Doctors Explain How Common A Sore Throat Can Be For COVID Patients

You've woken up to a bright fall day — and discovered that your throat suddenly feels completely red raw, to the point that swallowing is painful. Sore throats are annoying during fall and winter at the best of times, but with the spread of COVID-19, they suddenly take on more significance. But a sore throat does not a COVID diagnosis make. There's no such thing as a COVID-19-type sore throat, and it's not exactly clear how common sore throats are in COVID-19 patients.

"Unfortunately there are no symptoms that are specific or unique only to COVID-19 infection," Dr. Robert Mordkin M.D., chief medical officer for testing company LetsGetChecked, tells Bustle. "Many of the symptoms associated with other common infections can also be present as a result of COVID, and these include fever, cough, and sore throat." Your aching pharynx and tonsils might be caused by the flu, a cold, or a bacterial throat infection. Only a COVID test can show for sure.

There's a lot of scientific disagreement about how common a sore throat is for COVID-19 patients. Dr. Natasha Bhuyan, M.D., a family physician at medical provider OneMedical, told Bustle in August that only 12 to 14% of people with COVID-19 have sore throats, but that number isn't set in stone. In February, the World Health Organization released data showing that 13.9% of people with the coronavirus had a sore throat, and another study in March in Emerging Microbes & Infections found sore throats in 7.1% of cases. A letter to Journal of Medical Virology by researchers pointed out that some studies showed up to 17% of cases had sore throats, and a study of over 1,400 people with "mild or moderate COVID" in Europe in July found that 52% of them had the symptom. A prickly throat might be far more common in COVID-19 than you think, but it's clear that not everybody with the illness has one.

To make the picture more complicated, not all cases of COVID are created equal. Research by Kings College London, which is yet to be peer-reviewed, has identified six potential different symptom "clusters" of COVID-19. The clusters show that the coronavirus appears to show up in at least six different ways, and your symptom cluster depends on factors like age and pre-existing conditions. Only five out of the six clusters have sore throat as a symptom. This may be why the science is still not settled: people react to COVID-19 in really different ways.

It's also important to note that as the weather gets colder, rates of other illnesses that cause sore throats will be going up. "In addition to COVID, we have all the usual coughs, viruses, strep throat and so on in circulation," Gwen Murphy Ph.D. MPH, an epidemiologist at LetsGetChecked, tells Bustle. A study of COVID-19 and loss of smell published in April in International Forum of Allergy & Rhinology, right in spring flu season, found that many patients with just sore throats didn't have COVID at all.

If you wake up feeling like you accidentally swallowed razor blades, a chat with your doctor is a good idea. “A painful sore throat can be any number of things from an infection to a concerning growth inside the throat," Dr. Omid Mehdizadeh M.D., an otolaryngologist and laryngologist at Providence Saint John's Health Center, tells Bustle. It could just be nothing, but it pays to be cautious. If you've developed a sore throat, particularly if you've had any contact with a person who's later been diagnosed with COVID-19, or also have symptoms like fever or dry cough, experts recommend talking to your primary care provider about a COVID test. In the meantime, get some lozenges delivered and drink some honey tea.

Experts:

Dr. Natasha Bhuyan M.D.

Dr. Omid Mehdizadeh M.D.

Dr. Robert Mordkin M.D.

Gwen Murphy Ph.D. MPH

Studies cited:

Lovato, A., Rossettini, G., & de Filippis, C. (2020). Sore throat in COVID-19: Comment on "Clinical characteristics of hospitalized patients with SARS-CoV-2 infection: A single arm meta-analysis". Journal of medical virology, 92(7), 714–715. https://doi.org/10.1002/jmv.25815

Su, L., Ma, X., Yu, H., Zhang, Z., Bian, P., Han, Y., Sun, J., Liu, Y., Yang, C., Geng, J., Zhang, Z., & Gai, Z. (2020). The different clinical characteristics of corona virus disease cases between children and their families in China - the character of children with COVID-19. Emerging microbes & infections, 9(1), 707–713. https://doi.org/10.1080/22221751.2020.1744483

Wise J. (2020). Covid-19: Study reveals six clusters of symptoms that could be used as a clinical prediction tool. BMJ (Clinical research ed.), 370, m2911. https://doi.org/10.1136/bmj.m2911

Yan, C. H., Faraji, F., Prajapati, D. P., Boone, C. E., & DeConde, A. S. (2020). Association of chemosensory dysfunction and COVID-19 in patients presenting with influenza-like symptoms. International forum of allergy & rhinology, 10(7), 806–813. https://doi.org/10.1002/alr.22579