Sore throats in the fall months are common, and many people will wonder if they have strep throat or COVID-19, so what is the difference and how do you know if you have COVID or strep throat?

Craig P. Chase, M.D., a partner of Oviedo Medical Research, says, “Aside from getting body aches and fatigue, you don’t tend to have a lot of other symptoms with strep throat. You don’t tend to get runny noses; you don’t get cough or other respiratory problems. It usually is isolated just to the throat.”


What are the Differences and Similarities Between Strep and COVID?

Strep throat differs from COVID and even influenza in the underlying cause of the disease. The flu and COVID are both transmitted through viruses. Flu is caused by influenza viruses and COVID is caused by the 2019 novel coronavirus (SARS-CoV-2). Both cause respiratory illness that can be severe. In the case of COVID-19, many people have died from the disease.

Strep throat is a bacterial infection caused by group A Streptococcus bacteria. Although COVID, flu, and strep are different types of infections in the body, they are transmitted from person to person through tiny airborne droplets infected with these illnesses. Coughing, sneezing, or even talking, can spread these bacteria and viruses, and in the case of COVID-19, sometimes with deadly results.

What Are the Symptoms of COVID vs. Strep?

While COVID and strep can be transmitted through infected droplets from a sick person, there are some differences in how you will feel if you contract either of these disorders. For example, COVID symptoms include:

  • Chills and fever
  • Congestion or a runny nose
  • Coughing
  • Diarrhea
  • Fatigue
  • Headache
  • Loss of taste or smell
  • Nausea or vomiting
  • Shortness of breath
  • Sore throat

Influenza presents with many of these same symptoms, but it doesn’t cause the disruption to your sense of smell and taste that COVID does. Also, sore throat may or may not show up if you’re infected with COVID 19. One study from China of more than 55,000 COVID-19 patients showed that only 14% had sore throat symptoms with the virus.

The symptoms of strep throat are different from both COVID and the flu. According to Dr. Chase, strep throat presents as an “incredibly sore throat, painful to swallow, and you’re going to have a fever. On a physical exam, when you look in the throat, it’s typically bright red—fire engine red—and you’ve got yellow, gunky stuff all over your tonsils.” 

Strep throat symptoms include:

  • A body rash
  • Fever
  • Headache
  • Hoarseness 
  • Nausea or vomiting—especially in children
  • Pain when swallowing
  • Small red spots on the roof of your mouth
  • Swollen, red tonsils with white or yellow patches
  • Swollen, tender lymph nodes on your neck just under your ears

These symptoms are not present in COVID; while you may have a sore throat, there are other symptoms, including coughing, difficulty breathing and loss of smell and taste that are completely different from strep throat. Too, strep throat appears fairly suddenly, while COVID takes longer to incubate and show symptoms. 

When is it Time to See a Doctor?

It can be hard to know if your sore throat is strep-related or a part of COVID. In any case, if you’re worried you may have COVID or strep, it is definitely time to see your doctor. Strep throat is more common in children typically, but if one person has it, it’s highly infectious and may spread. It’s a good idea to seek medical care, where your doctor can examine, diagnose, and test for these illnesses—and then provide treatment.

A simple rapid strep test or throat culture can determine if you have the disease. Your doctor can’t make a guess that you have strep, but should back up the diagnosis with testing. A swab of the throat that is sent to the lab can confirm the diagnosis. The treatment for strep is with antibiotics to heal the infection.

To test for COVID, doctors will use a long swap to take a nose or throat sample. Like strep, the samples are sent to the lab for diagnosis. Unlike strep, there is currently no cure for COVID-19.

If your symptoms worsen for either illness, you may also need to seek emergency medical care, particularly if you’re having trouble breathing, which is one of the biggest issues that put COVID patients in the hospital. Some of the urgent warning signs for COVID-19 include:

  • Trouble breathing
  • Persistent pain or pressure in the chest
  • Confusion or the inability to stay awake
  • Blue face or lips

If these symptoms occur, either call 911 or seek emergency care immediately. 
Typically, you can convalesce from strep throat and COVID while at home, although many patients with the coronavirus are being hospitalized with severe symptoms of the illness. Unlike COVID-19, which, as we write this, has killed nearly 200,000 patients, the CDC estimates there are roughly up to 24,000 cases of strep annually with up to 1,900 patients that die from the disease.