Can You Have A Cough With A Cold?

The common cold, also known as viral rhinosinusitis or simply as cold, is caused by a viral infection that predominantly affects the upper airways (nose and throat). Cold is one of the most common acute illnesses in the industrialised world, especially in the cold (winter) months.¹ 

Cough is listed as one of the common symptoms a person experiences after catching a cold. Coughing is a bodily reaction invoked to clear mucus and other irritants build up from the throat. 

Other extremely common symptoms of the common cold are dyspnea (laboured breathing),  fever, nasal congestion and a general feeling of unwellness. Symptoms also include those of the upper and lower respiratory tract, therefore commonly confused with COVID-19 or flu virus symptoms.

It has also been reported that while both COVID-19 and the common cold spread in similar ways, they are in fact caused by different viruses and present in slightly different ways. COVID-19 is caused by the SARS-CoV-2 virus and symptoms generally appear two to 14 days after exposure, while the common cold is most often caused by rhinoviruses and cold symptoms onset within 3 days after you catch the virus.  

Preventing yourself from acquiring and/or spreading respiratory viruses such as the common cold is possible just by following the simple rules of daily hygiene. If you catch a cold and neglect to treat your health, in rare cases it could lead to a further decline in your health, meaning if the virus affects the deeper airways of the lungs and bronchi, it could potentially result in pneumonia and/or bronchitis.²

What is a common cold?

The common cold is caused by a viral infection that affects the upper airways (nose and throat). It is also known as viral rhinosinusitis or simply as cold and is caused by a viral infection that predominantly affects the upper airways (nose and throat).¹

Symptoms 

Symptoms of a common cold usually appear one to three days after exposure to a cold-causing virus and can vary from person to person. Symptoms can be:³

• sudden onset of fever (rarely)
• cough (can be severe and can last more than two weeks)
• muscle pain 
• headache 
• sneezing 
• sore throat 
• overproduction of mucus 
• runny nose 

Causes 

Many different viruses can cause common cold. Research into the cause of respiratory illnesses led to the discovery of several disease-causing agents including adenovirus, parainfluenza virus, rhinovirus, respiratory syncytial virus (RSV), enterovirus, and coronavirus - all with many different variants. Therefore, ‘the common cold’ is not caused by a specific virus but can be caused by numerous unrelated viruses. Among them, rhinovirus is the most frequent culprit causing the common cold. It is found in almost half of all sufferers.^4,5  

Risk Factors

Certain factors, such as cold weather, crowded places and stress can favour the onset of a cold even if they are not the direct cause.

Cold weather 

Viruses are the cause of most sicknesses during winter because of the way they infiltrate our bodies. Cold weather does not directly trigger the disease or make the virus more aggressive, but it does prevent your body from adequately defending itself. Low temperatures hamper the effectiveness of the body's natural outer first-line defences against the infection (otherwise known as the innate immune system). This includes slowed movement of mucus, hair-like cells in the throat (called cilia) and the eyelashes among others. Consequently, this creates the ideal conditions for the onset of viral infection.⁶ 

Indoors crowded places

During the cold season, more time is spent indoors, perhaps in crowded places where the virus is able to spread more easily. The common cold is in fact one of the most contagious diseases known so far, and being in crowded places certainly facilitates infection.⁶

Stress

Just like the cold weather, stress can also indirectly increase a person's exposure to catching a common cold. Perhaps even more so than low temperatures and humidity, stress makes our bodies more vulnerable to cold-causing viruses. Various research works have shown stress and the common cold to be related, for example, psychological stress was linked to an increased risk of acute infectious respiratory illness.⁶ 

Weak immune system

There are a variety of circumstances under which our immune system is not at its peak performance, consequently increasing the risk of contracting a cold. Infants, for example, in the first 4 to 6 weeks of life are at high risk of contracting a cold or other infections because their immune systems are functionally immature. Even the elderly, and people weakened by serious diseases that alter the immune system, or patients under chemotherapy or immunosuppressive therapy, are at a high risk of contracting a cold and developing complications.⁶

About colds and coughing 

Is a cough the sign of a cold?

Cold viruses override our immune system and spread throughout the body - often called “catching a cold”. The primary symptoms are usually fatigue, sore throat and rhinitis (snotty, runny and irritated nose).²

Viruses cause inflammation of the inside of the nose which swells and produces a greater amount of watery secretion - a runny nose. As the cold progresses your snot may become more viscous - a blocked nose. Frequently the inflammation in the nose also leads to a sense of pressure or pain in the face or the head.²

Inflammation in the upper respiratory tract (nose and throat) can also affect the lower respiratory tract (windpipe and lungs). In the case of a cold, sore throat and rhinitis are very often followed by a cough. Initially, you may experience a dry cough which later becomes a cough with mucus production.²

Can we have colds without a cough?

Yes, it is even possible to be exposed to cold viruses and not become infected. Even if you catch the cold-causing virus, you may not always show symptoms (this is known as a subclinical or asymptomatic infection).

However, most people with the common cold show mild symptoms. Some others can experience severe colds that can lead to symptoms like headache, fever, aches and pains all over, stuffy nose and coughing.

Is a cough the last symptom of a cold?

The Centre for Disease Control and Prevention (CDC) says that cough and other typical cold symptoms usually start within 2 to 3 days of contracting a cold-causing virus. These symptoms can remain for 10 to 14 days with cough usually being the last symptom to go away. Some people might also experience a post-infectious cough known as whooping cough that can last an average of 18 days after your cold subsides.

Whooping cough, also known as pertussis, starts with cold-like symptoms making it difficult for the doctors to diagnose until more severe symptoms appear. After one or two weeks, the disease can cause inflammation in the airways and the person has violent and rapid coughing fits.

Treatment

There are many cold remedies that can help relieve symptoms. Some non-prescriptive medications or remedies include:

• Pain relievers and antipyretics
• Decongestants for a stuffy nose
• Cough drops or throat sprays

No vaccine has been developed to protect us against the common cold due to the quantity and variety of viruses capable of causing it and the fact that these same viruses often change over time.⁷ 

Unlike COVID-19, a common cold is usually harmless. You can expect to get over your symptoms within a week, with some feeling better in a few days and some in a few weeks time. The inside of the nose favours the virulence of bacteria (the ability of bacteria to cause disease), which colonises the mucous membrane (smooth outer lining) of the respiratory tract.  A viral cold can therefore turn into a bacterial infection if the conditions are right and you may require a prescription for antibiotics. In this case, your symptoms might last beyond two weeks, and your snot turns from clear to thick or yellowish. You should seek medical advice from your doctor as you may require antibiotic treatment.⁸

Remedies

It is possible to manage cold symptoms by following some simple rules such as: 

• Drinking plenty of fluids helps replace those lost with increased sweating and nasal discharge
• Eating foods that are low in fat, and high in fibre along with plenty of fresh fruits and vegetables will help restore your energy levels

You may, however, lose your appetite while you are ill, so don’t force yourself to eat more than you reasonably can.

When to seek medical attention?

The CDC recommends that you seek medical care if 

• Your symptoms do not improve or suddenly get worse 
• You have had a high temperature for more than 4 days or feel hot and shivering 
• You have shortness of breath/ fast breathing or developing chest pain 
• You have a long-term medical condition that can compromise your immune system, or if you suffer from a chronic condition

Summary

The common cold is a viral infection of the upper airways (nose and throat). Symptoms of a common cold affect the nose and respiratory system - you may also develop a cough. Cough is one of the most common symptoms of a common cold as it helps clear mucus and other irritants build up from the throat  Most people recover from a common cold in a short period of time, though symptoms might last longer in some individuals. Generally, there is no need for medical attention for a common cold but if your symptoms don't improve or if they get worse, it is recommended that you see a doctor.