Health. Did you have the COVVI-19 and you still cough? What we know about this cough

Health. Did you have the COVVI-19 and you still cough? What we know about this cough


The first studies, a few months or years after the start of the COVVI-19 pandemic, revealed that coughing could either be an isolated symptom, or associated with other manifestations of the Long COVIR.

In the first post-infection months, around 20 % of people would cough more or less disabling, while a study carried out one year after the infection, and confirmed by other publications, found only 2.5 % of people still affected by cough.

In the case of an acute cough, for example after a viral infection like that caused by the SARS-COV-2 but also of the flu or other, the probability that it ceases itself is very high.

A clinical examination is enough, and it is not useful to start a specific treatment, because none has demonstrated its effectiveness to shorten cough, however very annoying on a daily basis. On the other hand, if cough persists beyond eight weeks (we then speak of chronic cough), the chances of spontaneous resolution decrease considerably.

Post-Covid chronic cough, a cough like the others?

A French study on 70,000 patients shows that adults between 30 and 60 are more affected by chronic coughs after a COVVI-19 infection and that it is less frequent in children and the elderly. In addition, contrary to what we thought, cough is not an indicator of seriousness of the disease.

Comparisons between survivors’ covid-19 patients and those who died show no difference in terms of cough frequency and severity.

Another study confirms that, although a pneumonia linked to the covid can be serious, it is not necessarily accompanied by a more intense cough. These results have been corroborated by several other scientific studies.

No direct link between coughs and lungs in the COVVI-19

These observations can be explained by the fact ” That there is no direct link between cough and pulmonary lesions as part of the COVID-19, indicates Pr Guilleminault, pulmonologist at the Toulouse University Hospital and specialist in cough. The cough seems to be more linked to a neurological dysfunction than a conventional respiratory involvement. »

Indeed, research on the SARS-COV-2 and other viruses show that cough is more linked to the impact of the virus on the nervous system than to the infection of the lungs themselves. The main objective of the virus is to cause neurological dysfunction in the host, which triggers the cough reflex.

This mechanism gives an evolving advantage to the virus, because it thus increases its chances of propagating and infecting other individuals, as in the case of COVID-19 or flu.

Toux is therefore a complex reflex, still partially understood, which begins when certain cough receptors located mainly in the airways detect irritants. These receivers transmit information to the brainstem. Usually, brain mechanisms (called inhibitors) prevent coughing without reason.

This is why we are not coughing all the time, even if light stimuli are present. But if this control mechanism is disrupted, in particular by activating the receptors by the COVIR virus, cough can then be triggered excessively.

Why continue to cough after Covid is healed?

The question remains asked. If the virus is capable of activating cough receptors to provoke it in a human being, why do we continue to cough once infection and therefore rid of the virus? According to the latest data, it seems that viral infection increases the sensitivity of the cough reflex.

Once cured, this hypersensitivity gradually decreases, but in some individuals, these mechanisms take time to recover, more precisely those who inhibit cough.

When to consult for a post-Cavid cough?

« A period of 8 to 12 post-infection is a reasonable threshold to consider explorations and therefore suitable treatment “Advises Laurent Guilleminault.

Your doctor can use an analog visual scale (graduated between 0 and 10) to assess the intensity of the cough. It will then be necessary to look for possible causes.

Indeed, although cough can be associated with COVID-19, it can also coincide with another pathology, such as bronchial cancer. In a smoking patient, a thoracic scanner must therefore be considered to exclude any cancer or precancerous pathology or even another disease (diffuse interstitial pneumopathy, etc.).

Of course, smoking, aggravating factor of cough, will have to be arrested. Certain drugs must also be stopped punctually, such as those used in cardiology and well known to cause cough (conversion enzyme inhibitors, IEC), in order to verify their possible involvement.

The doctor will also be able to take stock to eliminate the three main conventional and current causes of cough: Rhinosinusitis, asthma (which studies have shown that it could sometimes be triggered by COVVI-9) and gastro- reflux- Esophageal (GERD).

Do not forget the larynx, an organ that makes cough

In addition, larynx anomalies, an organ particularly likely to cause coughs, are frequent as part of the post-Cavid-19 cough. Explanation: The innervation of the larynx being complex, the virus can affect these specific areas, resulting in hypersensitivity of the cough reflex.

And if none of these causes is identified, chronic cough is then qualified as trocri, that is to say a “chronic refractory and unexplained cough”.

This means that no specific disease causes coughing, but that there is a dysfunction of the nervous system, probably induced by the infection by SARS-COV-2 but possibly also by many other causes. In this case, the doctor can use neuromodulatory treatments.

To find out more: cough after an infection: no worries for two months

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