My practice is small, but I still see enough patients to be able to observe things that might be happening in the general population.  For example, when my patients have been sick with COVID in the past, they call me right away.  In the past, when I have gotten a cluster of calls from my patients newly sick with COVID, it has always been a sign of a big spike in the general population of COVID cases in my area.

One observation I recently made that seems to common not to be a trend are very bad coughs after colds in patients who have previously had COVID.  Here is the typical scenario:  Patient got COVID months ago with full resolution of symptoms within two weeks or less.  Then, months later that get a very typical upper respiratory infection that is not COVID (everyone tests nowadays).  The cold resolves, but a very severe cough persists.

Persistent coughs after colds are not uncommon.  Years ago, I was actually featured in a story about this in The Washington Post.  However, what I am seeing now is different.  While these are all post-infectious coughs, they are occuring more frequently then I have seen in the past and seem to be more severe.  As mentioned in the article, I typical treat these coughs with asthma/COPD inhalers and patients generally respond well.  While these patients also respond to inhalers, the response is not as quick and not as complete.

In my research into Long COVID (Long Haul COVID), patients can have cough and other respiratory symptoms that last for months.  We now know that the virus which causes COVID can damage the lungs by attaching to ACE2 receptors that are highly prevalent in lung tissue.   It is my hypothesis that in patient who recovered from COVID but did not develop Long COVID might still have some lung damage from their initial COVID infection, but only develop symptoms when they get another (non-COVID) respiratory infection.  While I don’t have any proof of this, and my practice is small, I have reached out to other doctors on social media and they have shared similar observations.

Long COVID has many names (Long COVID, Long-Haul COVID, Post-Acute COVID-19, Post-Acute COVID-19 Syndrome or PASC and Chronic COVID). However, this is different, because patients are generally fine until they get a typical respiratory infection.  There is no official name for the typical post-infectious cough or what I will often call post-inflammatory bronchospasm that I mentioned in the Post article as well.  This situation is essentially a severe post-infectious cough that is made worse by a prior COVID infection.  (I wish I could come up with a clever name for this, but all I have for now is Post- COVID Severe Post-Infectious Cough .

Regardless of the name, my concern is that since the majority of US citizens have had COVID-19, we will see this much more commonly.  I hope I am wrong.

Author Matthew L. Mintz, MD, FACP

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