Strep Throat vs. Covid: How to Tell the Difference

By Jennifer Nadel, MD
Medically reviewed checkmarkMedically reviewed
March 31, 2022

Most of us know the uncomfortable feelings associated with a sore throat.

You suddenly feel like your throat is scratchy or dry, your voice may become hoarse or raspy, and the lymph nodes in your neck may become swollen or engorged.

As the sore throat develops, it can become painful to talk or swallow. In addition, you may experience other symptoms like fever, cough, chills, body aches, headaches, or runny nose.

In some cases, you may see red or white spots appear on the roof of your mouth or the surface of your tonsils. 

When you have a sore throat, it’s important to get to the bottom of what’s causing your symptoms.

Many conditions may be the culprit: for example, a bacterial infection, viral infection, and non-infectious conditions, including allergies , can all make your throat hurt.

Figuring out what you are suffering from can help you treat your pain effectively and avoid spreading your condition to others if you have an infection.

This article will explore the symptoms associated with strep throat, COVID-19, and other conditions that can cause asore throat.

I’ll also share information on the prescription medications and other treatment options available to patients and discuss when you should seek medical attention for your illness.

Strep Throat vs. Covid-19 Symptoms

Sore throats may be painful, but they are common, as well. When people have a sore throat they may feel irritation or a dry sensation in the back of their throat.

Their voice may get raspy or hoarse, the glands in their jaw and neck may begin to swell, and they may struggle to swallow without feeling discomfort. 

Several conditions cause sore throat, including strep throat and COVID-19.

Although the illnesses share similar symptoms, there are a few ways that doctors and patients can tell them apart.

Understanding the similarities and differences between strep throat and COVID-19 is a critical first step in treating your ailment and keeping your friends and family members safe.

A word of caution: if you are concerned about your sore throat and believe you may have COVID-19, call your doctor to discuss your symptoms and schedule a polymerase chain reaction (PCR) test.

Isolate yourself at home until you can get medical care, and continue isolation until your test comes back negative.

Always call ahead to your doctor’s office, testing facility, or hospital to let them know you may have been exposed to COVID-19 or that you may have COVID-19 so that they can adequately prepare for your arrival.

Similar Symptoms 

It can be difficult for a patient to distinguish between the symptoms of COVID-19 vs. strep throat, even though different infectious agents are behind each illness, the diseases share some common symptoms.

They include may: 

  • Fever
  • Sore or irritated throat 
  • Swollen lymph nodes in the neck, face, or jaw 
  • Headache 
  • Stomachache 
  • Nausea or vomiting 

Note how quickly you developed your symptoms if you are trying to tell the difference between strep throat and COVID-19.

Strep throat symptoms tend to develop very quickly, while signs of COVID-19 often appear more gradually.

Another thing to note is that while nausea and vomiting are common among adults with COVID-19, usually children with strep throat are more likely to experience those specific symptoms.

Strep Throat Symptoms

A few symptoms differentiate even mild cases of strep throat from other causes of sore throat and from COVID-19.

Many patients with a strep throat infection develop one or more of the following: 

  • Small, red spots or bumps on the roof of the mouth
  • Red, swollen tonsils
  • White spots or patches on the tonsils 
  • Streaks of pus on the tonsils 
  • Fever
  • They do not have a cough

If you see spots or streaks in your mouth, you might be experiencing strep throat symptoms.

Call your doctor to schedule a strep test and get an accurate diagnosis.

If your test comes back positive, your doctor may  prescribe a course of antibiotics that will address your throat infection and relieve your discomfort. 

COVID-19 Symptoms

Although some patients with COVID-19 experience sore throat symptoms similar to those of strep throat and other ailments, most also develop a host of other complaints of a respiratory illness. 

According to researchers at the Center for Disease Control (CDC), most patients with COVID-19 symptoms experience one or more of the following: 

While many cases of COVID-19 may be able to be managed at home, some patients can develop life-threatening symptoms that require emergency care in severe cases, including:  

  • Chest pain or pressure
  • Difficulty breathing or shortness of breath
  • Confusion 
  • Extreme fatigue
  • Fainting
  • Pale, blue, or gray skin, lips, or nails 

If you are experiencing severe illness, call 9-1-1 or go to your nearest emergency room for medical treatment.

Be sure to call any medical facility you intend to visit ahead of time so that they can safely prepare for your arrival. 

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Treatments

If you are suffering from a sore throat, your treatment will depend on the condition causing it.

Bacterial infections, like strep throat, can be treated with a prescription antibiotic.

Viral infections, like COVID-19, the flu, and the common cold, are not treated with antibiotics, but there are other medications to treat the symptoms to make you feel more comfortable.

Strep Throat Treatments

Strep throat occurs when group A Streptococcus bacteria invade your nose or mouth and begin to proliferate.

It starts when an infected person talks, laughs, or coughs, and the bacteria migrate through respiratory droplets from their body into yours.

It usually takes two to five days for people to develop strep throat symptoms once exposed to the disease.

Children are most at risk for developing strep throat, as they are likely to come into contact with bacteria at their school, playground, and daycare. 

If you believe you have strep throat, the best way to get diagnosis and treatment is to contact your doctor and ask for a rapid strep test.

They will swab the inside of your throat to see if you test positive.

If you don’t test positive but your doctor still suspects you have strep throat, your doctor may take a throat culture swab to double-check your diagnosis.

Throat culture swab results take longer but are considered more accurate than rapid tests.

Once your doctor confirms that you have strep throat, your doctor will prescribe you an antibiotic medication to address your bacterial infection and alleviate your symptoms.

Common antibiotics include: 

  • Amoxicillin (Amoxil) 
  • Azithromycin (Zithromax)
  • Cefixime (Suprax)
  • Cefuroxime (Ceftin)
  • Cephalexin (Keflex)
  • Clarithromycin (Biaxin)
  • Clindamycin (Cleocin)
  • Penicillin 

Always take your antibiotics exactly as prescribed and for the full course, even if you start to feel better. If you stop taking your medication before your doctor recommends it, you will run the risk of your throat infection returning. 

COVID-19 Treatments

Viruses, like COVID-19 and other ailments, are more challenging to treat than bacterial infections because they don’t respond to antibiotics.

Although experts are still developing medications for COVID-19 the Food and Drug Administration has only approved a few. Most are reserved for severe cases requiring hospitalization. 

For patients with milder symptoms, most doctors suggest treating COVID-19 the same way you would the common cold. 

  • Get rest
  • Drink plenty of fluids 
  • Take over-the-counter medications to treat symptoms 
  • Regularly wash your hands with soap and warm water for at least 20 seconds at a time
  • Avoid other people, but if you need to be anyone wear an N95 or KN95 mask Avoid sharing dishes, utensils, towels, bedding, or other personal items
  • Regularly disinfect surfaces
  • Stay isolated as much as possible to avoid spreading your illness to others 
  • Enlist other people’s help getting groceries or running errands

Closely monitor your health as you recover from COVID-19.

Sometimes mild symptoms can abruptly become more severe, sometimes enough to warrant emergency medical treatment.

If you feel you need to see a doctor right away, call the clinic or hospital ahead of time so that they can prepare for your arrival.

The best way to prevent yourself from getting sick with COVID-19 is to get vaccinated and boosted as soon as possible, and wear proper PPE while in public spaces.

COVID vaccines are a safe and effective way to avoid severe illness and protect your family members and friends.

What Else Could it Be?

If you have a sore throat, it doesn’t necessarily mean that you have strep throat or COVID-19.

There are a range of other ailments and diseases — some infectious, some not — that could be behind your discomfort.

Common Cold 

People with the common cold may experience a sore throat, along with a runny or stuffy nose, cough, headache, sneezing, fatigue,  fever, and general malaise.

Common colds are caused by a virus and are generally not dangerous, even though they make you feel uncomfortable. 

If you have a cold, the best thing you can do is drink fluids, get plenty of rest, and take over-the-counter medication to relieve your cold symptoms.

However, if you develop a high fever, your symptoms do not seem to get better, or if you start to have difficulty breathing, call your doctor. 

Influenza

People who have the flu often develop fever, chills,  body  aches, headache, fatigue, runny nose, chest discomfort, and sore throat. Most people get sick during cold and flu season, which is typically from October through May.

Flu symptoms often develop quickly. Most people only require home care and recover within one to two weeks.

In rare cases, people with the flu will develop pneumonia, which can become life-threatening if left untreated.

If you have a chronic condition like asthma or heart disease, you are at more of a risk of developing a more severe infection.  

Seasonal Allergies 

Some people with seasonal allergies experience a sore throat and other symptoms during certain times of the year.

Some common allergy symptoms include  runny nose, red or itchy eyes and nose, cough or wheeze, and fatigue. 

If you have allergies and they are causing you to feel unwell, you may find that taking an oral antihistamine or decongestant can alleviate your symptoms.

Reducing your exposure to your allergy triggers and keeping your household air and surfaces clean can also go a long way toward making you more comfortable.  

Other Conditions 

Other possible, though less common causes of a sore throat include:: 

Environmental and lifestyle factors can also cause a sore throat. They include: 

  • Exposure to cigarette smoke 
  • Dry indoor air 
  • Exposure to chemical irritants or pollutants

If you have a sore throat and are concerned that it may be related to a condition or illness that might require medical treatment, talk to your doctor or healthcare provider about your symptoms.

They will be able to examine you, assess your health, and offer you an accurate diagnosis and treatment plan.

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When to Seek Medical Attention

If you believe your symptoms are related to strep throat or COVID-19, talk to your provider

They will diagnose you  and then suggest an appropriate treatment plan to help relieve your symptoms.

After you are diagnosed, continue to monitor your symptoms.

If at any point you begin to experience more severe illness, including difficulty breathing, confusion, chest pain, extreme fatigue or the inability to stay awake, or pale, gray, or blue skin, lips, or nails, you may require emergency care.

Call 9-1-1 or go to your nearest hospital — be sure to call ahead so that they can safely prepare for your arrival.

How K Health Can Help

Did you know you can get affordable primary care with the K Health app?

Download K to check your symptoms, explore conditions and treatments, and if needed, text with a doctor in minutes. K Health’s AI-powered app is HIPAA compliant and based on 20 years of clinical data.

Frequently Asked Questions

What is the difference between strep throat and COVID-19 symptoms?
Strep throat and COVID-19 share some symptoms, including sore throat, fever, swollen lymph nodes, and headache. Patients with strep throat tend to develop red or white spots on the roof of their mouth or the surface of their tonsils. COVID-19 patients tend to experience upper respiratory symptoms like cough, difficulty breathing, runny nose, body aches, and loss of taste and smell, among other things.
Could a sore throat be a possible symptom of COVID-19?
A sore throat could be a sign that you have contracted COVID-19. If you have recently been exposed to the condition or have reason to be concerned, isolate yourself until you get tested. Once tested, continue to isolate until you receive a negative result.

K Health articles are all written and reviewed by MDs, PhDs, NPs, or PharmDs and are for informational purposes only. This information does not constitute and should not be relied on for professional medical advice. Always talk to your doctor about the risks and benefits of any treatment.

Jennifer Nadel, MD

Dr. Jennifer Nadel is a board certified emergency medicine physician and received her medical degree from the George Washington University School of Medicine. She has worked in varied practice environments, including academic urban level-one trauma centers, community hospital emergency departments, skilled nursing facilities, telemedicine, EMS medical control, and flight medicine.

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