
Get tested for sore throat & COVID-19
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, to 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 will be discussed by a provider depending on the results. At-home care such as rest, hydration, and soothing cough drops may be recommended if no other signs of infection are present.
Rapid strep tests
Because overuse of antibiotics is unsafe, skilled providers offer rapid strep tests if they suspect a severe 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:
- 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 will get an infection sample by gently wiping the patient’s tonsils with a soft cotton swab. The swab is 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-19
Now that you know sore throat is a sign of COVID-19 infection, we are here to help. Urgent care offers both COVID-19 testing and urgent care visits. 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 asthma, come see the experts at one of our urgent care locations. You can walk in without an appointment, or you can check in online. We’ll have you back to feeling better in no time.
Written by Sarah Thebarge, Physician Assistant