What You Should Know About Chronic Coughing After COVID-19

  • Recovery times for a COVID-19 illness can greatly vary based on your medical history, but virologists have established a timeline for average recovery from respiratory symptoms.

  • A majority of individuals can expect a chronic cough caused by a COVID-19 sickness to clear up within 10 to 21 days, depending on the strain of the virus at hand and whether hospitalization was required.

  • Coughs that extend past four weeks, or worsen after an initial infection, may be indicative of a long COVID condition.

  • Below, you'll learn: When a COVID cough usually goes away; whether coughing is normal after COVID-19; at what point a chronic cough may indicate long COVID development; and how you may treat a cough after COVID-19.

With more than one-in-five American adults likely experiencing long COVID symptoms this year, it's natural to stress about constantly coughing after testing positive for COVID-19. Make no mistake: A chronic cough that is painful and lingers for a few weeks may be a part of your body's normal response to overcoming a SARS-CoV-2 infection. After all, coughing after overcoming a respiratory illness is common — and in some cases, including those who are infected by seasonal influenza, a cough may span months after the initial infection. Jaclyn Leong, D.O., the co-director of University of California Irvine Health's COVID-19 recovery service, says that a cough theoretically could persist between six and eight weeks in some cases.

There's also a chance that your cough may be exacerbated by a health issue that's wholly unrelated to your first COVID-19 sickness. Dr. Leong explains that getting COVID-19 can open you up to a secondary bacterial infection in the days or weeks after you first test positive, which may be the real cause of a nagging cough. "You may also develop an overload of an inflammatory response within the lungs or body," she adds.

But if weeks turn into months and your chronic cough simply isn't fading away or lessening in any sense, discussions about long COVID with your healthcare provider should be entertained. After all, most specialists have had over two years to collect data about the average COVID-19 sickness and likely symptoms — and have come to a consensus on a timeline for when a full recovery should occur.

When will a COVID cough usually go away?

While every case can be different, there's a standard recovery period for COVID-19 that has been established by healthcare providers — symptoms caused by COVID-19, including coughing, should ease within 21 days of a first positive test. "After 4 weeks from the initial infection, a person should consider the possibility of development of long COVID or post-COVID conditions," Dr. Leong says.

Researchers have also established cases where coughing brought on by a SARS infection can span up to eight months, she adds, in more unique situations. The reason such a range exists is that individual factors, including issues like asthma, pre-existing respiratory or cardiac conditions or lifestyle choices like smoking can influence how our bodies work to overcome a cough.

Robert Klugman, M.D., associate vice president and medical director at UMass Memorial Health, tells Good Housekeeping the reason why some may experience a months-long persistent cough has to do with the way a respiratory virus can impact the body.

"Coughing is an evolutionary mechanism to expel foreign objects and clear the lungs, and bronchial tubes, of secretions," he explains. "The sensitive nerve endings in our bronchial system and lungs are attacked by these viruses." Lung inflammation may additionally be impacted by the severity of the strain of COVID that you are impacted with — meaning, there are a few ways a cough can be exacerbated for months on end for some.

It's more likely than not that you will notice some improvement within 10 days of becoming sick, Dr. Klugman adds — but nearly everyone should give themselves a grace period of at least three to four weeks. If your initial COVID-19 sickness caused hospitalization, you should give yourself even more of a recovery window, as both experts believe symptoms (including cough) to linger further in these cases.

Is it normal to cough after COVID-19?

Not every single COVID-19 illness will trigger a painful, lasting cough. But if you experienced upper respiratory symptoms during your initial sickness — which is extremely common among those infected by recently dominant XBB variants — you should expect to entertain a cough while your body actively recovers from infection. Experts suggest that respiratory symptoms like a cough could take between three and four weeks to fully clear up.

Unlike other seasonal illnesses this winter, COVID-19 impacts the lungs in more than one way, which may explain why a cough lingers beyond an initial wave of symptoms and sickness. "COVID is nastier than the flu, and other respiratory infections, in that it attacks not only the respiratory lining, but also the small blood vessels," Dr. Klugman explains. "This inflames them [over time], which adds to the lung injury overall."

There is a general recovery window of 10 to 31 days for a majority of individuals, which we've covered above; but certain pre-existing conditions or lifestyle factors make it impossible for anyone to calculate exactly when a cough may let up after a COVID-19 illness. And more research is needed to rule out other factors of how SARS-CoV-2 virus interacts with our immune systems in the long run.

"Studies are hypothesizing that [a lingering] cough may be a different mechanism from the COVID-19 infection; it is hypothesized that COVID-19 causes brain inflammation, immune system modulation, or nerve inflammation of the vagus nerve pathway, a nerve that controls cough," explains Dr. Leong. "These nerves in the brain and body become hypersensitive and easily triggered, which then can cause a prolonged cough. Potential treatment or relief from this particular symptom would therefore be aimed at this mechanism in the future."

While you should seek out additional healthcare advice if your cough doesn't lessen within a month after your first signs of sickness, you may speak with a specialist sooner if you're noticing that it is worsening during this period. Or, if you've identified other concurrent symptoms that are in line with a long COVID diagnosis.

When does a chronic cough become a long COVID symptom?

We've established that a continual cough should be examined further by a doctor if it persists past four weeks — but other long COVID symptoms beyond a cough may present sooner than this timeline, and clue you into a larger problem.

"A lingering cough should be considered a sign of a larger issue at hand when it's also associated with other symptoms of long COVID, including fatigue, brain fog, memory difficulties, shortness of breath or rapid heart rate," Dr. Leong adds, which may prompt your doctor to seek out additional treatment or a specialist's help.

She clarifies that experts have seen long COVID develop without more of these symptoms occur; meaning, you may have developed a post-COVID condition that simply includes a lingering cough alone. The combination of these symptoms, however, indicates a stronger likelihood that you've developed long COVID.

Outside being cognizant of a four-week window, a worsening cough that is consistent after you've recovered from other COVID-19 symptoms likely indicates you have a secondary illness to address. Dr. Leong advises that other conditions can cause a cough to worsen after testing positive for COVID-19, including untreated bronchitis, pneumonia, pertussis, or asthma exacerbation. Your healthcare provider can rule out other medical issues that could be contributing to a body-wracking cough, and prescribe treatments that are more effective than anything you'd have access to at home.

How do you get rid of a COVID-19 cough?

Your primary healthcare provider will dictate how you're able to soothe a painful cough as the symptom continues — over-the-counter cough medication may not be suitable for some individuals with pre-existing heart health issues. In any case, you'll turn to tried-and-true natural remedies that can alleviate much of the pain or discomfort around a cough. Think tools like warm tea, using an effective humidifier and staying far away from harsh pollutants or cigarette smoke as you recover.

If your doctor determines that you're suffering from a secondary bacterial infection, antibiotics may be prescribed to get you back to full health — or, if sinuses are impaired in any way, decongestants may be used.

But if you're experiencing a lingering cough within 10 days of your initial COVID-19 sickness, it's likely that doctors won't prescribe you anything additionally. Your respiratory system will take time to recover from COVID-19, and it's expected that symptoms will slowly fade over time rather than disappear overnight. Do your best to make yourself comfortable and keep in mind that your lungs are on the mend.

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