Blood-Streaked Sputum After COVID-19: When to Seek Medical Attention?

The diagnosed patient is coughing up sputum with a slight trace of blood?

I tested positive on May 19.
Initially, I had a cough but no phlegm.
By the morning of May 21, I noticed blood streaks in my phlegm when I coughed it up.
My wife said that my coughing technique might be wrong and could have hurt my throat, but I'm concerned it might be due to other reasons.
After a video consultation and taking medication, I am coughing less now and have no other symptoms, but I do cough occasionally and want to clear my phlegm.
From yesterday to today, I have coughed up phlegm about seven times, and three of those times had some blood streaks.
I would like to know if I need to go to the emergency room or if I should just monitor my condition before seeking further medical attention.
If I stop coughing and have no phlegm, will I still need to get an X-ray?

Zhi, 40~49 year old female. Ask Date: 2022/05/22

Dr. Hong Yuanbin reply Internal Medicine

Hello, COVID-19 patients may experience some microvascular bleeding in the throat during severe coughing, which can lead to blood-tinged sputum.
Symptomatic treatment is recommended, and it should gradually improve.
However, if there is persistent fever, chest pain, or severe shortness of breath, medical attention and a chest X-ray are necessary.
Thank you for your inquiry.

Reply Date: 2022/05/22

More Info

Blood-streaked sputum after a COVID-19 infection can be concerning, and it's essential to understand when to seek medical attention. Given your history of COVID-19 and the presence of blood in your sputum, there are several factors to consider.

Firstly, the presence of blood in your sputum (hemoptysis) can arise from various causes, some of which may be benign, while others could indicate a more serious condition. In the context of COVID-19, respiratory symptoms can persist even after the acute phase of the infection has resolved. The inflammation and irritation caused by the virus can lead to coughing, which may result in minor bleeding from the respiratory tract, especially if you have been coughing forcefully or if there is underlying bronchial irritation.

Here are some key points to consider regarding your situation:
1. Frequency and Amount of Blood: If the blood-streaked sputum is occasional and minimal, it may not be a cause for immediate concern. However, if you notice an increase in the frequency of blood in your sputum, or if the amount of blood increases significantly, it is crucial to seek medical attention promptly.

2. Associated Symptoms: You mentioned that you are not experiencing other symptoms, which is a positive sign. However, if you develop additional symptoms such as shortness of breath, chest pain, fever, or if your cough worsens, you should seek medical care immediately. These could be signs of a more serious condition, such as pneumonia or a pulmonary embolism.

3. Underlying Conditions: If you have any pre-existing respiratory conditions (such as asthma or chronic obstructive pulmonary disease) or if you are a smoker, these factors could contribute to your symptoms and warrant closer monitoring.

4. Consulting a Healthcare Provider: Since you have already had a telehealth consultation and received medication, it is advisable to follow up with your healthcare provider if the blood in your sputum persists. They may recommend further evaluation, such as a chest X-ray or a CT scan, to rule out any complications related to COVID-19, such as lung inflammation or infection.

5. When to Seek Emergency Care: If you experience any of the following, you should seek emergency medical care:
- Significant or worsening hemoptysis (large amounts of blood)
- Severe shortness of breath or difficulty breathing
- Chest pain that is persistent or worsening
- Dizziness or fainting
In summary, while occasional blood-streaked sputum may not be alarming, it is essential to monitor your symptoms closely. If you have any concerns or if your symptoms change, do not hesitate to reach out to your healthcare provider for further evaluation. It is always better to err on the side of caution, especially after a COVID-19 infection, as respiratory complications can arise.

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