The Persistence of ‘Long Covid’ Symptoms: A New Study Reveals a Surprising Link to Asthma
Research conducted in Korea sheds light on the characteristics and treatment of chronic long-Covid cough
The global outbreak of the new coronavirus infection, commonly known as Covid-19, has now reached an endemic stage. While the majority of patients recover within a few weeks, a significant number continue to experience persistent symptoms and seek medical attention long after their initial diagnosis. Termed ‘Prolonged Covid’, this phenomenon refers to the persistence of one or more unexplained symptoms and signs for a duration exceeding 12 weeks.
The most common symptoms associated with Long Covid include chronic cough, lethargy, general fatigue, loss of appetite, and brain fog. Among these, chronic cough has emerged as one of the most troubling complaints reported by patients. While most coughs caused by Covid-19 resolve quickly, approximately 20% of individuals experience cough symptoms that persist for over two months. Surprisingly, a recent study in Korea has found that nearly half of the patients suffering from chronic long-Covid cough also have a history of asthma.
The study, led by Professor Song Woo-jeong from the Department of Allergy at Seoul Asan Hospital and Professor Park So-young from Chung-Ang University Department of Respiratory Allergy Gwangmyeong Hospital, sought to unravel the characteristics and possible treatment options for chronic long-Covid cough. The researchers examined 121 patients with long-term chronic cough-Covid and compared them to 100 patients with general chronic cough. By conducting an exhaled nitric oxide (FeNO) test to measure bronchial inflammation, they discovered that 44.7% of the long chronic cough-Covid patients also had asthmatic cough, which was twice as high as the prevalence in the general chronic cough patients (22.7%).
Asthma cough, which is directly caused by asthma, is recognized as a major contributor to chronic cough. Diagnosing this condition is often challenging, as coughing is more noticeable than shortness of breath or wheezing, which are classic asthma symptoms.
Notably, the researchers found that adhering to the current treatment guidelines for chronic cough led to significant improvement in cough symptoms in about 83% of the long chronic cough-Covid patients. After one month of treatment, patients reported a substantial increase in their quality of life scores (EQ-VAS) from an average of 63 points to 74 points, with associated symptoms such as chronic fatigue, sleep disorders, and headaches decreasing as well.
However, the results of radiological examinations, including chest X-rays and computed tomography (CT) scans, did not reveal any significant differences between the long chronic Covid cough patients and those with general chronic cough.
Professor Song Woo-jeong commented, “Asthma symptoms typically worsen after a viral infection, and it appears that hidden asthma may become more evident following a Covid-19 infection.” The findings of this study provide initial evidence supporting the effectiveness of applying current cough treatment guidelines for long chronic Covid cough.
Nevertheless, approximately 20% of patients do not respond well to the current treatment options for chronic cough, and it remains uncertain whether the initial positive response can be sustained in the long term. Consequently, further research is ongoing to explore alternative strategies.
The results of this groundbreaking study, conducted in Korea, have been published in ‘Allergy Asthma Immunology Research,’ an esteemed English journal affiliated with the Korean Asthma and Allergy Society.
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The new coronavirus infection (Corona 19) has reached the endemic stage, but many patients are still looking for hospitals because of the after-effects caused by Corona 19. There are long-term sequelae of COVID-19, referred to as ‘Prolonged COVID’, refers to the persistence of one or more symptoms and signs unexplained by another disease after 12 weeks of diagnosis.
Chronic cough that doesn’t stop after getting coronaㅣSource: iClick Art
The main symptoms of Long Covid include △ chronic cough △ lethargy △ general fatigue △ loss of appetite △ brain fog. In particular, there are many patients who complain of discomfort due to chronic cough symptoms. Most coughs caused by COVID-19 get better quickly, but cough symptoms are known to persist for more than 2 months in about 1 in 5 people.
Until now, there have been no studies worldwide on the characteristics and treatment of chronic long-Covid cough. However, recently, a study was published that almost half of the patients with chronic long-Covid cough in Korea are asthmatic cough patients.
Long chronic cough patients of Covid, asthmatic cough 44.7%.
Department of Allergy Seoul Asan Hospital Song Woo-jeong and Chung-Ang University Department of Respiratory Allergy Gwangmyeong Hospital Prof. Park So-young Prof. Park So-young’s team measured the degree of bronchial inflammation in 121 patients with long-term chronic cough-COVID and 100 patients with a general chronic cough. As a result of carrying out an exhaled nitric oxide (FeNO) test to measure the degree of inflammation for them, it was revealed that about 44.7% of patients with a long chronic cough of Covid are asthmatic cough patients. This is twice as high as general chronic cough patients (22.7%).
Asthma cough is literally a cough caused by asthma, and is considered one of the main causes of chronic cough. A simple lung function test is difficult to diagnose because coughing is more noticeable than shortness of breath or wheezing.
Long chronic Covid cough can be treated ‘this way’
As a result of treating long chronic cough patients from Covid by applying the current chronic cough treatment guidelines, it was found that cough symptoms improved significantly after one month in about 83% of patients. Patients responded that their quality of life score (EQ-VAS) improved significantly from an average of 63 points to 74 points after treatment, as associated symptoms such as chronic fatigue, sleep disorders, and headaches decreased.
However, there was no significant difference in the results of radiological examinations such as chest X-rays and computed tomography (CT) examinations of patients with prolonged Covid and generalized chronic cough.
Song Woo-jeong, a professor of allergy medicine at Asan Medical Center, said, “Asthma is characterized by worsening symptoms after a cold virus infection, but it seems that hidden asthma is easier to manifest after infection with Corona virus 19. ” Through the results of this study, the current chronic evidence is beginning to be established that treatment by applying the cough treatment guidelines is effective.”
In addition, he added, “However, there are still around 20% of patients who do not respond well to current chronic cough treatments, and it is not yet known whether a good initial treatment response is sustained in the long term, therefore additional research is being conducted.”
The results of this study were recently published in ‘Allergy Asthma Immunology Research’, an English journal published by the Korean Asthma and Allergy Society.
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