Q: My wife and youngest son have been diagnosed with COVID on home testing. Our son is having only common cold symptoms and seems otherwise all right; however, my wife is having an increasingly sore throat, such that she can barely talk, apparently due to swelling. Should I be concerned about this worsening and what can I do to help her?
A: It is certainly possible to have a viral infection, such as COVID, and a bacterial infection, in this case possibly a strep throat, at the same time.
Given your wife’s age and lack of health issues that would place her at any greatly increased risk of hospitalization from COVID, the most important issue at this time would be to rule out strep throat which, if untreated, is well-known to cause the production of an antibody by the immune system, called antistreptolysin- O (ASO), which conveys significant protection against future infections by the same organism.
The problem is that ASO also recognizes certain tissues in the body as foreign, such as parts of joints, heart muscle, kidney tissue, and heart valve tissue (usually the mitral valve, which prevents backward flow of blood into the lungs when the heart contracts, leading to heart failure).
The most effective way to prevent the formation of ASO is to promptly start a full course (usually 10 days) of an antibiotic from the penicillin family or, if allergic, one from the macrolide family, such as erythromycin, which kills off the strep bacteria before the immune system can fully react to it. Thus, the best course at the time I spoke to you was to take her to an Urgent Care Clinic for a Rapid Strep test, which only requires a throat swab and produces results in just a few minutes.
If positive, antibiotic is strongly advisable; if negative, then the throat discomfort is probably just from COVID, which only requires supportive care, such as fluids, rest, generic Tylenol for discomfort, and appropriate isolation from those for whom a COVID infection could be severe or fatal (the very young, the elderly, diabetics, those with significant lung disease, and anyone of any age taking immuno suppressants, such as steroids).
I want to thank Charles B. very much for this question. To learn more about this and many other health topics, visit the American Academy of Family Physicians’ website at familydoctor. org, where you can click on the Search box in the upper right corner of the website, and enter your topic of interest.
If you have a particular topic you would like to hear about, please message me at paulmdake@gmail.com.
Dr. Paul Dake, a Newberry native, is a retired family physician. He lives in Pinconning, Michigan.