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You have a sore throat: Is it a cold, strep or COVID-19?

Published: July 18, 2023

Written by: Barbara Brody

Young mother in a hijab with her daughter on her lap speaking to a female doctor via video call on a laptop.

Here’s how to narrow down what might be causing your discomfort, how long it could last and how to treat it.

In this article:

Your throat feels scratchy, or maybe it hurts to swallow. Many respiratory illnesses can cause a sore throat, so you’ll have to do a little detective work to clarify what you have. “First consider whether you might have COVID-19,” says Shannon Neale, MD, a family physician with HealthPartners & Park Nicollet in St. Louis Park, MN. “The disease is still a major health threat, and you shouldn’t rule it out without testing for it first.”

Of course, not every sore throat is caused by COVID-19 — and plenty of people with COVID-19 don’t ever get a sore throat. Sore throats are can also be caused by strep infections or a garden-variety cold. So which one is it? You’ll always want to consult with your health care provider to be sure. But as you plan your next steps, this guide can help you better understand the most likely cause and what to do about it.

Hand holds a positive at-home COVID-19 test.

Do I have COVID-19?

If you were to make a chart of COVID-19 vs. cold symptoms, you’d see an awful lot of overlap. It’s true that COVID-19 symptoms sometimes include fever, loss of taste and loss of smell, and these issues are rare with a cold. But both COVID-19 and a cold could certainly cause a sore throat, coughing and a stuffy or runny nose.

That’s why, if you have any possible COVID-19 symptoms, it’s best to do an at-home test such as the CVS Health at Home COVID-19 Test Kit, the FlowFlex COVID-19 AntigenHome Test or the BinaxNOW COVID-19 Antigen Self Test.

If the test is positive, then you most likely have COVID-19. If not, you’re not necessarily off the hook — while the test did not detect the virus, that doesn’t rule out an infection. If you test negative, the Centers for Disease Control and Prevention (CDC) still advises retesting 48 hours later. You can also go see your doctor or visit a CVS MinuteClinic® location for additional testing options.

Mature man in a pharmacy speaks with pharmacist about his prescription.

Do you need a prescription?

If you’re unvaccinated or, over the age of 50 or have a weakened immune system, you’re considered at high-risk for COVID-19 complications. Taking Paxlovid, a prescription antiviral medication for treating COVID-19, may help keep you from getting becoming severely ill. Your doctor or a licensed pharmacist will need to assess your eligibility and give you a prescription, and you will need to start this medication as soon as possible after testing positive (i.e., within five days of symptom onset).

How long does COVID-19 last?

“COVID-19 can last anywhere from a few days to several weeks — and some people have symptoms, such as fatigue, that can linger for months,” says Dr. Neale. Stay home for at least five days. After that, if your symptoms have subsided, you can leave your home while wearing a mask on days 6 to 10. If you still feel sick, however, stay put until you feel fully recovered.

Do I have strep throat?

If you’ve ruled out COVID-19 and you don’t have other cold symptoms like a stuffy nose, cough or headache, you might have strep. “When considering whether to test for strep, doctors rely on four key clues,” says Andrew Bryant, MD, associate professor at the University of Florida College of Medicine. Those include fever, swelling in the lymph nodes in the neck, pus on the tonsils and the patient’s age (strep is most common in kids ages 3 to 14 and less common in adults age 45 and older).

Do you need a prescription?

Strep is caused by a bacterial infection, so you’ll need antibiotics to knock it out. Left untreated, strep could damage the heart or kidneys.

Over-the-counter (OTC) products to help relieve strep symptoms:

Prescription antibiotics are a must, but you can also take acetaminophen or ibuprofen to bring down a fever, as well as use OTC throat sprays and lozenges until your throat stops hurting.

How long does strep throat last?

Most people with strep feel well enough to go back to school or work about 24 hours after starting antibiotics (but you should finish the full course regardless). Assuming you’ve also been fever-free, you should no longer be contagious.

Hot tea with honey and lemon on a bedside table.

Do I have a cold?

There are no tests to confirm the common cold. However, if you’ve ruled out COVID-19 and strep and don’t have serious symptoms like trouble breathing or a high fever that might point to pneumonia or the flu, you may have a common cold.

Do you need a prescription?

No. Antibiotics won’t work against the common cold, which is caused by a viral infection, and there aren’t any antiviral medications you can take to combat it.

OTC products to help relieve cold symptoms:

OTC cold medicines won’t directly treat the common cold, but there are many that might help you feel better,” says Dr. Neale. She advises avoiding combination products and instead taking one or more single-ingredient ones that target your specific symptoms. Sprays and lozenges, like Halls Flavored Cough Drops, can soothe a sore throat, for example. Or for congestion, try a decongestant like Mucinex (guaifenesin). For a cough, try a cough suppressant like Robitussin (dextromethorphan). As always, drink plenty of fluids and get adequate rest, and you should feel better within the week. If not, please consult your trusted health care provider.

This content is for informational purposes only and is not medical advice. Consult with your health care provider before taking any vitamins or supplements, and prior to beginning or changing any health care practices.