Long-COVID severe refractory cough: discussion of a case with 6-week longitudinal cough characterization

Abstract

Long coronavirus disease (COVID) refers to an array of variable and fluctuating symptoms experienced after acute illness, with signs and symptoms that persist for 8–12 weeks and are not otherwise explicable. Cough is the most common symptom of acute COVID-19, but cough may persist in some individuals for weeks or months after recovery from acute phase. Long-COVID cough patients may get stigmatised because of the public fear of contagion and reinfection. However, clinical characteristics and longitudinal course of long-COVID cough have not been reported in detail, and evidence-based treatment is also lacking. In this paper, we describe a case of long-COVID severe refractory cough with features of laryngeal hypersensitivity and dysfunction. We characterized cough using patient-reported outcomes and engaged in continuous cough frequency monitoring. Through the case study, we discuss potential mechanisms, managements, and clinical implications of long-COVID refractory cough problems.

Characterizing and Predicting Post-Acute Sequelae of SARS CoV-2 infection (PASC) in a Large Academic Medical Center in the US

“…Among the 69 PASC-associated phenotypes, the majority were respiratory symptoms and in line with earlier reports (e.g., cough [54,55], dyspnea [56], respiratory insufficiency [57]). Also, the identified muscle-related symptoms, including myalgia, malaise and fatigue, were supported by previous PASC studies [58,59].…”

“…In addition to the results from the pre-COVID-19 period conditions, our findings from the acute-COVID-19 period also accord with previous studies. Among the 69 PASC-associated phenotypes, the majority were respiratory symptoms and in line with previous reports (e.g., cough [54, 55], dyspnea [56], respiratory insufficiency [57]). Also, the identified muscle-related symptoms, including myalgia, malaise and fatigue, were supported by previous PASC studies [58, 59].…”

Characterizing and Predicting Post-Acute Sequelae of SARS CoV-2 Infection (PASC) in a Large Academic Medical Center in the US

“…In addition to the results from the pre-COVID-19 period conditions, our findings from the acute-COVID-19 period also accord with previous studies. Among the 69 PASC-associated phenotypes, the majority were respiratory symptoms and in line with earlier reports (e.g., cough [ 55 , 56 ], dyspnea [ 57 ], respiratory insufficiency [ 58 ]). Additionally, the identified muscle-related symptoms, including myalgia, malaise, and fatigue, were supported by previous PASC studies [ 59 , 60 ].…”

The Statistics of Counting Coughs: Easy as 1, 2, 3?

“…Like busy streets, some people cough a lot, even more at certain times than at others; and like quiet cul-de-sacs, some people do not cough very much at all regardless of the time of day. And just as the number of cars passing by a given spot at a certain time can vary considerably from day-to-day, the number of times a person coughs during a given hour can change quite a bit from one day to the next, either purely by chance or in response to some internal or external change or treatments [8]. Distinguishing between these possibilities is a basic goal of cough science and one that can only be achieved after fully understanding the inherent randomness of coughing.…”