Bronchitis Vs. Covid

Overview

The novel coronavirus Covid-19 seems to have similar symptoms as Bronchitis. These similarities make it difficult to determine which is which based on how we feel. So let’s figure out what, exactly is what, shall we?

What Is Bronchitis?

Bronchitis is an inflammation of the airways, more specifically; the lining of the internal branches (bronchi) that carry the air to your lungs. It causes coughing, with bringing up mucus, wheezing, shortness of breath, chest tightness and a low-grade fever.¹

This is not to be confused with Bronchiolitis, which is typically caused by a virus and affects the smallest airways in your lungs; the bronchioles.²

Types

The most prevalent types are Acute Bronchitis (AB) and Chronic Bronchitis (CB). AB is very common as it can develop following a cold or other respiratory infections like the respiratory syncytial virus (RSV) and is better known as a chest cold. On the other hand, CB is a more serious affliction and is a chronic obstructive pulmonary disorder (COPD) where there is a constant irritation or infection of the abovementioned bronchial lining and the air flow into the lungs can be blocked, causing breathing problems.^3-5

Causes/Risk Factors

AB is typically caused by viruses, the same viruses that cause colds and flu, but only half of the patients will have identifiable pathogens.⁵ It was found that the most common cause of CB is cigarette smoke, affecting both smokers and people living with a smoker, and it was seen to increase the risk of both AB and CB. Additionally, polluted air, dust or toxic gases in your environment can also have a hand in aiding CB because it can irritate the lining and the lungs.6 Recurrent bouts of gastric reflux or heartburn can also irritate your throat and make you more prone to developing bronchitis. It is even possible to catch another acute infection on top of CB because your immune system is weakened.^3-5

Symptoms (For Each Type)

Symptoms for either type of Bronchitis may include a productive cough bringing up (discoloured) mucus (sputum) which can be streaked with blood. You can also have trouble breathing, shortness of breath, wheezing and chest tightness/discomfort. With this comes to fatigue and a low-grade fever.^3-5
If you have the Acute form, you may experience cold symptoms, like a mild headache or minor body aches. These symptoms tend to improve within a couple of weeks; however, the cough persist for several weeks.³

When you find you have had a productive cough for at least three month, this is CB. You will have recurring coughing spells and will have periods where the cough or other symptoms will worsen.^4,6

Diagnosis

It is difficult to differentiate between the signs and symptoms of Bronchitis and those of a common cold. It is best to see your physician for a physical exam if your cough lasts more than 3 weeks and is accompanied by a temperature higher than 38ºC (100.4ºF), if your cough produces blood or other coloured mucus, if you have shortness of breath or difficulty breathing and if it is preventing you from getting a good night’s sleep. Your physician will give your lungs a good listen and could opt for a Chest X-ray, a sputum test or a pulmonary function test. These tests can help determine the cause (bacterial or allergic), rule out other infectious or lung diseases (pneumonia, asthma, emphysema or lung cancer) and determine a course of treatment.⁷

Treatments

Most cases of AB tend to improve without treatment, usually within a couple of weeks and owing to the fact that the cause of AB is typically a virus, antibiotics are not prescribed. However, if your physician suspects a bacterial infection, they might prescribe an antibiotic. They may also recommend some cough medicine or cough suppressant if the cough prevents you from getting enough sleep at night.⁷

What Is Covid?

Covid is a contagious respiratory illness, caused by a novel coronavirus first identified in 2019: SARS-CoV-2 and the virus was the main culprit of a global pandemic starting in 2020. It can manifest itself as bronchitis or pneumonia.⁸

Causes/Risk Factors

Covid is caused by a coronavirus called Severe Acute Respiratory Syndrome (SARS)- coronavirus-2.⁹ Anyone can get infected and it usually happens when they are in close proximity to other infected individuals. Transmission is believed to typically occur when you breathe in virus particles in droplets/aerosols that are expelled by infected individuals when they cough, sneeze, sing, talk and yes, even breathe.^9,11-13

Symptoms

The symptoms are variable and depend on the variant contracted, ranging from very mild symptoms to very critical and potentially fatal illnesses. Typical symptoms include, but are not limited to, coughing, sore throat, fever, loss or change to your sense of smell or taste, muscle pain, headache, but also nasal congestion or a runny nose. More serious symptoms will include breathing difficulties. There are also people that are asymptomatic. The symptoms are very similar to those of other illnesses, such as the cold or the influenza virus.^11,14,15

Diagnosis

The preferred method of testing for Covid-19, based on the above symptoms is using a reverse transcription polymerase chain reaction (or a RT-PCR) to confirm the RNA of coronavirus in secretions obtained by a nasopharyngeal swab (or either nasal swab or sputum sample). The World Health Organisation (WHO) has published several testing protocols for this illness and the results are usually available within hours. There are also serological tests available, and they detect antibodies which are produced by the body in response to an infection with this coronavirus.^16,17

Treatments

Only since 2022 effective treatments have been found and several medications have been approved in different countries. Paxlovid (nirmatrelvir/ritonavir) or remdesivir can be taken by patients with mild to moderate symptoms, either of which can reduce the risk of becoming severely ill and needing hospitalisation. Before that, treatment included fluid therapy and prone positioning; where patients were placed on their stomachs to use the force of gravity to help oxygen into the lungs. Other types of oxygen support were also employed, both non-invasive and more invasive mechanical ventilation all to prevent severe lung damage.¹⁸

Recently, we have access to highly effective vaccines, demonstrating reduced mortality as far as Covid-19 goes and fewer people end up with severe complications.¹⁹

What Are The Similarities And Differences?

The similarities between Bronchitis and Covid are mainly the symptoms presenting in the first days: fever, cough, fatigue, headache, and difficulties breathing.^3,14

The differences between Bronchitis and Covid can help potentially tell them apart: when you have Bronchitis you will have a more productive cough, bringing up mucus and phlegm.³ The cough associated with Covid-19 is a continuous cough, not necessarily wet and productive. Additionally, the loss or change to your sense of smell or taste and the blocked or runny nose are also symptoms that are mostly linked to Covid-19.¹⁴ However, it is important to confirm the presence of Covid using laboratory tests.²⁰

What’s Worse: Bronchitis Or Covid?

If you have acute bronchitis, your symptoms tend to improve within a couple of weeks; however the cough can stay with you for several weeks.⁷ If you have contracted a mild variant of Covid, or you are asymptomatic, you will have no major Covid-19 symptoms which may make you think that having bronchitis is much worse. Due to the fact that the severity of Covid-19 varies, patients with mild symptoms will typically see improvement within a couple of weeks, while those with severe illness may take up to 6 weeks to make a recovery.¹⁵ Covid-19 complications should also be mentioned, these can include Covid-19 pneumonia, acute respiratory distress syndrome (ARDS), multi organ failure, septic shock, cardiovascular events, neurologic manifestations and of course death.^21-24 Among those who have died, the time from symptom onset to death has ranged from 2 to 8 weeks.²⁵

When Should I Contact My Doctor?

It is best to see your doctor for a physical exam if your cough lasts more than 3 weeks and is accompanied by a temperature higher than 38ºC (100.4ºF), if your cough produces blood or other coloured mucus, if you have difficulty breathing or chest pains. In the event of a new continuous cough, a sore throat and running a temperature it is best to take a rapid lateral flow test at home and phone your doctor for advice.²⁶

Summary

When comparing Bronchitis to Covid, acute bronchitis is probably the lesser evil provided it does not get out of hand. Because there is still a lot unknown about Covid and the long-term implications and patients suffering with multiple ongoing complaints after their initial infection it seems you are more likely to make a full recovery in a couple of weeks after catching bronchitis.