Since more than one-fifth of American adults will probably have long COVID symptoms this year, it’s normal to worry about coughing all the time if you tested positive for COVID-19. Make no mistake: It’s possible that a painful cough that lasts for a few weeks is a normal part of your body’s response to getting over a SARS-CoV-2 infection. After all, coughing is a common sign of recovery from a respiratory illness. In some cases, like with seasonal flu, a cough can last for months after the initial illness. Co-director of the University of California Irvine Health’s COVID-19 Recovery Service Jaclyn Leong, D.O., says that in some cases, a cough could last between six and eight weeks.
Your cough could also be made worse by a health problem that has nothing to do with your first COVID-19 illness. Dr. Leong says that if you test positive for COVID-19, you may get a second bacterial infection a few days or weeks later. This may be the real cause of a cough that won’t go away. “You could also end up with too much inflammation in your lungs or body,” she says.
But if weeks turn into months and your chronic cough doesn’t go away or get better in any way, you and your doctor should talk about long-term COVID. After all, most experts have had more than two years to gather information about the typical COVID-19 illness and its symptoms, and they have come to a consensus on when a full recovery should happen.
When does a cough from COVID usually stop?
Even though every case is different, doctors have come up with a standard recovery time for COVID-19. The coughing and other symptoms caused by COVID-19 should get better 21 days after the first positive test. “A person should think about the possibility of long COVID or post-COVID conditions after 4 weeks from the first infection,” says Dr. Leong.
She also says that researchers have found that coughing caused by a SARS infection can last up to eight months in some rare cases. The reason there is such a wide range is that different things, like asthma, pre-existing lung or heart problems, or lifestyle choices like smoking, can affect how our bodies work to get rid of a cough.
Robert Klugman, M.D., associate vice president and medical director at UMass Memorial Health, told Good Housekeeping that a respiratory virus can make some people have a cough that lasts for months.
“Coughing is an evolutionary way to get rid of foreign objects and clear secretions from the lungs and bronchial tubes,” he says. “These viruses attack the nerve endings in our bronchial tubes and lungs, which are very sensitive.” The severity of the COVID strain you have may also affect lung inflammation. This means that there are a few ways a cough can get worse for months at a time for some people.
Dr. Klugman says that you will probably start to feel better within 10 days of getting sick, but almost everyone should give themselves at least three to four weeks. If your first COVID-19 illness sent you to the hospital, you should give yourself even more time to get better, since both experts think that symptoms (like a cough) will last longer in these cases.
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Is coughing after COVID-19 normal?
Not every COVID-19 illness will cause a painful cough that lasts for a long time. But if you had upper respiratory symptoms when you were first sick, which is very common among people infected by recently dominant XBB variants, you should expect to have a cough as your body works to get rid of the infection. Experts say that it could take between three and four weeks for respiratory symptoms like a cough to go away for good.
Post-COVID conditions are symptoms that last weeks or months after you’ve had #COVID19. If you think you have a post-COVID condition, talk to your healthcare provider about options for treatment. Many patients with these symptoms get better with time. https://t.co/C4G6TXWodw. pic.twitter.com/POLXniigBz
— CDC (@CDCgov) May 10, 2021
COVID-19 is different from other winter illnesses because it affects the lungs in more than one way. This may explain why a cough lasts after the first wave of symptoms and sickness. Dr. Klugman says that COVID is worse than the flu and other respiratory infections because it attacks not only the lining of the lungs but also the small blood vessels. “This makes them more inflamed over time, which makes the lung damage worse as a whole.”
For most people, it takes between 10 and 31 days to get better, which we’ve already talked about. However, some pre-existing conditions or lifestyle choices make it impossible to know exactly when a cough may stop after a COVID-19 illness. More research is also needed to find out how the SARS-CoV-2 virus affects our immune systems over time.
“Studies suggest that [a persistent cough] may be caused by COVID-19 in a different way. It is thought that COVID-19 causes brain inflammation, immune system modulation, or nerve inflammation of the vagus nerve pathway, which controls coughing,” says Dr. Leong. “These nerves in the brain and body become overly sensitive and easy to set off, which can make you cough for a long time. In the future, any treatment or relief for this symptom would have to focus on this mechanism.”
If your cough doesn’t get better a month after your first signs of illness, you should talk to a specialist. You could talk to a specialist sooner if you notice that it’s getting worse during this time.
Or, if you have other symptoms at the same time that fit with a long COVID diagnosis.
When does a long-term cough become a sign of COVID?
We’ve already talked about how a persistent cough should be checked out by a doctor if it lasts for more than four weeks. However, there are other long-term COVID symptoms besides a cough that may show up before this time and point to a bigger problem.
— CDC (@CDCgov) May 24, 2022
“A long-lasting cough should be taken as a sign of a bigger problem,” says Dr. Leong. This is especially true if the cough is accompanied by other long-term COVID symptoms like fatigue, brain fog, memory problems, shortness of breath, or a fast heart rate. This may cause your doctor to look for more treatment or help from a specialist.
She says that experts have seen long-term COVID develop without more of these symptoms. This means that you may have developed a condition after COVID that is just a persistent cough. The fact that you have all of these symptoms, though, makes it more likely that you have long COVID.
Even if you are aware of the four-week window, a persistent cough that gets worse after your other COVID-19 symptoms have gone away probably means you have another illness to treat. Dr. Leong says that a cough that gets worse after a positive COVID-19 test could be caused by untreated bronchitis, pneumonia, pertussis, or a worsening of asthma. Your doctor can rule out other health problems that could be causing a cough that hurts your whole body and give you treatments that work better than anything you could get at home.
How do you stop coughing from COVID-19?
Your primary care doctor will tell you how to treat a painful cough as long as it lasts. Some people with heart health problems may not be able to take over-the-counter cough medicines. In any case, you’ll use tried-and-true natural remedies to ease the pain or discomfort of a cough. As you get better, you can use things like warm tea, and a good humidifier, and stay away from harsh pollutants and cigarette smoke.
If your doctor thinks you have a secondary bacterial infection, he or she may give you antibiotics to get you back to full health. If your sinuses are affected, decongestants may be used instead.
But if you have a cough that doesn’t go away within 10 days of your first COVID-19 illness, doctors probably won’t give you anything else. COVID-19 will take time to heal your respiratory system, and it’s likely that your symptoms won’t go away all at once but will get better over time. Try to make yourself as comfortable as possible and remember that your lungs are getting better.
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Jessa Martin is the author of Nogmagazine, A professional in writing by day, and novelist by night, she received her bachelor of arts in film from Howard University and her master of arts in media studies from the New School. A Brooklyn native, she is a lover of naps, cookie dough, and beaches, currently residing in the borough she loves, most likely multitasking.