Although a sore throat is a relatively common symptom, during the COVID era, it can no longer be dismissed or ignored. Having a sore throat by itself doesn’t necessarily indicate you do or don’t have COVID. However, other symptoms in addition to the sore throat may help distinguish between a sore throat COVID 19 related and other etiologies including:
- Strep throat
- Influenza (the flu)
- The common cold
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How would I know if my Sore throat is caused by COVID disease?
A Sore throat is very common and not necessarily indicative of COVID or a medical infection or disease. For most people, a Sore throat by itself is not something to worry about affecting your health. However, if a Sore throat is paired with other symptoms then it is important that one see a medical doctor. The easiest and most accurate way for someone to tell if a Sore throat is caused by a coronavirus such as COVID 19 is by getting an urgent coronavirus test. However, based on the combination of symptoms, it may be possible to have some insight into the underlying cause of a Sore throat before getting a medical test. Symptoms that point to sore throat COVID and are less likely in other infections include:
- Loss of smell (Anosmia)
- Loss of taste (Ageusia)
- Difficulty breathing or Shortness of breath (Dyspnea)
What common medical conditions besides Covid can cause a Sore throat?
A Sore throat, medically known as Pharyngitis, is an illness that can be caused by a number of underlying medical or non-medical conditions besides COVID. Sore throat is a symptom and not an actual medical diagnosis. Some common medical conditions that cause Sore throat other than COVID 19 are:
Other non Covid medical causes of a Sore throat: Strep throat
Strep throat is an infection caused by the bacterium Streptococcus pyogenes, also known by the name group A Strep. Although strep throat and COVID may share some health symptoms such as fever, headache, and Sore throat, there are also several symptoms that may help to separate the strep throat from COVID sore throat. Treatment and care of strep throat may require an antibiotic prescription from an urgent care medical group, community hospital, and/or pharmacy services. Coronavirus is more likely to cause loss of smell/taste, diarrhea, and body aches. These health symptoms are uncommonly associated with strep throat. On the other hand, the following symptoms are more associated with strep throat than COVID-19:
- Painful Swallowing (Odynophagia)
- Small Pinpoint Red Spots in the Throat and Roof of the Mouth (Petechiae)
- Swollen Lymph Nodes Present in the Neck
- A Rash
- Swollen Red Tonsils
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Other non Coronavirus medical causes of a Sore throat: Allergies
Allergies are caused by the body's immune response from a foreign substance known as irritants or allergens. Prevalent allergens include pollen, dander, and certain foods such as peanuts. The immune system normally works by fighting off harmful pathogens that are detrimental to one's health. However, it can go awry and find and fight off prevalent harmless environmental substances and cause symptoms like Sore throat. Although many allergy symptoms could be similar to those experienced in COVID coronavirus infection, individuals with allergies usually do not get loss of smell or taste, fever, body aches, or nausea. The most common allergy health symptoms include:
- Watery, Itchy, and Puffy Eyes
- Runny and or Congested Nose
- Sore throat
Other non Covid medical causes of a Sore throat: The Flu
The flu (Influenza) and COVID are both contagious viruses, although they are caused by different organisms. The flu is caused by influenza viruses while COVID-19 coronavirus is caused by a new strain of coronavirus. SARS-CoV-2 is the scientific name for the new coronavirus strain. When comparing the two it is important note that COVID spreads more easily than the flu and causes more serious health infections in some individuals. Additionally, COVID may remain latent for longer than the flu, meaning individuals get infected and are contagious, but sometimes not yet showing symptoms. Individuals with the flu virus commonly show symptoms 1-4 days after infection, while individuals with coronavirus usually develop symptoms 2-14 days after initial infection. If you are unaware if your symptoms are caused by COVID or the flu, it is important that one take urgent care to quarantine away from people and get tested to reduce the risk of spread. Other prevalent health symptoms of the flu include:
- Body aches and muscle pain
- Loss of appetite
- Sore throat
- Congested or runny nose
Other medical causes of a Sore throat: The Common cold
The common cold can be caused by several different viruses although the class of rhinoviruses are most common. Health symptoms of a cold commonly occur 2 - 3 days after an individual comes into contact with the virus. A cold is usually relatively harmless and the body's immune system can fight the virus on its own although sometimes symptoms like Sore throat may last a couple of days. Children are particularly prone to spreading colds. As colds are caused by viruses, antibiotics from an urgent care medical group and pharmacy services do not aid in fighting the infection. A cold commonly only lasts a few days and does not have many unique symptoms of COVID and coronavirus such as shortness of breath and loss of smell or taste. The most prevalent health symptoms of the common cold are:
- Runny nose
- Sore throat
- Dry or wet cough
- Nasal and sinus congestion
Other medical causes of a Sore throat: Tonsillitis
Tonsillitis is caused by inflammation of the pharyngeal tonsils. Tonsils are located bilaterally in the back of the throat. Tonsillitis can be caused by both bacterial and viral infections although viral infections are more common. Tonsillitis can be self-limited, meaning treatment by a medical professional is not necessary. However, infections can also be severe and require medical treatment, such as the use of antibiotics for the treatment of bacterial Tonsillitis. If tonsils are repeatedly infected and cause difficulty swallowing a surgery in which the tonsils are removed, Tonsillectomy, may be necessary. Tonsillitis commonly resolves in a few weeks and does not have many unique symptoms of COVID such as shortness of breath and loss of smell or taste. The most common symptoms include:
- Sore throat
- Painful swallowing
- Scratchy voice
- Pain with speaking
- Pain with eating
If I have Sore throat symptoms when should I see my Doctor or visit an Urgent care?
Prior to COVID, little care was given to a simple Sore throat. However, with the COVID medical pandemic, a Sore throat may be indicative of an infection with Coronavirus and it is important to note and take care by finding the correct diagnosis. If you develop symptoms of COVID coronavirus the most important first step is to quarantine away from people and make sure not to infect other individuals with the virus which is detrimental to their health. In order to be diagnosed with COVID, you may have to see your medical care doctor, a local urgent care, the hospital or your local health department to find an area that is conducting testing. Even if the medical test is negative, take care and quarantine away from people for at least 10 days as this reduces the risk of spread.
If you do get Coronavirus, try to take care and manage symptoms at home. If symptoms persist or cannot be managed, reach out to your medical doctor or visit a local community urgent care. Medications like steroids could help take care of symptoms like shortness of breath in some patients. Please note that if you get any of the following urgent health symptoms, dial 911 or proceed to the hospital emergency room:
- Difficulty breathing
- Chest pain or pressure
- Sudden dizziness or weakness
- Changes in vision and view
- Difficulty breathing
- Changes in mental status or confusion
- Persistent vomiting or diarrhea
- Coughing or vomiting blood
- Difficulty speaking
If I have a Sore throat symptoms and it is COVID disease related then when was I exposed to the viral spread?
Although a very small percent of individuals infected with COVID will present with ONLY a Sore throat, it is a possibility. If this is the case, according to the CDC services, exposure most likely occurred between 2-14 days prior to symptom onset. If you suspect infection due to COVID, it is important to take care and immediately quarantine away from people and get an urgent medical coronavirus test. If you have COVID and are infected it is urgent and important to reach out and notify individuals you were in contact with and remain at home for ten days time to reduce the spread of the disease.
What medical professionals specialize in treating Sore throats caused by Covid 19, Strep throat, Tonsillitis, the Flu or other infections ?
The majority of Sore throat presentation is to an outpatient clinic, and prompt/acute care also called urgent care. The medical professionals that one may see in these scenarios include internal medicine or family medicine trained health physicians, as well as nurse practitioners (NPs) and Physician assistants (PAs) that work in a group. However, if the Sore throat symptom lingers or has an abnormal health presentation a more specialized physician may be required to care for the patient or provide another point of view and other services. Otolaryngologists are the primary physicians that specialize in the management of diseases and disorders of the throat in patients including children.
An Otolaryngologist is a Physician with an Osteopathic medicine (D.O.) or Allopathy (M.D.) degree that has successfully completed a five year residency in the field of Otorhinolaryngology. The field of Otorhinolaryngology is more commonly known as Otolaryngology. These board-certified doctors are also known as ENTs because they work with diseases and conditions that affect the ears, nose, and throat of patients as well as the head and neck areas. As throat specialists, ENTs are the definitive experts on the causes and treatments for Sore throats. They are also the most experienced Physicians to diagnose and treat other symptoms of Covid 19 including Anosmia (loss of smell) and Ageusia (loss of taste) which are not usually encountered in non-covid related sore throats.
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Callie Torres is a Captain in the United States Air Force and a resident at Wash U/Barnes Jewish Hospital in St Louis. She is a freelance writer with many published medical articles as well as multiple peer-reviewed medical publications