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

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

Dear Ms. <br>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. <br>Therefore, your first question should have a chance of being addressed. <br>

COVID-19, abnormal breath sounds?

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 doctor mentioned that he had prescribed preventive medications, but none of them were antiviral drugs specifically for COVID-19, and I did not take Qing-Guo No.
1.
At the time of diagnosis, I only had a mild fever (around 37.8°C), which subsided within a day.
Gradually, I developed a cough with phlegm, and I am still experiencing coughing and phlegm production.
Currently, I am primarily receiving traditional Chinese medicine treatment, with weekly appointments ongoing.

This morning, while in a semi-conscious state, I noticed a wheezing sound in my chest and throat when breathing.
It seemed more pronounced when exhaling, and about three seconds after exhaling, it felt like there were bubbles moving in my chest, producing a sound.
After getting up, I tried to cough to clear that sound and sensation, and it did disappear after a cough.
However, during these two months since my diagnosis, there have been times when I coughed severely, accompanied by chest pain and a metallic taste in my throat.

I would like to ask the doctor:
1.
I found some information suggesting that this could be wheezing, but I do not have a persistent condition.
What is the likelihood that this is wheezing?
2.
If the likelihood is low, would you recommend scheduling an appointment, or should I continue to monitor for any recurrence? How frequent should symptoms be before seeking medical attention? (Currently, I do not have any symptoms during my appointments.)
3.
Assuming the first two points do not require a doctor's visit, would you recommend at least getting an X-ray to check for any lung issues?
Thank you for your response!

Miss Lin, 20~29 year old female. Ask Date: 2023/02/15

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 that you primarily consult a pulmonologist, who can perform chest X-rays and pulmonary function tests, which can still provide valuable information.
Additionally, we will conduct some blood tests to check for indicators related to wheezing.
Please find a time to come to the hospital for an examination.
Changhua Hospital cares about you.

Reply Date: 2023/02/15

More Info

Post-COVID symptoms can be quite varied and concerning, especially when they involve respiratory issues such as coughing and unusual breathing sounds. Your experience of having a cough with phlegm and the recent occurrence of wheezing sounds during breathing suggests that you may be dealing with some lingering effects of COVID-19, often referred to as "long COVID" or post-acute sequelae of SARS-CoV-2 infection (PASC).
1. Wheezing and Its Likelihood: Wheezing is typically associated with airway constriction or obstruction, which can occur due to inflammation or mucus buildup in the airways. Given your history of COVID-19, it is plausible that the virus has caused some degree of airway inflammation, leading to wheezing sounds, especially during exhalation. While you mentioned that the wheezing is not persistent, it can still be a sign of reactive airway disease, which is common after respiratory infections. Therefore, the likelihood of experiencing wheezing is significant, particularly in the context of your recent COVID-19 infection.

2. When to Seek Medical Attention: If your symptoms are infrequent and mild, you might consider monitoring them for a short period. However, if you experience any of the following, it would be prudent to seek medical attention:
- Increased frequency or severity of wheezing
- Persistent cough that does not improve
- Chest pain or discomfort that worsens
- Any new symptoms such as fever, shortness of breath, or significant fatigue
- Blood in your phlegm, as this can indicate a more serious underlying issue
In general, if you notice that your symptoms are affecting your daily life or if they worsen, it is advisable to consult a healthcare provider. They may recommend a visit to a pulmonologist or an ear, nose, and throat (ENT) specialist, depending on the specific symptoms you are experiencing.

3. Imaging and Further Evaluation: If your symptoms persist or if there are concerning signs (like chest pain or hemoptysis), a chest X-ray or even a CT scan may be warranted to evaluate your lung health. These imaging studies can help identify any potential complications, such as pneumonia, pleural effusion, or other abnormalities that could be contributing to your symptoms. Additionally, pulmonary function tests may be performed to assess how well your lungs are working and to identify any obstructive or restrictive patterns.

In summary, while it is common to experience lingering respiratory symptoms after a COVID-19 infection, it is essential to remain vigilant about any changes in your condition. Monitoring your symptoms and seeking medical advice when necessary can help ensure that you receive appropriate care and management. Remember that your health is paramount, and addressing these concerns early can lead to better outcomes.

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