Sore throat as a symptom of covid-19
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Sore Throat as a COVID-19 Symptom: Prevalence and Trends
Sore throat is recognized as a symptom of COVID-19, but its prevalence and significance have changed over time and with the emergence of new viral variants. Early in the pandemic, sore throat was considered a less common symptom, with prevalence rates reported as low as 7% in North America and 29% in Asia. However, more recent data indicate that sore throat is now reported in up to 50% of COVID-19 cases, especially with the spread of newer variants like Alpha, Delta, and the UK variant (B.1.1.7) 14. These variants are more frequently associated with upper respiratory symptoms, including sore throat, making it a more prominent feature in recent COVID-19 cases 14.
Sore Throat Compared to Other COVID-19 Symptoms
While sore throat is a recognized symptom, it is generally less common than fever and cough, which remain the most frequent symptoms of COVID-19 235789. In several studies, sore throat was reported in about 11–33% of patients, making it one of the more common ear, nose, and throat (ENT) manifestations, but still less frequent than fever and cough 3567. Other ENT symptoms, such as nasal congestion, headache, and loss of smell or taste, are also reported but at varying rates 5678.
Sore Throat as an Early or Initial Symptom
Sore throat can be one of the initial symptoms of COVID-19, sometimes appearing at the onset of illness alongside fever, cough, and malaise 138. In Japan, for example, sore throat was the fourth most common initial symptom, reported in about 13% of symptomatic patients . Upper respiratory symptoms, including sore throat, are often seen early in the course of the disease and may even precede more severe symptoms .
Sore Throat in Comparison to Other Viral Infections
When compared to other viral respiratory infections like influenza and the common cold, sore throat is less frequently reported in COVID-19. In influenza and the common cold, sore throat is present in over 80% of cases, while in COVID-19, it is reported in only about 12% of cases in some studies . This difference can help clinicians distinguish COVID-19 from other viral illnesses, especially during cold and flu season 110.
Impact of New Variants on Sore Throat Prevalence
The prevalence of sore throat as a COVID-19 symptom has increased with the emergence of new variants. The Alpha, Delta, and UK (B.1.1.7) variants are more likely to cause sore throat, making it a more common presenting symptom in recent waves of the pandemic 14. This shift highlights the importance of updating symptom checklists and public health guidance as the virus evolves 14.
Clinical and Public Health Implications
Recognizing sore throat as a possible early symptom of COVID-19 is important for timely testing, diagnosis, and isolation, especially as its prevalence increases with new variants 1458. However, because sore throat is also common in other viral infections, it should be considered alongside other symptoms and risk factors for COVID-19 110. Accurate symptom recognition can help guide testing and reduce the spread of the virus, particularly during periods when multiple respiratory viruses are circulating 110.
Conclusion
Sore throat is a recognized symptom of COVID-19, with its prevalence increasing in recent variants. While it is less common than fever and cough, it is now one of the more frequent ENT symptoms, especially with the Alpha, Delta, and UK variants. Clinicians and the public should be aware of this trend, particularly during cold and flu season, to ensure timely testing and appropriate public health measures.
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