Can a Sore Throat Be the Only Symptom of COVID-19?

COVID-19-related sore throat is relatively mild and lasts no more than 4-5 days.

Although rare, COVID-19 may present with only sore throat in about 5%-10% of cases. COVID-19-related sore throat is relatively mild and lasts no more than 4-5 days. 

Other symptoms that may occur at some point during the infection include extreme fatigue, fever, body ache, shortness of breath, chest pain, cough, loss of sense of smell, brain fog, and memory impairment.

What else can cause sore throat?

Sore throat can also be caused by:

• Other viruses, such as respiratory syncytial virus, adenovirus, Epstein-Barr, mumps, and influenza
• Bacterial infections, such as Staphylococcus, Streptococcus, Pneumococcus, Haemophilus influenzae and Gonococcus
• Seasonal allergies
• Pet dander
• Acid reflux 
• Postnasal drip due to sinusitis

Since sore throat has many causes, it is important to consult your doctor for proper diagnosis and treatment.

Do I have COVID-19 or strep throat?

In order to confirm whether your sore throat is caused by COVID-19 or strep, your doctor may order tests:

• Nasal/nasopharyngeal swabs (for COVID-19)
• Throat swabs (strep throat) 

While it may be difficult to differentiate between COVID-19 sore throat and strep throat, there are a few symptoms that point to strep A infection:

• Sore throat worsens throughout the day and causes severe pain when swallowing.
• Reddish rash (scarlatina) is found all over the body in the case of scarlet fever.
• Tonsils are red and swollen, with white patches or streaks of pus.
• There may be small red spots on the roof of the mouth.
• Lymph nodes in the neck are swollen.

Although fever, body ache, and stuffy nose are seen in both COVID-19 and strep A infection, the following symptoms are more common in COVID-19:

• Shortness of breath
• Inability to maintain tissue oxygen saturation
• Brain fog
• Bluish extremities

Can COVID-19 vaccines cause a sore throat?

COVID-19 vaccines can cause flu-like symptoms such as scratchy throat, headache, fever, and body ache. These side effects indicate that your body is developing an immune response that can offer protection from the COVID-19 virus. 

Vaccine side effects should go away within 1-2 days, although swollen lymph nodes may persist for up to 10 days. Such symptoms should not deter you from getting the COVID-19 vaccine or booster shots. If you are worried about vaccine-related events, you should consult with your physician.

12 home remedies for a sore throat

1. Rest: Get plenty of rest and let your sore throat run its course. Avoid spending too much time on your devices as they can disrupt your sleep, which is essential for healing and recovery.
2. OTC pain medication: Take over-the-counter pain medication, such as acetaminophen, ibuprofen, or naproxen, to reduce pain and fever.  
3. Hydration: Staying hydrated not only relieves a sore throat but also loosens mucus and reduces sinus congestion. Try to drink about 12-14 glasses of warm water throughout the day. Clear soups and teas can also help.
4. Humidifiers: Use a clean humidifier or cool mist vaporizer in the room so that the air is moist and does not irritate the airways.
5. Saltwater gargle: Add a teaspoon of salt in a glass of water and gargle. This can help relieve swollen tonsils.
6. Lozenges: Suck on ice chips, popsicles, or lozenges (do not give lozenges to children under 2 years of age), which can relieve scratchiness of the throat.
7. Honey, lemon, and turmeric: Taking a spoonful of warm honey with lemon and turmeric can help relieve a sore throat.
8. Turmeric latte: Warm milk with a pinch of turmeric makes for a tasty and healthy drink that can soothe the throat and has antibacterial properties.
9. Onion and pepper soup: Onion has decongestant properties. Drinking onion soup sprinkled with pepper may help relieve fever and improve immunity.
10. Herbal teas: Herbal teas made from licorice, slippery elm, and marshmallow root are popular remedies that may alleviate a sore throat. However, talk to your doctor before taking herbs, especially if you have hypertension, heart disease, or other chronic health conditions.
11. Sleep positions: Sleeping on your side may help you avoid postnasal discharge from tickling your throat when sleeping. 
12. Avoid smoke: Avoiding smoking, secondhand smoke, strong fumes, and bleach.

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What can I give my child for a sore throat?

Unless your child’s sore throat is due to strep throat or bacterial infection, antibiotics are not required. Rest, hydration, antihistamines, and nonsteroidal anti-inflammatory drugs are likely enough to relieve symptoms in most cases. 

Here is what you should keep in mind when giving your child medications for a sore throat:

• When choosing an over-the-counter medication, opt for acetaminophen in recommended doses.
• Avoid medications that contain codeine in any form. 
• Avoid giving children aspirin because it may cause rare and serious complications. Giving aspirin to a child under age 16 can cause Reye’s syndrome, a rare but very serious illness that damages the liver and brain.
• Ask your doctor or pharmacist about the appropriate doses.
• If your child gets sore throat frequently, talk to your doctor about the possibility of childhood asthma.

When to see a doctor for sore throat

Talk to your doctor if you:

• Test positive for COVID-19 
• Have severe pain and fever over 101 F for 2 or more days
• Have difficulty swallowing, talking, or sleeping due to swollen tonsils or adenoids
• Experience shortness of breath or rash
• Have compromised immunity due to diabetes, human immunodeficiency virus, cancer, steroid medications, or ongoing chemotherapy

How is sore throat treated?

If you test positive for COVID-19, self-isolation will be advised along with symptomatic treatment. Your doctor may initiate antiviral medications (favipiravir, ritonavir and lopinavir) on a case-to-case basis, although most people recover on their own. In the case of severe infection with poor tissue oxygenation and severe lung involvement, your doctor may advise hospitalization and intravenous antivirals and supportive oxygen.

If you test positive for strep throat, your doctor will start you on a course of antibiotics along with nonsteroidal anti-inflammatory drugs. 

If the sore throat is due to tonsillar abscess or tonsillar stone, your doctor may recommend a tonsillectomy (surgical removal of the tonsils).