A sore throat is a common complaint, shared by the bacterial infection Strep throat and the viral infection COVID-19. Both conditions are highly contagious and require different medical management to prevent complications and ensure recovery.
How Strep and COVID Differ
The distinction between the two illnesses lies in their causative agents. Strep throat is caused by the bacterium Streptococcus pyogenes (Group A Streptococcus). COVID-19 is a systemic viral infection caused by the Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2).
Bacterial infections like Strep throat are generally more localized, focusing their impact on the tonsils and pharynx. The Streptococcus bacteria typically spread through large respiratory droplets and direct contact. The SARS-CoV-2 virus is highly transmissible, often spreading via aerosols that can remain suspended in the air over longer distances.
Comparing Key Symptoms
While a sore throat is present in both, the quality of the pain offers initial clues. Strep throat typically presents with a sudden onset of severe throat pain, often described as a raw feeling, making swallowing extremely painful. The throat may appear fire-engine red, and a visual examination may reveal white patches, pus-filled streaks on the tonsils, or tiny red spots called petechiae on the roof of the mouth.
COVID-19 sore throats may be milder and are often just one component of a broader respiratory illness. A significant differentiator is the presence of a cough, which is almost universally absent in Strep throat but is a common feature of COVID-19. The viral infection is also frequently accompanied by congestion, a runny nose, and sometimes a new loss of taste or smell.
COVID-19 often causes severe fatigue, muscle aches, and headache. While fever is common in both, gastrointestinal issues such as nausea and vomiting are more frequently reported in children with Strep throat.
Testing and Confirmation
Because symptoms can overlap, accurate diagnosis requires laboratory testing. For Strep throat, the primary diagnostic tool is the rapid strep test, which involves a quick throat swab to detect Group A Streptococcus antigens. If the rapid test is negative, a throat culture may still be sent to the lab, especially in children, as it is more sensitive and can confirm the presence of bacteria missed by the rapid test.
Diagnosis of COVID-19 relies on detecting the SARS-CoV-2 virus itself. This can be done using a rapid antigen test, which provides quick results by detecting specific viral proteins. For a more definitive result, a Polymerase Chain Reaction (PCR) test is often used, which amplifies and detects the virus’s genetic material. A healthcare provider may recommend testing for both pathogens simultaneously.
Targeted Treatment Strategies
The distinct nature of the pathogens dictates different treatment approaches. A confirmed case of Strep throat requires a full course of antibiotics, such as penicillin or amoxicillin. Completing the entire prescribed course is necessary to cure the infection and prevent serious complications like acute rheumatic fever, which can damage the heart valves.
Treatment for COVID-19 focuses primarily on supportive care, including rest, hydration, and over-the-counter medications to manage fever and body aches. Since the illness is viral, antibiotics are ineffective unless a secondary bacterial infection develops. For individuals considered high-risk for severe illness, specific antiviral medications, such as Paxlovid, may be prescribed. These treatments work by interfering with the virus’s ability to replicate, helping to reduce the severity of the disease.