How to determine whether a sore throat is COVID-19, and what it could be instead

• Sore throat is a common COVID-19 symptom, but it can also be from the flu, allergies, or a cold.
• The best way to determine whether a sore throat is a symptom of COVID-19 is to take a test.

Up to 80% of sore throat cases happen due to viral infections, such as influenza, rhinovirus, and coronavirus.

COVID-19, another viral infection, can also cause a sore throat — but it may feel a little different. You may feel less soreness in your throat and more scratchiness, says Dr. Cassandra Pierre, an infectious disease physician at Boston Medical Center.

Almost half of people with COVID-19 develop a sore throat, according to health data from the Zoe Health Study. The best way to be sure a sore throat isn't COVID-19 is to take a test, says Pierre.

Here's what you need to know about whether sore throat can occur with COVID-19, what other conditions can cause throat discomfort, and how to alleviate it.

Is sore throat a COVID-19 symptom?

While the early strains of COVID-19 caused more lower respiratory symptoms, recent Omicron infections tend to cause mild to moderate symptoms, including sore throat. Pierre has noticed that patients are noting sore throat as a COVID-19 symptom more often.

Though some people with COVID-related sore throats have severe soreness, Pierre says that mild or itchy sore throats are the most common with COVID-19.

Sore throat may be someone's only sign of COVID-19, but Pierre says it's more common to have other symptoms, too.

Other common COVID-19 symptoms

According to the Centers for Disease Control and Prevention (CDC), the most common symptoms of COVID-19 include:

• Fatigue
• Runny nose
• Congestion
• Cough
• Headache
• Fever or chills
• New loss of taste or smell
• Body aches
• Nausea and vomiting
• Diarrhea

These symptoms are just as common as sore throat; in fact, Pierre says she sees them as frequently in her practice. "Every patient is going to experience infection differently," she says.

Dr. Benjamin Singer, assistant professor of pulmonary and critical care medicine at Northwestern University Feinberg School of Medicine, says severe cases of COVID-19 can also include shortness of breath and pneumonia.

If you have these signs and symptoms, it's important to see a medical provider for emergency care right away:

• Difficulty breathing
• Chest pain or pressure that doesn't go away
• New confusion
• Difficulty staying awake
• Pale, gray, or bluish skin, lips, or nail beds

What else could it be?

Sore throat accounts for around 12 million outpatient medical visits every year. While sore throat can be a sign of COVID-19, it can also be a symptom of other conditions.

1. Strep throat

Strep throat is a bacterial infection of the throat. "It usually causes a more severe sore throat than other infections," says Singer.

According to the Centers for Disease Control and Prevention, strep throat often causes pain while swallowing and fever without a cough.

You may also have swollen lymph nodes and red streaks or white patches in the back of your mouth. Strep is contagious, and it's important to treat Strep with antibiotics to avoid developing any post-recovery complications like poststreptococcal disorder.

2. Viral infection

COVID-19 is a viral infection, but other viruses can also cause sore throat.

Rhinovirus, adenovirus, and coronavirus — viruses that cause the common cold — can infect nose and throat tissue, triggering inflammation and pain.

Singer says these viruses also lead to more mucus production, which can cause throat irritation known as post-nasal drip.

Along with throat discomfort, these viruses may cause a cough, runny nose, or pink eye. While viruses are contagious, they're not bacterial, so they can't be treated with prescription medication like antibiotics.

3. Tonsillitis

Tonsillitis is a viral or bacterial infection of the tonsils that can cause a very painful sore throat.

"When people look in the back of the throat, they see a whitish material that almost looks like pus," Singer says.

This type of infection is more common in kids and adults, he says, but it can happen to anyone. It's often recurrent, causing a consistent sore throat that can last for up to two weeks.

Along with pain in the tonsils, tonsillitis can also cause fever and swollen lymph nodes, along with white debris on the tonsils (strep, on the other hand, affects the throat itself). It can vary in severity, but in severe cases, medical providers may recommend surgical removal of tonsils.

4. Sinus Infection

A sinus infection happens when the air-filled pockets beside and between the nasal passages — aka your sinuses — become infected, usually as a result of fluid build-up.

According to Singer, most people with sinus infections have sinus pain or pressure and a fever. "But if you have a sinus infection that's draining, it could irritate the throat," he says.

5. The Flu

Influenza, aka the flu, is a viral infection affecting the upper respiratory system.

Like COVID-19 and the common cold, the flu can cause a sore throat; however, Singer says sore throat is not one of the most common symptoms.

If you have the flu, he says you'll likely experience more severe symptoms, such as fever, muscle aches, fatigue, and dry cough.

Tamiflu, a prescription antiviral medication, can help reduce the severity of symptoms and the duration of illness, but only if you take it within a few days after your first symptoms.

6. Seasonal allergies

Sore throat can also have non-infectious causes, such as seasonal allergies.

Allergies occur when your immune system reacts to a substance, such as pollen. According to the National Institutes of Health, seasonal allergies can cause several symptoms, including sneezing, coughing, and a runny nose.

Singer says allergies can also cause post-nasal drip and throat inflammation, resulting in sore or scratchy throat.

How to determine if a sore throat is a COVID-19 symptom

Taking a test is the best way to determine whether your sore throat is due to COVID-19 or something else.

According to Pierre, polymerase chain reaction (PCR) or molecular tests are the most accurate way to find out if you have COVID-19. You can get a PCR test at a pharmacy or doctor's office.

If you don't have access to a PCR test, you can purchase rapid at-home tests over-the-counter at a pharmacy, or online.

Pierre recommends taking at least two at-home tests within a few days of each other. "The sensitivity can range with home tests, so if yours is negative, I would also take one on another day," she says. "You can test negative with symptoms, and then test positive later."

Typically, Pierre says, people develop COVID-19 symptoms and test positive 2-6 days after exposure. If you're simply exposed and have no symptoms or positive test, she says you don't have to quarantine, but you should wear a mask whenever leaving the home and test five days after exposure or at the onset of symptoms.

If you test positive for COVID-19, the Centers for Disease Control and Prevention recommends isolating for a minimum of five days or as long as symptoms persist. Wear a mask outside of the home until ten days have passed since the onset of symptoms.

Best at-home COVID tests

Unsure if a symptom you're experiencing is due to COVID-19? Our guide to the best at-home COVID tests can give you quick and accurate results, and all are available to order online.

• Best free at-home PCR test: Pixel by LabCorp COVID-19 Test, available at LabCorp, free with insurance, can be billed to the federal fund if uninsured
• Most accurate at-home PCR test: EmpowerDX Nasal Swab, available at Amazon and EmpowerDX from $99
• Most doctor-recommended rapid test: BinaxNOW COVID-19 Antigen Self Test (2-pack), available at Walmart and Walgreens, from $19.88
• Rapid test with the quickest results: Quickvue COVID-19 Home Test, available at CVS and Walgreens, $23.99
  
  

Note: Insurance coverage of COVID-19 tests has changed, and some included tests may no longer offer insurance coverage.

When to see a doctor

A sore throat can be uncomfortable, but it often goes away on its own with time.

However, if your throat pain is severe enough to prevent you from eating, drinking, or swallowing — even when you're taking over-the-counter pain relievers — then Pierre says it's important to see a doctor. Neck swelling or significant changes to your voice should also prompt a visit to a medical provider, she says.

Your doctor will likely ask about your symptoms and examine your throat before deciding on a course of treatment.

If pain is mild or inconsistent, there are methods of resolving a sore throat from home. Singer says you can take an over-the-counter pain reliever like ibuprofen or acetaminophen or suck on a throat lozenge. Home remedies, such as drinking warm beverages or gargling with salt water, may also be comforting.

Insider's takeaway

Having a sore throat is painful but common, and it can happen for several reasons, including respiratory infections and allergies.

If you have a sore throat, don't dismiss the possibility of COVID-19 infection, because it's an increasingly common symptom.

"Things you'd associate with any other common cold can be seen with COVID-19, especially with the Omicron strain," says Singer. "Sore throat is high among them."