Why does the cough last much longer than other cold symptoms? – WWN

Why can the cough last much longer after a cold episode than other symptoms?

He replies Sergio Hararidirector of Pneumology, San Giuseppe MultiMedica Hospital – University of Milan (GO TO THE FORUM)

Cough a protective physiological reflex of the airways, but it can also be the consequence of an inflammatory state. And this is exactly what happens when the cough manifests itself for a long time after a cold syndrome that can accompany a banal flu or even Covid. Viruses have an irritating action on the airways, acting on the epithelium that lines them. By comparison, like when you scrape your knees as a child, the epidermis is scarified and requires time to heal completely, completing the healing process. Here, viruses, but also bacteria although to a somewhat lesser extent, determine damage to the bronchial epitheliumsimilar to that of peeling the skin, which thus causes coughing.

The possible causes

The healthy reflex, but when it becomes too invasive it must be controlled with drugs so that it does not cause damage (such as, for example, a costal infraction). Another mechanism that can be triggered following an infection can be that of a post-infectious asthmaparticularly frequent after Sars-CoV-2 infections: it can occur both in predisposed subjects who have already had a history of asthma and in people who have never suffered from it. a response to inflammation resulting from the damage caused by the virus. Finally, a third reason why the cough can persist for a long time can be traced back to development of thick secretionswhich can also drain from the nose, via the posterior canalicular route, into the trachea and large bronchi, giving what is called a rhino-bronchial syndrome or what English-speaking authors call a post-nasal drip.

The treatments

The therapeutic approach must start from a clarification of the underlying cause of the cough, the therapy will then come accordingly. In the case of a simply irritative form, dei topical corticosteroids, even via aerosol, are usually resolved within 10-15 days. If instead it is a post-infectious asthma, the treatment will be the same as for common cases of asthma: it is difficult to predict whether the condition will persist over time or will resolve after a few months. For the post nasal drip an evaluation by the ENT specialist may also be necessary, and, if the disorder persists, a CT study of the nasal and paranasal sinuses to exclude the presence of sinus disease.

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