Treatment of cough in covid-19
Pro Research Analysisby 
Searched over 200M research papers
Pharmacological Treatments for COVID-19-Related Cough
Cough is a common and persistent symptom in COVID-19 patients, affecting both quality of life and recovery. Several pharmacological options have been explored for managing cough in COVID-19, with varying degrees of effectiveness.
Antitussive and Mucoactive Drugs
Antitussive medications, which suppress the cough reflex, are considered important in managing COVID-19-related cough. Both central and peripheral acting antitussives, as well as mucoactive drugs like expectorants, mucokinetics, mucolytics, and mucoregulators, are recommended based on the underlying mechanisms of cough in COVID-19, which include viral damage to airway epithelium and irritation of vagal nerve endings 2.
A randomized controlled trial compared noscapine plus licorice syrup to diphenhydramine in outpatients with COVID-19. Both treatments were effective, but noscapine plus licorice showed slightly better results in reducing cough severity, improving cough-related quality of life, and relieving dyspnea 1.
Novel and Repurposed Therapies
Indomethacin, a nonsteroidal anti-inflammatory drug, has been proposed as a potential treatment for COVID-19-induced dry cough. This is based on its ability to reduce bradykinin levels, which are implicated in persistent dry cough in COVID-19, similar to cough caused by ACE inhibitors. Indomethacin is low-cost and widely available, making it a promising option, especially for refractory cases 5.
Ensitrelvir, an antiviral agent, was found to be effective in reducing cough severity and improving cough-specific quality of life in patients with asthma infected with the COVID-19 Omicron variant. Early administration led to greater improvements compared to symptomatic treatment alone 6.
ELOM-080, a phytomedicine that enhances mucociliary clearance, did not show significant benefit in the general outpatient population with COVID-19. However, in patients with suspected dysfunctional mucociliary clearance, ELOM-080 significantly reduced coughing fits and improved breathing difficulty 4.
Inhaled Corticosteroids and Symptomatic Relief
For post-COVID-19 persistent cough, inhaled corticosteroids may be considered if initial symptomatic treatments fail, as they help suppress airway inflammation. However, some patients may continue to experience refractory cough despite these interventions 7.
Herbal and Traditional Chinese Medicine (TCM) Approaches
Several studies have evaluated the role of herbal medicines and TCM in treating COVID-19-related cough. Meta-analyses and randomized controlled trials indicate that combining herbal medicine or TCM with standard Western medicine improves cough symptom disappearance rates, shortens the duration of cough, and enhances overall symptom recovery compared to Western medicine alone 8910.
Specifically, Lianhuaqingwen (LH) capsules, a Chinese herbal product, significantly increased the rate of cough recovery and shortened the time to symptom resolution without serious adverse events 9. These findings suggest that herbal and TCM therapies can be valuable adjuncts in the management of COVID-19 cough.
Pediatric Considerations
In children, COVID-19-related cough can be acute, persistent, or chronic, and may worsen pre-existing respiratory conditions. Treatment should be tailored to the underlying cause, with careful use of cough relievers and expectorants. Expert consensus emphasizes the importance of appropriate diagnosis and individualized therapy to avoid unnecessary adverse effects 3.
Conclusion
The treatment of cough in COVID-19 involves a range of options, including antitussives, mucoactive agents, inhaled corticosteroids, novel antivirals, and herbal or traditional medicines. Noscapine plus licorice, indomethacin, and ensitrelvir have shown promise in specific patient groups. TCM and herbal therapies, when combined with standard care, can further improve outcomes. Individualized treatment based on patient characteristics and cough etiology remains essential for optimal management.
Sources and full results
Most relevant research papers on this topic