Strep vs. COVID-19: How Do I Tell the Difference?


Before the COVID-19 pandemic, a sore throat might have been treated with a lozenge or a soothing cup of tea. Once it became a symptom of a potentially dangerous virus, people started to panic.

However, sore throat is only one symptom of COVID-19, and a recent study found that only between 5% and 17.4% of people experience this symptom. A sore throat can indicate a number of other medical conditions, including strep throat.

According to estimates from the Centers for Disease Control and Prevention (CDC), between 14,000 and 25,000 people get group A strep disease in the U.S. each year, with between 1,500 and 2,300 annual deaths reported.

In this article, we'll discuss the differences between strep throat and COVID-19, including symptoms, treatment options, and when you should seek medical treatment.

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Strep vs. COVID-19

Because COVID-19 and strep throat often both begin with a sore throat, it's easy to confuse the two. Even if they feel the same, these medical conditions are actually quite different.

COVID-19 is a highly infectious disease caused by the SARS-CoV-2 virus. It is spread through respiratory droplets that are released when we cough, sneeze, speak, or breathe. Most people have recovered from the disease, but more than 6 million people have died worldwide.

By comparison, strep throat has a much lower mortality rate — very few people die from the condition, and complications only occur if streptococcal toxic shock syndrome (STSS) sets in.

Strep throat is caused by group A Streptococcus bacteria. It is a bacterial infection that may cause a scratchy or sore throat and it mainly affects children. It’s also possible to have strep throat but show no symptoms.

Key Point: What is STSS?

Streptococcal toxic shock syndrome, or STSS, is a rare and dangerous condition. It occurs when group A streptococcus bacteria gets in through the skin or mucous membranes, and then enters the bloodstream.

This type of bacterial infection can quickly cause:

  • Low blood pressure
  • Multiple organ failure
  • Death

Some ways to prevent this potentially deadly condition include practicing:

  • Proper wound care
  • Proper hygiene — especially when it comes to washing hands

Are strep throat and COVID-19 contagious?

Both strep throat and COVID-19 are communicable diseases, which means they can be transmitted to others. The difference is that strep throat is rarely fatal, while COVID-19 may result in death.

Here’s how to protect yourself and others.

Preventing the spread of strep throat

The CDC provides a few simple steps for preventing strep throat infections. These include:

  • Covering your mouth and nose during a cough or sneeze

  • Properly disposing of all used tissues

  • Sneezing or coughing into an elbow and not your hands (if there’s no tissue available)

  • Cleaning your hands with an alcohol sanitizer or soap and water

Preventing the spread of COVID-19

To prevent the spread of COVID-19, the WHO suggests:

  • Getting vaccinated

  • Wearing a mask

  • Practicing social distancing

  • Washing your hands with soap and water

  • Sanitizing your hands with an alcohol solution

  • Disinfecting surfaces that may have been exposed to COVID-19

Strep Throat Symptoms vs. COVID-19 Symptoms

Because there is symptom overlap between strep throat and COVID-19, it’s easy to mistake one for the other. Both conditions can cause what looks and feels like cold symptoms. There are, however, key differences.

It’s important to understand the distinctions between strep throat and COVID-19. You’ll need to know which condition you have to get the right treatment and feel better.

See below for the differences between COVID-19 and strep throat symptoms.

Symptom

Strep Throat

COVID-19

Sore throat

Yes

Sometimes

Fever

Yes

Yes

Headache

Yes

Sometimes

Body aches

Yes

Yes

Vomiting

Yes

Sometimes

Pain when swallowing

Yes

No

Swollen, red, or patchy tonsils

Yes

No

Swollen lymph nodes

Yes

Sometimes

Rash

Yes

Rarely

Loss of taste or smell

No

Yes

Cough

No

Yes

Difficulty breathing/shortness of breath

No

Yes

Congestion

No

Yes

Fatigue

No

Yes

Chest pain

No

Yes

What are My Treatment Options?

Rapid test kits are available for both COVID-19 and strep throat, but without visiting a doctor or doing an at-home test, the best you can do is assess your symptoms and make an educated guess.

Before starting treatment, be sure to perform a test and follow the tips mentioned earlier to protect yourself and others.

Treatment for strep throat

Strep throat can resolve on its own within three to seven days, but antibiotics — such as penicillin or amoxicillin — are commonly used.

Antibiotics help to relieve symptoms, reduce the risk of complications, and prevent the spread of infection. It may also reduce the duration of your illness.

Those who are allergic to antibiotics or prefer not to use them can find symptomatic relief by:

  • Using over-the-counter pain relief medication, such as acetaminophen

  • Using throat spray or throat lozenges

  • Drinking warm, soothing beverages, like tea

Treatment for COVID-19

Much like strep throat, COVID-19 can also resolve on its own without any medical treatments.

Some remedies that will provide relief from symptoms and aid recovery include:

  • Bed rest

  • Drinking fluids

  • Using over-the-counter pain relief medication

  • Using a decongestant, such as a nasal rinse

Unless you have comorbidities or experience any of the more serious upper respiratory symptoms, such as chest pain or breathing difficulties, you are unlikely to require hospitalization.

The FDA has approved certain medications for patients at high risk of being hospitalized with the virus.

FDA-approved COVID-19 treatments

Antiviral treatments

These medications prevent the virus from multiplying. The FDA has approved Paxlovid and Veklury for COVID-19 treatment.

Monoclonal antibodies (mAbs)

These are synthetic antibodies that strengthen the immune system and help you fight COVID-19. The antibody treatments approved by the FDA are Bebtelovimab and Molnupiravir.

What Else Could it Be?

It's possible to display some of the symptoms mentioned above and not have COVID-19 or strep throat.

There are several other medical conditions that share the same symptoms, and only a doctor can provide an accurate diagnosis.

If you don't have strep or COVID-19, your symptoms may be caused by one of the following:

  • Colds or flu

  • Mononucleosis

  • Allergies

  • Other viruses

Should I Get Tested for COVID-19?

If in doubt, it’s always best to take the test — especially if you’re not finding relief from over-the-counter medications or home remedies.

It’s especially important to get tested if you have existing conditions that leave you more vulnerable to complications related to the virus.

Until you can get tested, keep wearing your mask, washing your hands, and maintaining a safe distance from others to protect them from possible infection.

Concerned about COVID-19?

Book an online appointment with a doctor now to get your symptoms assessed.

Where Can I Learn More About Strep Throat and COVID-19?

Are you experiencing sore throat symptoms? Not sure whether you have strep or COVID-19? LifeMD can help. Make a telehealth appointment at LifeMD today, and speak with a board-certified doctor or nurse practitioner from your smartphone or computer.

Dr. Banita Sehgal

Dr. Sehgal received her medical degree from Western University in Los Angeles and trained as Chief Resident at White Memorial Medical Center, also in Los Angeles. She’s been practicing medicine for 20+ years and has a specific interest in women’s health.

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This article is intended for informational purposes only and should not be considered medical advice. Consult a healthcare professional or call a doctor in the case of a medical emergency.

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