新型冠状病毒感染后慢性咳嗽的诊治

Diagnosis and treatment of chronic cough after coronavirus disease 2019

咳嗽是新型冠状病毒感染(COVID-19)后常见症状,部分患者可持续为慢性咳嗽。文章从临床表现、诊断、鉴别诊断、治疗4个方面对COVID-19后慢性咳嗽进行介绍。COVID-19后持续咳嗽>8周,结合病史、血常规和胸部影像学检查,除外其他慢性咳嗽病因,可诊断COVID-19后慢性咳嗽。诊断时首先要明确咳嗽与COVID-19的时间关系,需注意鉴别COVID-19后纤维化或机化性肺炎、既往慢性气道相关基础疾病加重等。既往有慢性咳嗽病史者建议行慢性咳嗽病因相关检查并予以病因治疗。患有慢性气道疾病的患者应继续原方案治疗。对于原因不明的COVID-19后慢性咳嗽可考虑止咳、吸入糖皮质激素(ICS)或ICS联合长效β2受体激动剂抗炎治疗和物理治疗。

Cough is a common symptom after coronavirus disease 2019(COVID-19),and some patients can continue to have chronic cough.This article introduces chronic cough after COVID-19 from four aspects:clinical manifestations,diagnosis,differential diagnosis and treatment.Chronic cough after COVID-19 can be diagnosed by coughing persistently for more than 8 weeks after COVID-19,combined with history,blood routine test,and chest imaging to exclude other causes of chronic cough.When diagnosing,it is first necessary to clarify the time relationship between cough and COVID-19 infection and pay attention to identifying fibrotic or organic pneumonia after COVID-19 infection,and the exacerbation of previous chronic airway-related underlying diseases.Patients with a history of chronic cough are advised to have tests for the cause of chronic cough and treat the cause.Patients with chronic airway disease should continue the original treatment.For unexplained chronic cough after COVID-19,cough suppression,inhaled corticosteroids(ICS)or ICS combined with long-acting beta-2 agonists and physical therapy may be considered.