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Post-viral cough is a dry cough that lasts for more than eight weeks after a viral respiratory infection. It can be difficult to treat, but cough syrup with codeine may help. The cause is not well understood, but it may be related to airway inflammation. Careful evaluation can determine if there is an underlying problem that needs to be addressed.
A post-viral cough is a dry cough that persists for more than eight weeks after an upper respiratory infection caused by a virus. This can be irritating to the patient, especially since it can be difficult to treat by conventional means. For a severe cough, a medical evaluation can confirm that an underlying problem isn’t responsible, and the patient can be given some aggressive treatment options to see if the problem has been resolved. If not, the patient may need to allow the cough to run its course.
The precise causes of post-viral cough are not well understood. Researchers believe it may be related to airway inflammation caused by the infection, which can excite cells and signaling pathways involved in the cough reflex. After the infection has resolved, the patient may continue coughing. Initially the cough may include mucus and particulate matter as the airways clear. Subsequently, it resolves to a dry, nonproductive cough, indicating that the airways may be irritated but are no longer producing mucus.
This cough can get worse in very dry environments and can be triggered by talking or eating. Some patients with post-viral cough find it helpful to drink plenty of fluids to stay hydrated. Cough lozenges are generally not effective, and measures such as steam curtains may offer limited comfort. If the cough becomes severe, the patient may have difficulty sleeping or exercising due to throat irritation.
In case a patient needs more aggressive treatment, the best option is usually a cough syrup that contains codeine. Opioids suppress the cough reflex and may reduce post-viral coughing as the airways recover. Such products should be used with care and the patient may need to taper off at the end of the treatment cycle to prevent withdrawal symptoms. It is also advised not to save or share the drug, as this could lead to inappropriate use which could be dangerous.
Post-viral cough cases can be carefully evaluated to see if the patient has asthma, an airway obstruction, or another problem. These problems may have been masked before or may have been triggered by the infection. Such tests may include imaging of the lungs, spirometry studies to evaluate airway function, and a careful interview of the patient to look for telltale symptoms that may not have been previously identified and addressed. If the cause is something other than a virus, other treatments may be needed to fix the problem and help the patient recover from the cough.
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