What's Behind That Sore Throat? How to Know if It's COVID, Allergies, Strep or More

Have a sore throat but aren't sure what's causing it?

There are several possibilities that could be behind the symptom, with things like COVID, allergies and strep throat all leading to similar symptoms.

Currently, allergy season is peaking in the Chicago area, bringing a rash of cold-like symptoms, with the peak expected to continue until the end of September for those particularly sensitive to ragweed.

While there are several overlapping symptoms when it comes to allergies and COVID - such as runny nose, sneezing, irritation in the throat - Loyola Allergist Dr. Rachna Shah said there are some ways to differentiate.

“The symptoms that we see when it’s COVID compared to those that they have allergies are generally sore throat, fevers, body aches and pains," Shah said.

Meanwhile, symptoms like itchy eyes or ears are largely signs of allergies. Meanwhile, strep throat usually doesn't come with the viral infection symptoms COVID does, like congestion, loss of taste or smell, coughing or difficulty breathing.

Currently, the highly contagious BA.4 and BA.5 omicron subvariants account for most reported cases this summer.

Those subvariants have caused more upper respiratory, cold and flu-like symptoms, according to Chicago's top doctor.

Before self-diagnosing, health officials have said the best way to identify the source of your symptoms is through testing, especially given some overlap between the coronavirus and seasonal allergies.

"The at home tests they are still a good way to kind of screen and determine if you have COVID or not," Shah said.

And other experts agree.

"When in doubt, I would say test up before you actually go and expose other people," Dr. Sai Nimmagadda , an allergist at Lurie Children’s Hospital, told NBC 5 last month.

That's especially important for those who will be around immunocompromised or at-risk individuals.

"If you test negative the first time, you should repeat it - especially if your symptoms are continuing or they're not responding to your classic allergy treatment medication," Nimmagadda said.

Similarly, under revised guidance from the FDA, individuals who have been exposed to COVID-19 may need to take as many as three at-home tests.

Here’s a list of COVID, strep throat and allergy symptoms as outlined by the CDC:

COVID Symptoms 

• Fever or chills
• Cough
• Shortness of breath or difficulty breathing
• Fatigue
• Muscle or body aches
• Headache
• New loss of taste or smell (although doctors have noted that the latest COVID variants typically will not cause loss of taste or smell)
• Sore throat
• Congestion or runny nose
• Nausea or vomiting
• Diarrhea

Even those who receive the coronavirus vaccine can also still contract the virus and may experience symptoms. Most vaccinated people, though, either have no symptoms or exhibit very mild symptoms, according to health officials, and the virus rarely results in hospitalization or death for those individuals.

The CDC advises seeking medical attention if a person is experiencing trouble breathing, persistent pain or pressure in the chest, new confusion and inability to wake or stay awake, as well as pale, gray or blue-colored skin, lips or nail beds.

Allergy Symptoms 

• Symptoms from allergic rhinitis include:
  • sneezing
  • runny nose
  • congestion
• Symptoms from allergic conjunctivitis include:
  • red, watery, or itchy eyes

Strep Throat Symptoms

• Sore throat that can start very quickly
• Pain when swallowing
• Fever
• Red and swollen tonsils, sometimes with white patches or streaks of pus
• Tiny, red spots (petechiae — pronounced pi-TEE-kee-eye) on the roof of the mouth (the soft or hard palate)
• Swollen lymph nodes in the front of the neck