Post-COVID Coughing: When to Seek Chest X-Ray for Blood-Streaked Phlegm?

What is the appropriate timing for a chest examination after being diagnosed with a condition and still experiencing hemoptysis?

Hello doctor, I was diagnosed at the end of last year and completed isolation in early January.
I continued to self-isolate until I tested negative on a rapid test.
It has been about two weeks since then, but I still often feel phlegm deep in my throat.
It does not affect my breathing (which is generally smooth), but I occasionally feel the urge to cough it up.
The phlegm I cough up is yellowish and contains blood.
I would like to ask the doctor if these symptoms after recovery require an urgent visit to a pulmonologist for a chest X-ray to check for lung fibrosis, or should I wait for a certain period before seeking further examination if the symptoms persist? Thank you, doctor.

Liao Xiansheng, 30~39 year old female. Ask Date: 2023/01/19

Dr. Hong Yuanbin reply Internal Medicine

Hello, if you cough forcefully, it can easily cause microvascular rupture in the throat, leading to blood-tinged sputum.
This should gradually improve as the cough resolves.
Whether a follow-up chest X-ray is necessary mainly depends on whether you experience shortness of breath while walking or have chest pain.
If you do, then a follow-up chest X-ray can be considered.
Thank you for your question.

Reply Date: 2023/01/19

More Info

When it comes to post-COVID symptoms, particularly coughing up blood-streaked phlegm, it is essential to approach the situation with caution and awareness of potential underlying issues. Given your recent history of COVID-19, it is understandable to be concerned about any lingering symptoms, especially those involving blood in your sputum.

Firstly, the presence of blood in phlegm, known as hemoptysis, can arise from various causes, including but not limited to irritation of the airways, bronchitis, or more serious conditions such as pneumonia, pulmonary embolism, or even malignancies. In the context of post-COVID recovery, it is important to consider that COVID-19 can lead to complications such as lung inflammation, fibrosis, or secondary infections, which may manifest as persistent cough or changes in sputum.

In your case, since you are experiencing yellow phlegm with blood, it is advisable to seek medical attention sooner rather than later. While it is possible that the blood is a result of minor irritation from coughing, especially if you have been coughing frequently, it is crucial to rule out any serious conditions. The fact that you have a history of COVID-19 adds an additional layer of complexity, as the virus can have lasting effects on lung health.

A chest X-ray is a valuable diagnostic tool that can help visualize the lungs and identify any abnormalities such as infections, fluid accumulation, or structural changes. Given your symptoms, it would be prudent to consult with a healthcare provider who can evaluate your condition and determine whether a chest X-ray is warranted. If you experience any of the following symptoms, you should seek immediate medical attention:
1. Increased Severity of Cough: If your cough worsens or becomes more persistent.

2. Shortness of Breath: Any difficulty in breathing or feeling of tightness in the chest.

3. Chest Pain: Any new or worsening chest pain, especially if it is sharp or associated with breathing.

4. Fever or Chills: If you develop a fever or experience chills, it may indicate an infection.

5. Weight Loss or Fatigue: Unexplained weight loss or significant fatigue should also be evaluated.

If your symptoms persist for more than a couple of weeks or worsen, it is advisable to follow up with a healthcare provider for further evaluation. They may recommend a chest X-ray or even a CT scan for a more detailed view of the lung structures. Additionally, they may consider other tests such as sputum analysis or bronchoscopy if necessary.

In summary, while some post-COVID symptoms may resolve on their own, the presence of blood in your phlegm is a signal that should not be ignored. It is best to err on the side of caution and consult with a healthcare professional who can provide personalized advice based on your specific situation. Early intervention can be crucial in managing any potential complications and ensuring a smooth recovery.

Similar Q&A

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

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 t...

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 sho...

Understanding Blood-tinged Phlegm and Nasal Discharge After COVID-19

Hello Doctor, I am currently 23 years old, do not smoke, and have no history of asthma (although I had acute bronchitis several years ago). Since being diagnosed with COVID-19 early last year, I have frequently felt a buildup of thick phlegm in my chest that I cannot expel, along...

Dr. Shen Bochan reply Pulmonology
Hello, it is recommended to seek medical attention at our hospital to clarify your condition. Indeed, most mycoplasma infections can resolve on their own without medication due to the immune response; however, if it progresses to pneumonia, specific pharmacological treatment is n...

Post-COVID Cough and Unusual Breathing Sounds: What to Know

Hello, doctor. I was diagnosed with COVID-19 on December 19 of last year. Initially, I thought it was just a cold, so after my appointment, I went home and did a rapid test, which confirmed I was positive. I immediately informed the clinic where I had just been seen, and the doct...

Dr. Huang Yiwen reply Pulmonology
Dear Ms. Lin: It is indeed possible that the symptoms you mentioned after COVID-19 are related to changes in the immune system caused by the viral infection, which may trigger wheezing responses. Therefore, your first question should have a chance of being addressed. We recommend...

Understanding Lung Infiltration: When to Seek Further Medical Evaluation

Doctor, I have a question. I went to see a family physician because I had a cold, and I underwent an X-ray, blood tests, and sputum analysis (my sputum has always been white, without any yellow or blood-tinged coloration). Later, my cough symptoms improved, and during a follow-up...

Dr. Hong Yuanbin reply Internal Medicine
Hello, based on the current pandemic situation, it is recommended to first undergo COVID-19 testing. If the result is negative and symptoms persist, further evaluation by a pulmonologist at a major hospital may be necessary. As for pulmonary infiltrates, it is essentially inflamm...