Even with COVID vaccines and boosters widely available, it’s still nerve-wracking when you’re hit with a symptom associated with the virus—especially now that the Eris variant is making itself known. Any hint of a fever, cough or fatigue can cause feelings of dread and worry to creep in. When it comes to COVID, it’s important to remember that symptoms can vary from person to person; some people don’t experience any symptoms at all.
For people with COVID who do experience symptoms, a sore throat is not uncommon. In fact, it’s one of the top five most prevalent COVID symptoms. But there are plenty of other illnesses that can cause a sore throat too, including other viral infections, the flu, tonsillitis and seasonal allergies. How do you know for sure if your sore throat is COVID-related? Here, doctors share what a COVID sore throat feels like and how it differs from other types of sore throats.
How Can COVID Cause a Sore Throat?
Family physician and author of Up The Down Escalator: A Doctor Navigates Disease and Disorder, Dr. Lisa Doggett, MD, MPH, explains that the COVID virus infects cells in the nasal pockets and the throat. This causes the cells to get inflamed and swell, which results in a sore throat.
“The exact [way] COVID-19 causes a sore throat is not fully understood, but it is thought to be related to the virus’s ability to bind to ACE2 receptors in the throat and upper respiratory tract,” says Dr. Sunjya Schweig, MD, the Founder and Director of the California Center for Functional Medicine and the Founder and Executive Director of The Functional Medicine Research and Technology Center.
He explains that ACE2 receptors are found in the cells in the respiratory tract. “When the virus binds to these receptors, it can cause inflammation and irritation in the throat, leading to symptoms such as a sore throat,” he says.
Another reason why COVID can cause a sore throat, Dr. Schweig says, is because the immune system is weakened. This can lead to a sore throat as well as other COVID symptoms such as a fever, chills, fatigue and body aches.
What Does a COVID Sore Throat Feel Like?
Dr. Doggett says that, typically, a sore throat is one of the earliest signs of COVID. She says it’s also one of the earliest symptoms of other viral infections as well as the common cold. That means if you feel a sore throat coming on, don’t automatically assume that you know what the reason is.
“Unfortunately in many cases, it’s not possible to tell the difference between a sore throat from COVID versus a sore throat from another viral infection,” Dr. Doggett explains. She says that whether your sore throat is due to COVID or another virus, pain can range from moderate to severe and the inside of the throat can look red. “The feelings can range from subtle scratchiness to severe pain. Each person’s experience can be unique even when receiving the same diagnosis,” Dr. Schweig shares.
Though a sore throat typically feels the same regardless of the cause, both experts say that there are some qualities that differentiate it from strep throat—another illness that causes a sore throat. Dr. Doggett explains that with strep throat, there is an appearance of white spots on the throat—something that isn’t seen with a COVID sore throat.
Other than that, both doctors say that it will be very difficult to determine what illness you have based on how your throat feels and looks alone. That’s why it’s crucial to consider your other symptoms and to take a COVID test. Dr. Schweig says that the common cold and COVID are caused by the same type of illness, which creates similar symptoms.
Besides a sore throat, COVID symptoms can include fever or chills, body aches, fatigue, shortness of breath, headaches, loss of taste or smell, runny nose, nausea or diarrhea. In addition to a sore throat, the symptoms of the common cold can include a fever, runny nose, coughing, mucus dripping down your throat and coughing. “A sore throat from the flu is often quite abrupt and usually is associated with body aches, fevers and headaches,” Dr. Schweig says of yet another illness that can cause a sore throat. See why it’s so confusing to know for sure why you have a sore throat?
Both doctors emphasize that the only way to know for sure whether or not your sore throat is a COVID symptom is to take a COVID test. “While tests for strep throat and the flu are usually done in a physician’s office or sometimes a pharmacy, we now have easy access to COVID tests and you get the results in minutes,” Dr. Doggett says.
How To Treat a Sore Throat Caused by COVID—and How Long You Can Expect It To Last
If you do test positive for COVID, both doctors stress that it’s important to isolate yourself from others to prevent the virus from spreading. (The Centers for Disease Control and Prevention recommends isolating for five days, followed by five additional days of mask-wearing when around others.)
If you don’t have any underlying health conditions and are younger than 50, Dr. Doggett says it’s safe to follow these general quarantining guidelines, but if you have an underlying health condition or are older than 50, she recommends seeing your healthcare provider. If your symptoms are severe (such as having trouble breathing), she says this is another time to see your healthcare provider. “Doctors can offer Paxlovid [an antiviral therapy consisting of two medications packaged together], which is a really important treatment for people over 50 or with pre-existing conditions,” Dr. Doggett explains.
In terms of how long you can expect a COVID-related sore throat to stick around, Dr. Schweig says that the average time is between two and five days. (He also adds that it tends to get worse the first couple of days and then slowly starts getting better.) “If it persists beyond five days, it is likely due to something other than COVID, such as a bacterial infection. However, for some people, a sore throat from COVID may persist for several weeks,” he says.
While you’re recovering, both doctors say it’s important to stay hydrated and rest up. They also recommend soothing your sore throat with herbal tea and honey. “Additionally, a warm salt water gargle can help soothe the throat,” Dr. Schweig suggests.
What has always—and remains—tricky about COVID is that its symptoms are the same as so many other types of illnesses. That’s why if there’s any chance you have the virus it’s best to take a test rather than try to figure it out based on your symptoms alone.
Dr. Lisa Doggett, MD, MPH, family physician and author of Up The Down Escalator: A Doctor Navigates Disease and Disorder
Dr. Sunjya Schweig, MD, the Founder and Director of the California Center for Functional Medicine and the Founder and Executive Director of The Functional Medicine Research and Technology Center