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Kabc t1_izjd1fr wrote

Work as a provider and get to explain this a bit!

Your sinuses during the virus get filled up with mucus and cause a post nasal drip (mucus running back in down your throat which irritates your throat and causes you to cough due to that irritation and your bodies desire to keep that pathway clear). The virus also irritates your oropharynx, which is then irritated MORE by the PND. This is why when you lay down, you tend to cough more.

Once the virus is defeated, the inflammatory responses are still in place dealing with the “damage” caused by the virus.. your congestion needs to drain from your sinuses, but in doing so your throat stays irritated, even after the virus is donzo. This CAN lead to secondary infection, but doesn’t always.

Doing things like nasal sprays (normal saline rinses) can help clear your sinuses. Using things like Flonase can also help. Taking antihistamines can also alleviate these symptoms. HOWEVER, sometimes antihistamines can have the opposite affect and cause your congestion to linger further—so it’s not ALWAYS the best choice.

Edit; this got more updoots then I expected. But please remember; I am a random dude on Reddit; don’t take medical advice form this website, if you are concerned see someone.

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bawki t1_izkhzqf wrote

I just want to emphasise one point you made: usually there is no bacterial superinfection, the symptoms are, as you rightly pointed out, due to the damaged/irritated lining of the upper respiratory tract. Sadly that takes some time to heal.

I did a quick search and found one study which tried to estimate the rate of superinfection by evaluating CRP levels on first presentation compared to subsequent visits. This approach has its obvious limitations, but if we are conservative in our estimate by doubling the reported likelihood of 8,1%, it still shows how rare bacterial superinfections in URTI are.

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obsidianop t1_izl3zvq wrote

Is it the case, then, that once the initial sinus congestion has cleared you are not contagious with virus even if the cough remains? I want to avoid getting others sick but I don't know how realistic it is to remain alone in my apartment for a week or two or more.

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OnenonlyAl t1_izm8x8b wrote

Most infectious between 3-7 days with a viral illness. Usually peaks at 5 or so.

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Kabc t1_izkjgjs wrote

Awesome! Thanks for that!

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Nyrin t1_izlql9p wrote

A potential crude analogy to this with a healing process that's much more visible to us is with sunburns.

While your skin is actively damaged by overexposure, you may or may not experience a certain set of symptoms with flushing, itching, irritation and sensitivity. For a long time afterwards, even with no active damage continuing to happen, you then deal with itchiness, sensitivity, flaking, peeling, and all the other delights of dermal repair.

Respiratory infections damage respiratory tissue in a parallel way to the sunburn. Once infection has been fought off, a lot of inflamed, compromised structure needs to be repaired and replaced and we respond to inflammation and debris by coughing.

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[deleted] OP t1_izjnvh5 wrote

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[deleted] OP t1_izjo9n4 wrote

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[deleted] OP t1_izjvhix wrote

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StJimmy75 t1_izkygzt wrote

Are there any signs that antihistamines would make it worse or is it just try it and stop if it gets worse?

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Kabc t1_izl9v2e wrote

It varies. I would say that if you have a more rhinorrhea (nasal drippings) antihistamines will work better.

Sometimes, you can have tympanic membrane bulging (TM for short) from sinus pressure. This can be without an infection. Antihistamines CAN help with that (Benadryl seems to work well, but obvious need to take it at night). Short course of steroids are really effective to help that as well.

NOTE; I wouldn’t take random advice from peeps on Reddit, but this is what I have seen in my personal bubble of patients I have

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[deleted] OP t1_izm9j05 wrote

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Pharmie2013 t1_izmd8cs wrote

2nd gen antihistamines don’t typically work as well for this. Diphenhydramine and chlorpheniramine should be the go to.

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OnenonlyAl t1_izmdt07 wrote

That's great info, I'll start to have to incorporate that more. Surprised my the otolaryngologist I followed recommended more 2nd generations. Maybe due to less drowsiness during the day. Makes sense though!

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