Strep throat is an infection caused by the bacterium Streptococcus pyogenes (Group A Streptococcus or GAS). COVID-19 is a respiratory illness caused by the SARS-CoV-2 virus. Confusion arises because a sore throat can be a symptom of both conditions. Understanding the fundamental differences in their origins is necessary for correct diagnosis and effective treatment.
Are They Related
Strep throat and COVID-19 are not related conditions, as they are caused by entirely different infectious agents: Strep is bacterial, and COVID-19 is viral. One infection cannot turn into the other, nor does the presence of one pathogen cause the other to appear. It is possible, however, for a person to have both infections simultaneously, which is known as a co-infection. The distinction between a bacterial and a viral cause is the most important factor guiding the appropriate medical response.
Key Differences in Symptoms
Strep throat often presents with a sudden onset of symptoms, most notably a severe sore throat and pain when swallowing. A hallmark of the bacterial infection is the presence of red, swollen tonsils that may display white patches, streaks of pus, or tiny red spots on the roof of the mouth, called petechiae. Typically, symptoms like a cough or a runny nose are absent, which helps distinguish it from many viral illnesses. Some patients may also develop a characteristic red, sandpaper-like rash, indicating scarlet fever.
COVID-19 symptoms often develop more gradually and are associated with broader systemic issues. Common manifestations include a new or persistent cough, fatigue, fever, and sometimes shortness of breath. A significant differentiator is the potential for loss of taste or smell, which is not a feature of Strep throat. Gastrointestinal issues, such as nausea, vomiting, or diarrhea, are also commonly reported with the viral infection.
Testing and Diagnosis
Professional testing is necessary for a definitive diagnosis since both conditions can cause a sore throat and fever. For Strep throat, a medical provider performs a throat swab to collect a sample. This sample is often used for a Rapid Strep Test (RST), which provides results within about 15 minutes. If the RST is negative but Strep is still suspected, the sample may be sent for a throat culture, which is more accurate but requires two to three days.
The diagnosis of COVID-19 relies on detecting the SARS-CoV-2 virus using a nasal or saliva swab. Two primary types of tests are used: antigen tests and Polymerase Chain Reaction (PCR) tests. Antigen tests provide rapid results but are less sensitive, potentially missing an early infection. PCR tests are considered the gold standard for accuracy because they detect small amounts of viral genetic material, though results take longer to process.
Treatment Approaches
Strep throat, being a bacterial infection, requires treatment with antibiotics, such as penicillin or amoxicillin. Starting an antibiotic regimen promptly is necessary to alleviate symptoms and prevent serious, delayed complications, most notably rheumatic fever. Patients must take the full course of antibiotics prescribed, even if they feel better, to ensure the complete eradication of the bacteria.
Treatment for COVID-19, a viral infection, is primarily supportive care, focusing on rest, hydration, and using over-the-counter medications. Antibiotics are ineffective against the virus and should not be used for uncomplicated COVID-19. Specific antiviral medications, such as Paxlovid, may be prescribed for individuals at high risk of developing severe illness. These antivirals are most effective when initiated early in the course of the infection, ideally within five days of symptom onset.