Is it just the flu or is it Corona? This is how coughing differs

Many people in Switzerland are currently coughing. Do coronaviruses cause a different cough than flu or RS viruses?
MARTIJN BRUTSCHE: Artificial intelligence revealed that coughs can be distinguished from person to person. The cough of two people in the same room is different because it comes from the vocal cords. And the voice is unique for everyone. In general, we only distinguish between a dry cough and a productive cough when phlegm is coughed up

Which organs are involved in coughing?
In an acute cough, it goes from the tip of the nose to the smallest bronchi in the lungs. The bronchi are important, but the nasopharynx and paranasal sinuses also play a role. That is why we refer to acute coughing as infections of the upper and lower respiratory tract

After an infection, a lot of mucus collects in the airways, making it impossible for us to swallow it. How does this cause the cough?
Coughing is a vital reflex that keeps our airways open at all times. Anything that disrupts the airways, for example mucus, swallowed something or, in the worst case, a tumor, triggers the cough reflex. In an acute respiratory infection we have mucus on the organs and inflammation. This stimulates the ‘cough sensors’ that monitor and activate the cough. Thanks to the cough, the mucus is transported out and the airways function. The mucus often carries viruses and bacteria. If the mucus remains, it can become further inflamed and the bacteria will continue to multiply

Coughing is controlled by the cough center in the brain. Does this mean that every person’s cough is different?
The cough varies in severity from person to person. But the reflex is so important that it is activated in everyone. After anesthesia, a stroke or taking medication, the cough reflex may be absent, which is life-threatening. Then we have to use machines that artificially induce the cough

What causes the reflex?
The cough receptors are located in the nose, paranasal sinuses, upper and lower airways and esophagus. There are sensors everywhere that can stimulate coughing. The signals from the receptors are sent to the brain and modulated there. This modulation can then lead to varying degrees of coughing. The severity depends on whether you are awake, asleep or nervous, for example. Nervousness can make the cough worse

When the signals reach the brain, it sends out the cough signal, which activates the muscle groups, causes the vocal cords to short-close and then open explosively. This creates a very strong air current that dissipates the mucus. Speeds of over 100 km/h are measured.

Is there an effective prevention against cough?
It is important to keep the immune system healthy. A healthy diet and a healthy amount of exercise help. If you are sensitive, you can take a vitamin shower. Some people swear by zinc. For people with previously weakened lungs, such as asthma patients or COPD, who suffer from aggravation even with a minor cold, we use Broncho-Vaxom as a preventive measure. These are tablets that act as a small oral vaccination and strengthen the immune system

We also work with a natural product made from black geranium. However, it must be said that the protective mask is the best prevention, even if many people do not like it. We investigated this together with the Infectious Diseases Clinic. During the Covid pandemic, due to the mask requirement, we had only half as many cases of pneumonia and COPD as before the 2019 pandemic. Now without masks, this has changed again.

When the cough serves to expel mucus from the body. Are breastfeeding medications for coughs useful at all?
Breastfeeding cough medicines do not address the cause of the problem, but only the symptom. This can be useful if someone is seriously disturbed in their sleep. Or if someone has to lead an important meeting and is temporarily not allowed to cough…

When do we speak of chronic cough?
Chronic cough occurs when someone coughs for more than eight weeks. In contrast to an acute cough, a medical evaluation is important. The cause of chronic cough can lie in three organ areas: firstly in the ear, nose and throat area, secondly in the lung area and thirdly in the esophagus. In this case, reflux of stomach acid is typical, in the lungs it is chronic bronchitis, and in the ear, nose and throat area it is chronic sinusitis, an inflammation of the paranasal sinuses. However, there are a number of diseases that can lead to chronic cough

There are also recent findings in chronic cough showing that the reflex itself is becoming a model of the disease. This creates a chronic cough that actually has no cause at all. So no increased mucus formation. The patient coughs because the coughing mechanism is too sensitive. This is called a chronic, unexplained cough. There are currently drugs in the testing phase. However, coughing can actually have benefits for certain people.

How?
In a study together with the University of St.Gallen, we saw that coughing correlates with the severity of asthma. If coughing increases in asthmatics, it can be predicted that their asthma condition will worsen – and vice versa. The cough is, as it were, a warning system for asthma patients

That is why we developed the ‘myCough’ app together with the university and a spin-off that resulted from it. This is a tool that allows asthma patients to measure their cough themselves, so that they can then make a prediction about their asthma via the app. The app has now been certified as a medical product. Coughing can be a useful symptom for asthmatics. Whether this also works for other chronic lung diseases is currently being clinically tested.

Smoker’s cough COPD is feared. How quickly do coughing smokers recover when they stop smoking?
You can have a positive effect on your cough by quitting smoking. It is often the case that the cough first increases because the airways wake up again. When you smoke, they go to sleep because the cilia responsible for transporting mucus become paralyzed

If the paralysis disappears, the former smoker will have to cough again. After two or three weeks it disappears, and after a month even more. Whether coughing stops completely depends on how much damage the lungs have already suffered from smoking.

How does Long Covid affect coughing?
Long Covid is complex and not precisely defined. You have to distinguish between two diseases: on the one hand, the post-Covid situation. The lungs were damaged by the Covid infection, causing scarring on the lungs during the healing process. The scars remain for life, which can lead to loss of performance and coughing, even if the person is no longer ill. Such scars are also seen in patients who have been in intensive care for another type of pneumonia

Secondly, you see the Long Covid symptoms such as fatigue and fatigue, chronic fatigue. The cough doesn’t play a role. Normal lung function is observed in these patients. It is difficult to correctly diagnose the disease. Much research still needs to be done. In general, a new sensitivity to coughing has developed in connection with Covid. More and more research is also being done. (aargauerzeitung.ch)