Strep throat is a bacterial infection caused by group A Streptococcus (group A strep) that is a common cause of sore throat. Covid (COVID-19 or coronavirus disease 2019) is caused by a novel strain of coronavirus.
While sore throat can be a symptom of COVID, strep throat is a separate illness with a different cause. Sore throats associated with COVID tend to be mild and usually last on average two to three days, and no more than five days.
It is possible, however, to be infected with both strep throat and COVID at the same time.
What Are Symptoms of Strep Throat vs. Covid?
Symptoms of strep throat include:
- Sore throat that may come on quickly
- Pain when swallowing
- Red and swollen tonsils
- White patches or streaks of pus on the tonsils
- Tiny, red spots on the roof of the mouth
- Swollen lymph nodes in the front of the neck
- Stomach pain
- Rash (scarlet fever)
Additional symptoms of COVID may include:
- Shortness of breath
- Fever or chills
- Changes in taste and/or smell
- Body aches
- Feeling unwell (malaise)
- Loss of appetite
- Runny nose
Emergency warning signs that require immediate medical attention (call 9-1-1 or go to a hospital’s emergency department):
- Difficulty breathing
- Persistent pain or pressure in the chest
- Bluish lips or face
- New confusion or inability to arouse
How Are Strep Throat and Covid Diagnosed?
Strep throat is diagnosed with:
- A rapid strep test: This involves swabbing the throat and running a test on the swab to see if strep bacteria are present in the patient’s throat. Results are usually available in about 15 minutes.
- A throat culture: In some cases, the rapid strep test results are negative but a doctor may still suspect strep infection is present. In this case, a throat culture swab may be obtained. This test can take 2-3 days to yield results but it is more accurate than a rapid strep test.
COVID is diagnosed with a physical examination and a patient history which will include asking if the patient had any known recent exposure to the virus.
If COVID is suspected, tests used to diagnose the virus include:
- PCR tests (genetic or molecular test)
- PCR test results can take hours to up to one week
- More accurate than an antigen test
- Antigen test
- COVID antigen test results are available in less than one hour
- Less accurate than a PCR test
An antibody test may be used to determine if a person had a past COVID-19 infection, but it is not used to diagnose current infections because it takes up to 3 weeks following infection for the body to produce antibodies to the virus.
What Is the Treatment for Strep Throat or Covid?
Strep Throat Treatment
Strep throat is treated with antibiotics. The first line choices are usually penicillin or amoxicillin. Other antibiotics may be used in people allergic to penicillin.
If antibiotics are prescribed, take the entire dose as prescribed, even if you feel better before you have finished all the medication.
If a person tests positive for strep throat but has no symptoms (is a “carrier”) treatment is usually not needed.
There is no specific treatment for COVID-19, and supportive care is aimed at relieving symptoms in mild cases.
In mild cases, staying home and self-isolating for 14 days is recommended to avoid spreading the virus. Treatments for mild COVID-19 symptoms include:
- Pain relievers
- Cough suppressants
- Adequate fluid intake
Casirivimab/imdevimab (Regen-COV), a monoclonal antibody combination, has received Emergency Use Authorization (EUA) from the Food and Drug Administration (FDA) to treat mild-to-moderate COVID-19 in adult and pediatric patients 12 years and older who are at high risk for progressing to severe COVID-19 and/or hospitalization.
Regen-COV is effective against the Delta variant of COVID, but it has been shown to be less effective against the Omicron variant.
Tixagevimab/cilgavimab (Evusheld), a monoclonal antibody combination, has received Emergency Use Authorization (EUA) from the Food and Drug Administration (FDA) for the pre-exposure prevention of COVID-19 in certain adults and pediatric individuals (12 years of age and older weighing at least 40 kilograms [about 88 pounds]).
Monoclonal antibodies are not indicated for use in severe cases.
More severe COVID-19 cases may require hospitalization and treatments may include:
- Antiviral therapy with remdesivir
- Antithrombotic therapy - anticoagulants and antiplatelet therapy
- High-flow nasal cannula (HFNC) oxygen
Hydroxychloroquine has been touted as a possible treatment, but studies have shown it to be ineffective with a high risk of fatal heart arrythmias, and it is not recommended.
The medication ivermectin has also been suggested as a possible treatment for COVID. While ivermectin is approved for human use to treat infections caused by some parasitic worms and head lice and skin conditions like rosacea, the Food and Drug Administration (FDA) has not authorized or approved ivermectin for use in preventing or treating COVID-19 in humans or animals. Currently available data do not show ivermectin is effective against COVID-19 and taking large doses of ivermectin is dangerous.
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