Data from millions of users of the ZOE COVID Symptom Study app has shown that a persistent cough can be a symptom of COVID-19. Here’s how to spot it and what it feels like.

What is the ‘COVID cough’ like?

A persistent cough is widely known as one of the three ‘classic’ symptoms of COVID-19, along with fever and loss of smell, although only around four in ten people who are ill with COVID-19 will have a persistent cough.

In this context, persistent means coughing many times a day, for half a day or more. It can be hard to notice if you’re coughing more than usual, so make sure you’re keeping an eye on yourself and others around you. 

This is usually a dry (unproductive) cough, unless you have an underlying lung condition that normally makes you cough up phlegm or mucus. 

However, if you have COVID-19 and start coughing up yellow or green phlegm (‘gunk’) then this may be a sign of an additional bacterial infection in the lungs that needs treatment.

Coughing is a major way that coronavirus spreads. If you have a cough that could be COVID-19 you must get a test and self-isolate. 

Whether you’re ill or not, always make sure you cover your coughs - for example by coughing into your elbow - and wear a face covering or mask to protect others.

When does a cough happen in COVID-19?

Coughing tends to come a few days into the illness, although it can be there from the start, and usually lasts for an average of four or five days.

How common is a cough in COVID-19?

Coughing is a reasonably common symptom of COVID-19, affecting more than four in ten (46%) adults who are ill with the disease. It’s less common in children, affecting around a quarter of children (26%).

Importantly, this means that just over half of adults and three quarters of children with COVID-19 will not have a cough. 

Coughing usually occurs along with other symptoms, and only around one in ten people with COVID-19 have a persistent cough as their only symptom. 

What other symptoms of COVID-19 are common alongside coughing?

A persistent cough is highly likely to occur alongside fatigue (tiredness) and headaches. It often comes together with symptoms like a sore throat, chest pain, shortness of breath, hoarseness and loss of smell.

Depending on your age and sex, you should contact your doctor if you have multiple different symptoms of COVID-19 in the first week of being ill.

What should I do if I have a cough and think it might be COVID-19?

If you start coughing more than normal without an obvious explanation, it could be COVID-19. You should:

• Follow the NHS guidelines and self-isolate at home to help protect the people around you and the wider community.
• Book a COVID test as soon as possible, either through the app or the NHS.
• Download the ZOE COVID Symptom Study app and start logging your health daily, if you’re not already, to help us understand more about how COVID-19 affects people and contribute to life-saving scientific research.
• Check out our tips on looking after yourself if you are sick with COVID-19, monitoring your health at home and staying hydrated.
  

Coughing a lot can be uncomfortable. It’s best to avoid lying on your back, so try to sit up or lie on your side instead. Staying hydrated is important, and drinking warm water or having a spoonful of honey can also help to ease your cough. Find out more about how to treat the symptoms of COVID-19 from the NHS website.

COVID-19 can cause blood oxygen levels to fall dangerously, even for people who seem to be breathing normally. If you fall ill, you can buy a pulse oximeter or ask your doctor to send you one to monitor your blood oxygen levels at home.

Having an underlying lung condition can increase the risk from COVID-19. You can find advice for people with asthma on our blog, and the British Lung Foundation has lots of helpful information about lung conditions and COVID-19.

You should get urgent medical help if you have worsening shortness of breath, are breathing very fast, or your lips or face are turning blue. 

Stay safe and keep logging.