Persistent Cough and Fever After Negative COVID Test: What to Know

After testing negative for COVID-19, I have been experiencing persistent coughing and recurrent fever?

I would like to ask about my friend who was previously diagnosed with COVID-19.
Although he tested negative on a rapid test afterward, he has been experiencing low-grade fevers every evening and a persistent cough that has lasted for over a week.
He visited a hospital for a diagnosis, but the doctor only advised him to rest and did not mention any issues.
My friend is from China, and he told me that doctors there often just go through the motions and are not very reliable.
I'm a bit worried that there might be an undiagnosed problem, so I would like to know what could be the possible reasons for his condition.

Melodi, 20~29 year old female. Ask Date: 2022/12/29

Dr. Hong Yuanbin reply Internal Medicine

Many people do continue to cough for a long time after recovering from COVID-19.
It is important to determine whether there is a complication such as pneumonia.
If pneumonia is present, antibiotic treatment may be necessary.
The most accurate way to assess this is through a chest X-ray.
If an X-ray cannot be performed, one can evaluate symptoms such as high fever, difficulty breathing, and persistent yellow sputum.
If all these symptoms are present, the likelihood of developing bacterial pneumonia is high, and antibiotic treatment should be considered.
Thank you for your question.

Reply Date: 2022/12/29

More Info

Persistent cough and fever after a negative COVID-19 test can be concerning, especially if symptoms linger for more than a week. It's important to understand that while a negative test result may indicate that COVID-19 is not the cause of the symptoms, it does not rule out other potential underlying issues. Here are some possible reasons for your friend's persistent cough and fever:
1. Post-Viral Syndrome: After recovering from a viral infection, some individuals may experience lingering symptoms, known as post-viral syndrome. This can include fatigue, cough, and low-grade fever. The immune system may still be in a heightened state of response, leading to these symptoms.

2. Secondary Infections: Following a viral illness, the immune system can be weakened, making it easier for bacteria to cause secondary infections. Conditions such as bacterial pneumonia or bronchitis can develop after a viral infection, leading to persistent cough and fever.

3. Allergic Reactions or Irritants: Environmental factors, such as allergens (pollen, dust, pet dander) or irritants (smoke, pollution), can trigger respiratory symptoms. If your friend is exposed to such irritants, it could explain the ongoing cough and fever, especially if they have a history of allergies or asthma.

4. Other Viral Infections: There are many viruses besides COVID-19 that can cause respiratory symptoms. Influenza, respiratory syncytial virus (RSV), and other common cold viruses can lead to prolonged cough and fever.

5. Chronic Conditions: If your friend has pre-existing conditions such as asthma, chronic obstructive pulmonary disease (COPD), or other respiratory issues, these could be exacerbated by a recent viral infection, leading to persistent symptoms.

6. COVID-19 Variants: While your friend tested negative for COVID-19, it's worth noting that some variants may not be detected by certain tests, especially if the viral load is low. If symptoms persist, it may be worth discussing further testing options with a healthcare provider.

Given your friend's situation, it is advisable for them to follow up with a healthcare professional, especially if symptoms do not improve or worsen. They may need additional tests, such as a chest X-ray, blood tests, or even a referral to a specialist, such as a pulmonologist, to rule out any serious conditions.

In the meantime, your friend should focus on self-care measures, including:
- Rest: Ensuring adequate rest is crucial for recovery.

- Hydration: Staying well-hydrated can help thin mucus and ease coughing.

- Over-the-Counter Medications: Using medications like cough suppressants or fever reducers (e.g., acetaminophen or ibuprofen) can provide symptomatic relief.

- Monitoring Symptoms: Keeping track of any changes in symptoms, such as increased fever, difficulty breathing, or chest pain, is important for timely medical intervention.

In conclusion, while a negative COVID-19 test is reassuring, persistent cough and fever warrant further investigation to rule out other causes. Encourage your friend to seek medical advice if symptoms continue, as early intervention can lead to better outcomes.

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We recommend that you discuss the above situation further with your telemedicine attending physician to determine if any additional treatment is necessary. Thank you, and wishing you good health!