COVID-19 often causes a persistent, irritating cough that can cause significant discomfort. This symptom is one of the most common signs of the illness and frequently lingers even after other initial symptoms have subsided. For many people, the cough is dry and tickly, though it can become productive with mucus in severe cases. This guide provides strategies for managing the COVID-19 cough, from immediate home care to medical treatment options.
Immediate Self-Care and Home Remedies
Hydration is a simple tool against a cough, as consistently drinking fluids helps keep the throat moist. Warm beverages, such as herbal tea with honey, can be soothing to the irritated tissues in the throat and upper airways. Honey acts as a demulcent, coating the throat and reducing the urge to cough for adults.
Inhaling steam helps loosen thick mucus and reduce coughing episodes. This is achieved by taking a hot shower or using a humidifier to increase the moisture content in the air. A moisturized airway is less reactive, which helps calm the cough reflex.
Sucking on lozenges or hard candies stimulates saliva production, lubricating the throat and providing temporary relief from a dry cough. Positional adjustments also help, particularly when resting or sleeping. Elevating the head and chest with extra pillows prevents mucus from pooling and irritating the airways, which often triggers nocturnal coughing fits.
Over-the-Counter and Prescription Treatments
Over-the-counter (OTC) medications target the cough in two main ways, depending on its nature. For a dry, non-productive cough that interferes with sleep or daily activities, a cough suppressant is the appropriate choice. These products often contain dextromethorphan (DM), which works by raising the cough threshold in the brain.
If the cough is productive, meaning it brings up phlegm or mucus, an expectorant containing guaifenesin may be helpful. Guaifenesin thins the mucus, making it easier to clear from the airways. Only use expectorants when there is actual chest congestion, and always read labels carefully, as some combination products contain both a suppressant and an expectorant.
In cases where the cough is severe or persistent, a doctor may recommend prescription treatments. These can include a short course of inhaled corticosteroids to reduce inflammation in the airways, a common driver of post-viral coughing. Prescription-strength cough medications or antiviral treatments like Paxlovid for high-risk individuals may also be considered to lessen the severity and duration of the illness. Consultation with a healthcare provider or pharmacist is advisable to ensure safety and effectiveness.
Understanding the Persistence of the COVID Cough
The cough associated with COVID-19 frequently outlasts the acute infection, transitioning into a post-viral or subacute cough. This lingering symptom is not typically a sign that the person is still infectious, but rather a consequence of the initial viral damage. The SARS-CoV-2 virus causes inflammation and irritation in the respiratory tract, leading to airway hypersensitivity.
Even after the virus is cleared, this hypersensitivity can cause the cough reflex to be triggered by minor irritants, such as talking, cold air, or laughing. A cough is considered subacute if it lasts between three and eight weeks from the onset of symptoms. While this persistence is frustrating, the majority of post-viral coughs gradually resolve as the airway inflammation subsides.
Warning Signs Requiring Prompt Medical Care
While most COVID-19 coughs can be managed at home, certain symptoms indicate a serious medical situation requiring immediate attention. These emergency warning signs suggest that the respiratory system is under severe distress.
Immediate medical care is necessary if you experience trouble breathing or severe shortness of breath. Persistent pain or pressure in the chest is another serious indicator. New confusion, an inability to wake up or stay awake, or a change in skin color suggesting poor oxygenation (such as pale, gray, or blue lips or face) are also red flags. If you exhibit any of these signs, seek emergency medical help immediately.