Severe chronic cough relating to post-COVID-19 interstitial lung disease: a case report

Abstract

Cough is a common symptom occurring in patients with acute coronavirus disease 2019 (COVID-19) infection as well as during the post-COVID-19 period. The post-COVID-19 cough can improve over time and the incidence of sustained post-COVID-19 chronic cough is low. Approaching post-COVID-19 cough is challenging to clinicians including pulmonologists and allergists due to a diverse set of etiologies and the lack of published guidance on effective treatments. A 60-year-old male ex-smoker presented to the outpatient long COVID-19 clinic because of a prolonged cough for 4 months after a severe COVID-19 infection. His cough was so violent that he had suffered a spontaneous pneumothorax on 2 occasions. In addition, he also complained of exertional breathlessness. Due to concerns over ongoing systemic inflammation from COVID-19 or thromboembolism, a serum C-reactive protein and d-dimer where checked and were normal. Chest computed tomography (CT) images revealed diffuse ground glass opacities combined with scattered emphysema in the bilateral upper lobes and several small bullae located close to the pleura. His diagnosis was post-COVID-19 interstitial lung disease (ILD) and he was treated with methylprednisolone 32 mg/day. After 2 weeks of treatment, he showed improvement with near cessation of cough and a significant decline in dyspnea. The follow-up chest CT also showed improvement in the ground glass opacities. Severe chronic cough could be a manifestation of post-COVID-19 ILD. This case demonstrates the use of systemic corticosteroid to improve both post-COVID-19 ILD and its associated chronic cough.

Coronavirus disease 2019–associated persistent cough and Chiari malformation type I resulting in acute respiratory failure: illustrative case

“…Cough due to COVID-19 is among the most common symptoms and can be mild, moderate, or severe and associated with pneumonia and interstitial lung disease in select cases. 40 Our patient's radiographic and intraoperative findings revealed various findings associated with both extradural and intradural pathology associated with CM-I (Fig. 1A and B and Fig.…”

“…Cough due to COVID-19 is among the most common symptoms and can be mild, moderate, or severe and associated with pneumonia and interstitial lung disease in select cases. 40 …”

Potential Beneficial Effects of Naringin and Naringenin on Long COVID—A Review of the Literature

“…Sensory neurons release a variety of neuropeptides (calcitonin gene-related peptide, substance P, and neurokinin A), eventually leading to hypersensitivity of the cough pathway [ 176 ]. In addition, the underlying mechanisms of chronic cough may also be related to post-infectious lung abnormalities, cough underlying disease, upper airway cough syndrome, or cough-variant asthma (CVA) [ 177 , 178 , 179 ].…”

Bio-guided chemical characterization and nano-formulation studies of selected edible volatile oils with potential antibacterial and anti-SARS-CoV-2 activities

“…The upper respiratory tract (URT) is the entry point for SARS-CoV-2, and SARS-CoV-2 most likely interacts with the URT microbiome and will progress to severe diseases with the emergence of secondary bacterial infections. The most common respiratory symptoms in patients with COVID-19 sequelae are a persistent cough (mostly dry) and shortness of breath, while dyspnea is the most common persistent symptom after COVID-19 recovery ( Nguyen-Ho et al, 2022 ). To address these issues, novel medications must be created that treat both acute and chronic respiratory conditions more safely and effectively.…”