Why A Sore Throat Feels The Same Whether It’s COVID-19 Or A Cold

Coronavirus can really do a number on your throat — and not just because the test involves a swab that feels like somebody having a sword fight with your uvula (ouch). It turns out that if you have a hard time swallowing your morning coffee, it's difficult for doctors to tell at a glance whether your sore throat is caused by a standard cold, the flu, or COVID-19.

"A sore throat from COVID-19 does not differ in any way from the sore throat that might be caused by another type of infection such as the flu or a cold," Dr. Robert Mordkin, M.D., chief medical officer for testing company LetsGetChecked, tells Bustle. He says this is part of the difficulty of diagnosing coronavirus: many of the symptoms look a lot like the cold or flu, meaning it's really hard to tell if somebody has COVID-19 without doing swabs of their throat and nasal passages.

What Happens In Your Body When You Have A Sore Throat

The ache in your throat from coronavirus is technically called pharyngitis, and it's caused by the virus entering the membranes that line your nose and throat, making them swell. The same thing happens with the common cold and influenza viruses. It's an inflammatory response by your immune system to fight the illness, Dr. Omid Mehdizadeh, M.D., an otolaryngologist and laryngologist at Providence Saint John's Health Center, tells Bustle. "Cells and chemicals which mediate our body's response to a virus enter into the affected tissue and cause pain, swelling, mucus production, and fever," he says.

Studies have shown that colds and mild coronaviruses tend to stick to the top of the respiratory tract, including the throat and nose. Both the flu and more serious coronavirus cases, though, can also create infections in the lower respiratory tract, causing bronchitis and pneumonia, an infection of the lungs. If your sore throat develops into a rattling in your lungs or any difficulty breathing, you need to get medical help and a COVID-19 test immediately.

Sore Throat Is A Symptom Of Many Illnesses

Sore throats are far from a hard-and-fast indicator that you've got coronavirus. "It only occurs in about 12 to 14% of people who have the virus," Dr. Natasha Bhuyan, M.D., a family physician at medical provider One Medical, tells Bustle. An early study by the World Health Organization in February found that 13.9% of people with coronavirus had a sore throat, but a later study in Emerging Microbes & Infections found it only showed up in 7.1% of cases. If you've got a sore throat and it's your only obvious symptom, it's far more likely to be the common cold, or perhaps an allergy to something like pollen or dander — but you should get tested just in case.

The timing of your sore throat might matter, too. A mathematical model of COVID-19 symptoms published in Frontiers In Public Health found that it's very common for people to first experience fever, then cough, then sore throat, muscle pain, or headache. If you have a cold, you'll likely get the sniffles and a sore throat first, then other symptoms later. The flu, meanwhile, often comes on in a rush, with sore throat accompanied by fever, chills, and other symptoms. These sequences aren't set in stone, though, and any combination of COVID-19 symptoms is concerning, however they turn up.

"Given how prevalent community spread is of the virus, it's still important to consider COVID-19 as a possibility if you have a sore throat," Dr. Bhuyan says. You should get tested for COVID-19 if you can, particularly if you also have fever, cough, and other symptoms, or have been exposed to anyone with the virus. Another box to check off your list? Get your flu shot this year — because that will eliminate one possible cause if you wake up feeling like a hedgehog is living in the back of your mouth.

Experts:

Dr. Natasha Bhuyan, M.D.

Dr. Omid B. Mehdizadeh, M.D.

Dr. Robert Mordkin, M.D.

Studies:

Larsen, J., Martin, M., Martin, J., Kuhn, P, and Hicks, J. (2020). Modeling the Onset of Symptoms of COVID-19. Modeling the Onset of Symptoms of COVID-19. Frontiers in Public Health. https://doi.org/10.3389/fpubh.2020.00473

Subbarao, K., & Mahanty, S. (2020). Respiratory Virus Infections: Understanding COVID-19. Immunity, 52(6), 905–909. https://doi.org/10.1016/j.immuni.2020.05.004

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

World Health Organization (2020). Report of the WHO-China Joint Mission on Coronavirus Disease 2019 (COVID-19). https://www.who.int/docs/default-source/coronaviruse/who-china-joint-mission-on-covid-19-final-report.pdf