Doctors Explain What a Dry Cough Actually Feels Like for COVID-19

Korin Miller
·6 min read
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Doctors Explain What a Dry Cough Actually Feels Like for COVID-19
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If you developed a dry cough a few years ago, you may have simply written it off as having a cold. But these days, it’s understandable to be on high alert for a slew of possible illnesses. Do you have a dry cough from COVID? The flu? RSV? Something else entirely? Either way, it makes sense to be a little wary if you happen to develop a dry cough.

But what does it mean if you happen to develop a dry cough and, while we’re at it, what is a dry cough, anyway? Here’s the deal.

What is a dry cough, exactly?

There’s actually no specific medical criteria to classify a dry cough and a wet cough, explains David Cutler, M.D., a family medicine physician at Providence Saint John’s Health Center in Santa Monica, Calif. That’s because it’s open to interpretation. “Your wet cough might seem like a dry cough to me,” he says.

But, in general, a dry cough means you’re coughing but nothing is coming up, like phlegm or mucus, says Purvi Parikh, M.D., an allergist with Allergy & Asthma Network. If you’re regularly producing phlegm when you cough, you’re likely dealing with a wet cough.

“A dry cough is an irritating cough, but you’re not bringing anything up,” says William Schaffner, M.D., an infectious disease specialist and professor at the Vanderbilt University School of Medicine.

What causes a dry cough?

It’s easy to think that you have COVID-19 when you develop a dry cough (and it’s entirely possible you do). But experts say there are actually a lot of different things that can cause a dry cough. Those include:

“A dry cough is most commonly seen in viral infections,” says Thomas Russo, M.D., professor and chief of infectious disease at the University at Buffalo in New York. Bacterial infections, like bronchitis and pneumonia, however, are more likely to cause a wet cough, he says.

What does a dry cough feel like?

In general, it can feel like any cough without the phlegm. You can also feel like you’re having dryness, a tickle, or tightness in your chest, Dr. Parikh says.

Ultimately, it feels a lot like your lungs are irritated, says Aline M. Holmes, D.N.P., R.N., a clinical associate professor at Rutgers University School of Nursing. “It may feel like a sense of needing to clear your throat or could be deeper in terms of large airways irritated as well,” Dr. Russo says.

When should you be worried about a dry cough as a sign of COVID-19?

❗If you have trouble breathing, persistent chest pain or pressure, new confusion, blue lips, or cannot stay awake, seek medical attention ASAP.

If you develop a dry cough, it’s very possible that you could simply be dealing with allergies, being inside all day or other environmental factors.

But it may also be pointing to COVID-19, the flu, or RSV—so it’s important to pay attention to signs of those viruses, too. According to the Centers for Disease Control and Prevention (CDC), symptoms of COVID-19 can include but are not limited to:

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  • Fever or chills

  • Cough

  • Shortness of breath or difficulty breathing

  • Fatigue

  • Muscle or body aches

  • Headache

  • New loss of taste or smell

  • Sore throat

  • Congestion or runny nose

  • Nausea or vomiting

  • Diarrhea

Again, you don’t necessarily need to have a dry cough in order to have COVID-19. “It’s usually a dry cough, but a productive one can also occur,” Richard Watkins, M.D., an infectious disease physician and professor of internal medicine at the Northeast Ohio Medical University.

Symptoms of the flu include, per the CDC:

  • fever or feeling feverish/chills

  • cough

  • sore throat

  • runny or stuffy nose

  • muscle or body aches

  • headaches

  • fatigue

And these are the symptoms of RSV, according to the CDC:

  • Runny nose

  • Decrease in appetite

  • Coughing

  • Sneezing

  • Fever

  • Wheezing

When should you be worried about a dry cough as a sign of COVID-19?

Any cough that’s linked with a fever over 100.4° F should be concerning, Dr. Parikh says. Ditto if you happen to develop a cough without a fever and you’re not sure what’s causing it, says Dr. Russo.

What to do if you develop a dry cough

If you develop a dry cough, it’s a good idea to test yourself for COVID-19 with a home test, Dr. Schaffner says. “It could be COVID, it could be flu, it might be RSV, or it could be something else,” he says. But starting with a home COVID test is often the easiest place to start, Dr. Schaffner points out. If that’s negative and you have symptoms of the flu, he recommends that you contact your doctor about getting tested.

It's important to find out what’s behind your cough to both help protect others and to find the right treatment, Dr. Russo says. “Certainly, if you’re vulnerable and have influenza, Tamiflu is the order of the day,” he says. If you have COVID-19, it’s a good idea to consider taking Paxlovid, both to lower your risk of developing serious complications and to decrease the odds you’ll develop long COVID, he says.

How to treat a dry cough

If you have a dry cough and it’s not bothering you, Dr. Russo says you don’t necessarily need to do anything for it. But, if you’re uncomfortable or it’s keeping you up at night, Dr. Adalja suggests taking a cough syrup that contains the cough suppressant dextromethorphan.

Medication that contains guaifenesin, which thins mucus and makes it easier to clear out of your lungs, can also help, Dr. Watkins says.

You can also try taking a steamy shower, which is “always very helpful” for lung irritation, Dr. Schaffner says. “That can bring moisture to those mucus membranes and offer some relief,” he says, noting that it’s also important to drink lots of water.

Dr. Russo recommends keeping an eye on your cough to make sure it’s not getting worse. “If you feel your cough is deep down in your lungs, it’s good to monitor your oxygen levels through a home pulse oximeter,” he says. Dr. Russo suggests calling your doctor about next steps if your oxygen levels dip below 94%, provided they’ve been consistently higher in the past. “The trend is important,” he says. “If your baseline is higher and dropping [call your doctor],” he says. If your baseline is lower and stable, Dr. Russo recommends that you continue to monitor your symptoms. The big concern, he says, is the possibility of COVID pneumonia.

When to call your doctor for a dry cough

Experts say there are a few reasons to call your doctor about a dry cough:

  • You’re coughing up blood or blood-tinged phlegm.

  • You have chest pain.

  • You have shortness of breath.

And, of course, if you’re unsure if you need help, it doesn’t hurt to at least check in with your doctor’s office to be sure everything is OK.

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