2023-11-18 08:38:53
on Sergio Harari
Viruses have an irritating action on the airways, acting on the epithelium that lines them. Making a comparison, like when you scrape your knees as a child: the skin is scarified and it takes time for it to heal completely.
Why can the cough last much longer after a cold episode than other symptoms?
Sergio Harari, director of Pneumology, San Giuseppe MultiMedica Hospital – University of Milan (GO TO THE FORUM) replies
Coughing is 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, cause damage to the bronchial epithelium, similar to that of peeling the skin, which thus causes coughing.
The possible causes
The reflex is healthy, but when it becomes too intrusive it must be controlled with drugs so that it does not cause damage (such as, for example, a rib fracture). Another mechanism that can be triggered as a result of an infection can be that of post-infectious asthma, which is particularly 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 is due to the development of dense secretions, which 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 follow accordingly. In the case of a simply irritative form, topical corticosteroids, even via aerosol, are usually resolving within 10-15 days. However, if it is 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 post nasal drip, an evaluation by the ENT specialist may also be necessary, and, if the disorder persists, a CT scan of the nasal and paranasal sinuses to exclude the presence of sinus disease.
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November 18, 2023 (modified November 18, 2023 | 07:38)
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