Rai Deependra K, Sharma Priya, Karmakar Saurabh, Thakur Somesh, Ameet H, Yadav Rajesh, Gupta Vatsal B
Department of Pulmonary Medicine, AIIMS Patna, Patna, Bihar, India.
Lung India. 2023 Mar-Apr;40(2):149-154. doi: 10.4103/lungindia.lungindia_250_22.
A large proportion of patients who completely recovered from acute coronavirus disease 2019 (COVID-19) infection later continued to experience symptoms even after recovery, irrespective of the severity of the disease. Various terms with varying duration were used for those who had persistent symptoms, of which cough was the most common. We systematically searched the published literature concerning post-COVID-19 cough, its prevalence, and the potential ways to reduce it in clinical practice. The aim of this review was to provide an overview of existing literature concerning post-COVID-19 cough. Literature shows that augmented cough reflex sensitivity is responsible for persistent cough after acute viral upper respiratory infection (URI). Overall, the heightened cough reflex associated with SARSCoV2 induces neurotropism, neuroinflammation, and neuroimmunomodulation via the vagal sensory nerves. Therapies for post-COVID-19 cough aim at the suppression of cough reflex. For a patient who does not respond to early symptomatic treatment, Inhaled corticosteroids can be given a trial to suppress airway inflammation. More trials of novel cough therapies in patients with post-COVID-19 cough using various outcome measures need to be studied in future research. Several agents are currently available for symptomatic relief. However, non-response or refractory cough continues to preclude adequate symptom relief.
很大一部分从2019年冠状病毒病(COVID-19)急性感染中完全康复的患者,即使康复后仍继续出现症状,无论疾病的严重程度如何。对于那些有持续症状的患者,使用了各种持续时间不同的术语来描述,其中咳嗽最为常见。我们系统地检索了已发表的关于COVID-19后咳嗽、其患病率以及在临床实践中减轻咳嗽的潜在方法的文献。本综述的目的是概述关于COVID-19后咳嗽的现有文献。文献表明,咳嗽反射敏感性增强是急性病毒性上呼吸道感染(URI)后持续性咳嗽的原因。总体而言,与严重急性呼吸综合征冠状病毒2(SARS-CoV-2)相关的咳嗽反射增强通过迷走感觉神经诱发神经嗜性、神经炎症和神经免疫调节。COVID-19后咳嗽的治疗旨在抑制咳嗽反射。对于对早期对症治疗无反应的患者,可以尝试使用吸入性糖皮质激素来抑制气道炎症。未来的研究需要使用各种结局指标,对更多COVID-19后咳嗽患者进行新型咳嗽治疗的试验。目前有几种药物可用于缓解症状。然而,无反应或难治性咳嗽仍然无法实现充分的症状缓解。