Can Cough Be Caused by COVID-19?

Quick Answer

Yes, cough is a common symptom of COVID-19. COVID-19, caused by the SARS-CoV-2 virus, often leads to respiratory symptoms, and a dry cough is one of the most frequent signs. According to the World Health Organization (WHO), about 60-70% of people with COVID-19 experience a dry cough, making it one of the hallmark symptoms of the infection.

How COVID-19 Causes Cough

COVID-19 primarily affects the respiratory system. When the SARS-CoV-2 virus enters your body, it targets cells in your airways and lungs. Here’s how it leads to a cough:

1. Viral Invasion: The virus binds to ACE2 receptors, which are abundant in the cells lining your airways and lungs. This allows the virus to enter and infect these cells.
2. Inflammation: Your immune system detects the virus and triggers an inflammatory response to fight it off. This inflammation can irritate your airways.
3. Irritation and Cough Reflex: The irritation in your airways activates the cough reflex, which is your body’s way of trying to clear out irritants or infections. This often results in a dry cough, meaning you don’t produce much mucus.
4. Damage to Lung Tissue: In more severe cases, the virus can cause damage to the tiny air sacs (alveoli) in your lungs, leading to conditions like pneumonia, which can worsen the cough and cause other symptoms like shortness of breath.

Source: Nature Reviews Immunology, National Institutes of Health (NIH)

Other Symptoms of COVID-19

While cough is a common symptom, COVID-19 can cause a wide range of symptoms, which may appear 2-14 days after exposure to the virus. These include:

• Fever or chills
• 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

In severe cases, COVID-19 can lead to pneumonia, acute respiratory distress syndrome (ARDS), or other complications that require hospitalization.

Source: Centers for Disease Control and Prevention (CDC)

How Common Is This?

Cough is one of the most common symptoms of COVID-19. According to data from the WHO and CDC:

• Approximately 60-70% of people with COVID-19 report having a dry cough.
• In a study of over 55,000 confirmed cases in China, 67.7% of patients experienced a cough.
• Cough is often one of the first symptoms to appear, sometimes even before fever or fatigue.

While cough is common, not everyone with COVID-19 will experience it. Some people, especially those who are vaccinated or have mild cases, may have minimal or no respiratory symptoms.

Source: WHO, CDC

Differentiating From Other Causes

Cough can be caused by many conditions, not just COVID-19. Here’s how to tell if your cough might be due to COVID-19 or another cause:

COVID-19 Cough vs. Common Cold or Flu

Source: Mayo Clinic

COVID-19 Cough vs. Allergies or Asthma

• Allergies: Cough due to allergies is often accompanied by itchy eyes, sneezing, or a runny nose. It’s usually seasonal and doesn’t cause fever or body aches.
• Asthma: Asthma-related coughing may be triggered by exercise, cold air, or allergens. It often comes with wheezing or tightness in the chest but not typically fever or loss of taste/smell.

COVID-19 Cough vs. Other Infections

• Bacterial Pneumonia: Cough may produce thick, colored mucus, and symptoms like high fever and chills are common. Unlike COVID-19, bacterial pneumonia usually doesn’t cause loss of taste or smell.
• Bronchitis: Cough is often productive, with mucus that may change color. Symptoms like fever and fatigue are less severe compared to COVID-19.

Getting a Diagnosis

If you suspect your cough is due to COVID-19, getting tested is the best way to confirm. Here’s what you need to know:

Types of Tests

• PCR Test: This is the gold standard for diagnosing COVID-19. It detects the virus’s genetic material and is highly accurate. Results usually take 1-3 days.
• Rapid Antigen Test: These tests provide results in about 15-30 minutes but are less accurate than PCR tests, especially if you don’t have symptoms. A negative rapid test may need to be confirmed with a PCR test.

When to Get Tested

• If you have symptoms of COVID-19, get tested as soon as possible.
• If you’ve been exposed to someone with COVID-19, wait at least 5 days after exposure to get tested, unless you develop symptoms earlier.

What to Do While Waiting for Results

• Stay home and isolate from others to prevent spreading the virus.
• Wear a mask if you must be around other people.
• Monitor your symptoms and stay hydrated.
• Follow CDC guidelines for isolation and quarantine.

Source: CDC, FDA

Treatment Options

There is no specific cure for COVID-19, but treatments can help manage symptoms, including cough, and reduce the risk of severe illness. Here’s what you can do:

At-Home Care

• Rest: Give your body time to heal by getting plenty of sleep.
• Hydration: Drink fluids like water, herbal tea, or broth to stay hydrated and soothe your throat.
• Humidifier: Use a humidifier to add moisture to the air, which can ease a dry cough.
• Honey or Throat Lozenges: These can help soothe a sore throat and reduce coughing. Note: Do not give honey to children under 1 year old.
• Over-the-Counter Medications:
  • Cough suppressants (like dextromethorphan) may help reduce coughing.
  • Pain relievers (like acetaminophen or ibuprofen) can help with fever, body aches, or headache.

Medical Treatments

For people at high risk of severe illness (e.g., older adults, those with underlying conditions), the following treatments may be recommended:

• Antiviral Medications: Drugs like Paxlovid (nirmatrelvir/ritonavir) or remdesivir can reduce the risk of hospitalization if taken early in the infection.
• Monoclonal Antibodies: These lab-made proteins can help your immune system fight the virus. Availability depends on the dominant COVID-19 variant.
• Steroids: In severe cases, corticosteroids like dexamethasone may be used to reduce inflammation in the lungs.

Note: Always consult a healthcare provider before taking any medication, especially if you have other health conditions or are taking other medications.

Source: NIH, FDA

When It's NOT COVID-19

If your cough isn’t due to COVID-19, other possible causes include:

• Common Cold or Flu: As mentioned earlier, these can cause coughing but usually have different accompanying symptoms.
• Allergies: Seasonal allergies can lead to a persistent cough, often with sneezing or itchy eyes.
• Asthma: Coughing, wheezing, and chest tightness are common in asthma, especially when triggered by allergens or exercise.
• GERD (Gastroesophageal Reflux Disease): Stomach acid flowing back into the esophagus can irritate your throat and cause a chronic cough.
• Chronic Obstructive Pulmonary Disease (COPD): This includes conditions like chronic bronchitis and emphysema, which cause long-term coughing and breathing difficulties.
• Postnasal Drip: Mucus dripping down the back of your throat can trigger a cough, often due to sinus infections or allergies.
• Environmental Irritants: Smoke, pollution, or strong odors can irritate your airways and cause coughing.

If your cough persists for more than a few weeks or is accompanied by other concerning symptoms (like weight loss or coughing up blood), see a doctor to rule out more serious conditions.

When to See a Doctor

While many cases of COVID-19 can be managed at home, seek medical attention immediately if you or someone else experiences:

• Trouble breathing or persistent chest pain/pressure.
• Confusion or inability to wake up.
• Bluish lips or face, which may indicate low oxygen levels.
• Severe weakness or inability to stay awake.

Additionally, contact a healthcare provider if:

• Your symptoms worsen after a few days.
• You have underlying health conditions (e.g., heart disease, diabetes, or a weakened immune system).
• You’re older than 65 or pregnant.
• Your cough lasts longer than a few weeks or is accompanied by other unusual symptoms.

Source: CDC, WHO

Key Takeaways

• Yes, COVID-19 commonly causes a dry cough due to inflammation and irritation in the airways.
• Cough is often one of the first symptoms of COVID-19, along with fever, fatigue, and loss of taste/smell.
• About 60-70% of people with COVID-19 experience a cough, making it a hallmark symptom.
• Differentiate COVID-19 cough from other causes by looking at accompanying symptoms (e.g., fever, body aches, loss of taste/smell).
• Get tested if you suspect COVID-19, especially if you’ve been exposed or have symptoms.
• Treatment focuses on managing symptoms at home, but antiviral medications may be available for high-risk individuals.
• Seek emergency care for severe symptoms like trouble breathing, confusion, or bluish lips.
• If your cough isn’t due to COVID-19, consider other causes like allergies, asthma, GERD, or infections.

For the most up-to-date information, always refer to trusted sources like the CDC, WHO, or your healthcare provider.