Respiratory tract infections frequently begin with the uncomfortable sensation of a sore or swollen throat. The pain and inflammation often described by patients is medically known as pharyngitis, which is a symptom rather than a diagnosis. For those wondering if the COVID-19 virus, SARS-CoV-2, specifically causes this discomfort, the answer is yes. A swollen throat is a recognized manifestation of the infection, resulting from the body’s localized response to the virus.
Swollen Throat as a Confirmed COVID-19 Symptom
A sore throat is a highly prevalent symptom of COVID-19, particularly with newer variants. Data collected during the Omicron variant’s dominance showed that a sore throat was significantly more likely to be reported than during the earlier Delta wave. This suggested a shift in where the virus primarily replicated.
The symptom profile of COVID-19 has evolved to more closely resemble a common cold, with throat irritation often appearing early in the illness. While earlier strains were associated with a loss of taste or smell, that symptom became far less common with newer variants. A painful, scratchy, or swollen throat now serves as a common, early indication of a SARS-CoV-2 infection.
Biological Mechanism Behind Viral Throat Swelling
The sensation of swelling and pain in the throat results directly from the body’s immune system responding to the viral invader. SARS-CoV-2 gains entry into human cells by binding to the Angiotensin-Converting Enzyme 2 (ACE2) receptor protein. These ACE2 receptors are present in high concentrations on the epithelial cells lining the upper respiratory tract, including the throat.
When the virus enters these cells, it triggers a localized inflammatory cascade in the throat tissue. This involves the release of signaling molecules known as cytokines, which recruit immune cells to the site of infection. The resulting congestion of fluid and immune cells in the pharynx causes the tissue to swell and become tender, creating the feeling of a swollen or sore throat.
Differentiating COVID-Related Sore Throat from Other Infections
A sore throat is a general symptom of many illnesses, making it difficult to differentiate COVID-19 from influenza, the common cold, or Strep throat based on this symptom alone. Both COVID-19 and the flu are viral infections that can produce a range of overlapping symptoms, including fever, cough, and body aches. The presence of a sore throat with other viral symptoms like a runny nose or congestion often indicates a common respiratory virus.
Strep throat is a bacterial infection, and its presentation often differs from viral pharyngitis. It typically has a sudden onset and is commonly accompanied by white patches on the tonsils, small red spots on the roof of the mouth, or swollen neck lymph nodes, usually without a cough. In contrast, a COVID-related sore throat is almost always accompanied by other respiratory symptoms like coughing, fatigue, or congestion. A definitive diagnosis requires a specific laboratory test, as symptoms alone are insufficient to distinguish between the causes.
Management and Relief for Throat Discomfort
Relief for throat discomfort, regardless of the underlying viral or bacterial cause, centers on reducing inflammation and keeping the throat moist. Over-the-counter pain relievers, such as acetaminophen or ibuprofen, can help diminish the pain and lower any accompanying fever. Hydration is also important, as drinking plenty of fluids like water, broth, or decaffeinated warm tea helps to keep the throat lubricated and thins mucus.
Simple home remedies provide soothing effects, including gargling with warm salt water several times a day. Sucking on lozenges or hard candies can temporarily numb the area and stimulate saliva production. Using a cool-mist humidifier, especially while sleeping, introduces moisture into the air to reduce throat dryness and irritation. Seek immediate medical attention if the swollen throat is accompanied by difficulty breathing, persistent chest pressure, or an inability to swallow liquids.