Why Am I Still Coughing Weeks After Having a Cold? - Verywell Health

Lingering coughs after upper respiratory infections like the common cold or flu are called post-infectious or post-viral coughs. A lingering cough is mostly dry and are often referred to as "sub-acute," meaning it persists for more than three weeks after the infection, but less than eight.

Post-infectious coughs are a common type of lingering cough, affecting between 11% and 25% of adults who have recently had an upper respiratory infection.

Verywell / Laura Porter

This article describes the types of infections that tend to cause lingering coughs, as well as how healthcare providers diagnose and treat a cough that won't go away. It also offers tips on how to reduce your risk of post-infectious coughs and upper respiratory infections in general.

What Causes a Lingering Cough After a Cold?

Lingering coughs often happen with upper respiratory tract infections. These types of infections occur anywhere within the nose, sinuses, throat (pharynx), or voicebox (larynx). Symptoms generally last seven to 14 days and may include fever, cough, sore throat, stuffy/runny nose, sneezing, headache, and muscle aches.

Lingering coughs are believed to be caused by either mucous draining into your throat (postnasal drip) or inflammation related to the initial infection.

Certain risk factors increase the likelihood of post-infectious cough. These include having an upper respiratory infection that causes large amounts of mucus and/or the inability to adequately clear mucus from the lungs.

Inflammation in the airways can cause swelling and increased mucus production. This leads to postnatal drip. When the mucus runs down your throat it can cause irritation, leading to a cough.

The risk of having a lingering cough tends to increase the longer a person is ill with an upper respiratory infection.

The vast majority of upper respiratory infections are caused by viruses such as:

Much less commonly, upper respiratory tract infections may be caused by bacteria. This is called bacterial sinusitis. It can mimic that of a post-infectious cough until you're treated with an antibiotic.

Other Causes of a Lingering Cough

A lingering cough can also have causes unrelated to an infection. These include problems like:

• Asthma
• Congestive heart failure
• Gastroesophageal reflux disease (GERD)
• ACE inhibitor medication
• Smoking
• Lung cancer
• COVID-19/long COVID

These are less likely causes of a lingering cough, but it is important to see your healthcare provider to rule them out.

A cough from COVID-19 commonly lasts an average of 19 days. In about 5% of patients, a COVID cough can last about four weeks. 

However, some people develop a condition known as long COVID. With long COVID, symptoms persist beyond four weeks after the diagnosis. If you are still coughing significantly a month after getting sick, see your doctor for further evaluation of a lingering cough after COVID.

When to Seek Medical Attention

A lingering cough on its own is not always a reason to worry. However, it's important to seek medical attention right away if you are experiencing a lingering cough and any of these symptoms:

• Coughing up significant amounts of mucous (wet cough)
• Wheezing or trouble breathing
• Persistent fever
• Unexplained weight loss
• Chest pain
• Coughing up blood
• Vomiting during or after coughing
• Unusual fatigue
• Weight loss

You should also see a healthcare provider if you have a lingering cough that lasts longer than eight weeks or is not improving with home remedies and OTC medicine. 

How to Get Rid of a Lingering Cough After a Cold

Non-medical treatments may help ease a lingering cough. Certain home remedies are reasonable approaches to managing a post-infectious cough. Some people may even find them more soothing than other therapies.

Eucalyptus Oil

Eucalyptus oil is a colorless or pale yellow liquid that has a number of potential health benefits, including relieving post-infectious cough.

Eucalyptus oil is believed to calm cough by loosening a person's phlegm. You can use it by inhaling steam infused with eucalyptus oil (drop 12 drops of eucalyptus oil per 3/4 of boiling water). You can also apply an over-the-counter product that contains the oil, like Vicks VapoRub, to the skin on your chest.

Keep in mind that eucalyptus oil should not be used in children younger than age 2, or while a person is pregnant or breastfeeding.

It's also important to never ingest eucalyptus oil, as it's toxic if consumed by mouth.

Even when inhaled or applied to the skin, eucalyptus oil may interact with various medications, so be sure to tell your healthcare provider if you are using it.

Honey and Tea/Coffee

Drinking tea mixed with honey is a classic home remedy for treating a nagging cough. Experts suspect the medicinal effect of honey may be due to its antioxidant and antimicrobial properties.

For adults with a post-infectious cough, drinking coffee with honey in it has also been found to soothe a lingering cough, though the studies that have been done so far are small, and more research is needed.

Due to the risk of infant botulism—a potentially life-threatening condition caused by a bacteria-generated toxin—never give honey to a child younger than 12 months old. Also, you should avoid giving caffeinated tea or coffee to children.

Hydrate

Staying well-hydrated can help thin mucus, making it easier to clear. Make sure you're drinking enough fluids every day. If your urine is clear or pale yellow, it's a sign that you are well-hydrated.

Saline Rinse

A saline rinse may also help clear out mucus and improve your cough. Try using an over-the-counter saline nose spray, or make your own solution from distilled water and table salt.

Mix 1/2 teaspoon of non-iodized salt into one cup of distilled water (do not use tap water unless it has been boiled). Put the solution into a clean syringe or a nasal cleansing pot. Insert the tip of the device into one nostril and gently squirt/pour the solution into your nose. You can do this up to three times a day.

Humidifier

By releasing moisture into the air, a humidifier may help clear mucus and ease a lingering cough. Some humidifiers may have a feature that allows you to add essential oils like eucalyptus or peppermint oil for extra cough relief.

For children, be sure to use a cool-mist humidifier. Warm-mist humidifiers or vaporizers can burn your child if they get too close to the steam.

Also, clean your humidifier daily, if possible, to prevent bacteria and mold from growing.

Gargle With Salt Water

Gargling salt water may help with a lingering cough by loosening and washing away phlegm in your throat.

To gargle salt water, add 1/2 teaspoon of salt to a cup of warm water and mix until it is dissolved. Then, take a sip of the salt water, tilt your head back, gargle for around 10 seconds, and then spit it out.

If you're not sure if your young child can reliably spit the water out, avoid having them try to gargle.

How Is a Lingering Cough Diagnosed?

A lingering cough can last up to eight weeks. The diagnosis of post-infectious lingering cough is clinical, meaning it is based primarily on your symptoms and physical exam.

Your healthcare provider will ask you questions about when your cold symptoms started, what they were, the characteristics of your current cough, and whether you have any other symptoms.

They will also check your vitals (e.g., fever, heart rate, etc.) and perform a physical exam, during which they will look inside your nose and listen to your heart and lung sounds with a stethoscope.

A recent viral upper respiratory infection, a lack of fever, clear lungs, and cough that has not persisted past eight weeks are all signs a post-infectious cough.

Still, your healthcare provider may want to rule out other possible causes of your lingering cough, including:

If you have a history of heart or lung issues, see your healthcare provider to rule out non-infectious causes of your cough.

Depending on your healthcare provider's suspicion of the cause, various other tests may need to be performed before moving on to a treatment plan for a lingering cough that won't go away.

For example, your healthcare provider may order a chest X-ray. Findings should be normal with a diagnosis of post-infectious cough.

Tests like a computed tomography (CT) scan of your sinuses or chest or a pH monitoring test (measures the acidity level within your esophagus) may also be ordered.

Medication for a Lingering Cough

Even if it's not serious, having a lingering cough can be very annoying and disruptive. A post-infectious cough can significantly impact your quality of life. You may find it difficult to sleep or get your work done at home or at your job.

Medications for Postnasal Drip

To avoid harmful side effects or medication interactions, be sure to check in with your healthcare provider about any treatments for a lingering cough you plan to try.

A lingering cough related to postnasal drip is treated with an antihistamine like Dayhist (clemastine) or Chlor-Trimeton (chlorpheniramine).

While more sedating than newer drugs, these particular antihistamines are more effective at minimizing a post-viral cough.

If you are unable to tolerate the sedating effects of these medications, your healthcare provider may suggest a nasal spray like Astelin (azelastine), Flonase Allergy Relief (fluticasone propionate), or Atrovent nasal spray (ipratropium bromide) to help with a lingering cough.

The following antihistamines may also be tried:

Medications for Inflammation

Some treatments for a lingering cough are a little more involved. A post-infectious cough related to inflammatory changes in airway tissue is treated similarly to asthma.

Your healthcare provider may perform a methacholine challenge test in which you breathe in a drug that narrows your airways. If it affects your ability to breathe well, you will be prescribed one or more of the following types of medications, depending on the severity of your symptoms:

If the test does not show that you have sensitive airways, your healthcare provider may prescribe Atrovent HFA (inhaled ipratropium bromide).

Over-the-Counter Cough Medications

Even though there isn't much scientific evidence to back up their use, many people turn to over-the-counter medications to help with a lingering cough that won't go away.

• Dextromethorphan is a common ingredient in cough suppressants like Delsym cough syrup. These medications block the cough reflex.
• Guaifenesin, another over-the-counter cough medicine, is found in Mucinex. In contrast to dextromethorphan, guaifenesin is a cough expectorant. It works by thinning the mucus in your airways so you can get rid of it more easily.
• Cough drops, or throat lozenges, are also commonly used to manage a post-infectious cough, regardless of the underlying cause. Cough drops often contain a combination of ingredients including honey, menthol, eucalyptus oil, and dextromethorphan.

Unfortunately, the benefit of these lozenges is questionable. In fact, experts suspect that cough drops maybe not be any better for managing your cough than sucking on a piece of hard candy.

There is also some concern that menthol, which cools and numbs your throat, may actually worsen a lingering cough.

How to Prevent a Lingering Cough

If you want to avoid getting a lingering cough that won't go away, prevention is key. There are a few easy steps you can take to prevent developing an upper respiratory illness and a subsequent post-infectious cough.

These steps include:

• Wash your hands frequently with soap and water.
• Minimize close contact with people who are coughing or sneezing.
• Avoid touching your eyes, nose, and mouth. 
• Regularly disinfect common areas within your home and workplace.
• Stay up to date on your vaccinations (e.g., flu, pertussis, pneumonia, and COVID-19).

If you happen to get sick with an upper respiratory infection, resting your body is important. While it won't guarantee that you'll avoid a post-infectious cough, it will give your body a better chance for a quick and full recovery. Studies show that the risk of getting a lingering cough increases with the duration of the illness.

Another factor that may contribute to the risk of a post-infectious cough is the undertreatment of an upper respiratory infection. If there is a heavy build-up of mucus, you may be well served to get an expectorant like Mucinex to help clear the mucus rather than letting it sit in the lungs. Seek advice from a medical professional.

It's also sensible to try and avoid potential environmental irritants that may trigger or worsen a nagging cough, like dust or smoke.

Summary

A post-infectious cough is a lingering cough from an upper respiratory infection, like the common cold or flu, that persists for up to eight weeks after the infection has otherwise cleared.

The goal of treatment for a lingering cough is to ease symptoms while you recover. Cough suppressants, antihistamines, expectorants, or inhaled or oral steroids. Home remedies like humidifiers, eucalyptus aromatherapy, and gargling with salt water may also help.

Post-infectious cough can possibly be avoided by treating upper respiratory infections appropriately. This includes getting plenty of rest during the infection and using an expectorant to avoid the build-up of mucus in the lungs.

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