I am 23. Is my post-COVID cough concerning?

Question

Hello doctor,

I am 23 years old and a smoker. Last month I had COVID-19 (coronavirus disease). I recovered, and for about a week, everything was fine, but a few days ago, I started coughing again. I am coughing up phlegm, but there is no blood, chest pain, or fever. My nose is slightly congested.

When I take deep breaths (three inhales and three exhales), I sometimes hear a wheezing sound at the end of the exhale, which triggers coughing.

I am worried and wondering if there is any reason for concern. I tend to be a hypochondriac and often check my breathing, which might be making it worse.

Please confirm that it is not cancer or anything serious.

Please help.

Thank you.

Answer 1

Hello,

Welcome to icliniq.com.

I have gone through your query and understand your concern.

I completely understand your concern. The good news is that what you describe sounds much more like airway irritation or mild acute bronchitis rather than anything serious. The cough with phlegm and the slight wheeze you hear at the end of exhalation simply indicate that your breathing tubes are a bit inflamed and temporarily narrowed, a common after-effect of viral infections or smoking.

At your age (23 years), and with no alarming symptoms such as blood in sputum, weight loss, or chest pain, anything serious like cancer is extremely unlikely. The most likely causes are acute bronchitis, post-viral airway hyperreactivity, or smoking-related irritation, all of which are reversible with simple treatment.

However, since you are a smoker and have noticed wheezing, it is best to visit a doctor in person and have your chest examined with a stethoscope. This helps confirm whether there are any wheezes, crackles, or signs of infection. Based on the findings, the doctor may suggest a chest X-ray or spirometry just to be thorough.

For now, you may follow these measures to ease your symptoms:

Tablet Montelukast 10 mg + Levocetirizine 5 mg one tablet once daily at night for 10 days.
Steam inhalation, two to three times a day for five minutes.
Syrup containing Ambroxol + Guaifenesin + Terbutaline, 10 ml (two teaspoonfuls) three times a day after meals for five days.
Warm fluids: Drink plenty of warm water, soups, and herbal tea.
Avoid smoking altogether; even one cigarette can keep the inflammation active.
Inhaler: Your doctor may prescribe a mild bronchodilator or steroid inhaler after listening to your chest, as it helps control the wheeze more quickly.

Avoid checking your breathing repeatedly, as this can increase airway irritation and anxiety. With this care, your cough and wheeze should improve within one to two weeks. Still, please have your chest examined in person by a pulmonologist to ensure everything sounds clear.

I hope I have answered your question.

Let me know if I can assist you further.

Thank you.