한빛사 논문
Woo-Jung Song MDa, Christopher K M Hui MDb, James H Hull PhDc, Prof Surinder S Birring MDd, Prof Lorcan McGarveye, Prof Stuart B Mazzone PhDf, Prof Kian Fan Chung DScc,g,*
aDepartment of Allergy and Clinical Immunology, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea
bRoyal Free Hampstead NHS Foundation Trust, London, UK
cDepartment of Respiratory Medicine, Royal Brompton and Harefield NHS Trust, London, UK
dCentre for Human & Applied Physiological Sciences, School of Basic & Medical Biosciences, Faculty of Life Sciences & Medicine, King's College London, London, UK
eWellcome-Wolfson Institute for Experimental Medicine, School of Medicine, Dentistry and Biomedical Sciences, Queen's University Belfast, Belfast, UK
fDepartment of Anatomy and Physiology, University of Melbourne, VIC, Australia
gExperimental Studies Unit, National Heart & Lung Institute, Imperial College London, UK
*Corresponding author
Abstract
Cough is one of the most common presenting symptoms of COVID-19, along with fever and loss of taste and smell. Cough can persist for weeks or months after SARS-CoV-2 infection, often accompanied by chronic fatigue, cognitive impairment, dyspnoea, or pain—a collection of long-term effects referred to as the post-COVID syndrome or long COVID. We hypothesise that the pathways of neurotropism, neuroinflammation, and neuroimmunomodulation through the vagal sensory nerves, which are implicated in SARS-CoV-2 infection, lead to a cough hypersensitivity state. The post-COVID syndrome might also result from neuroinflammatory events in the brain. We highlight gaps in understanding of the mechanisms of acute and chronic COVID-19-associated cough and post-COVID syndrome, consider potential ways to reduce the effect of COVID-19 by controlling cough, and suggest future directions for research and clinical practice. Although neuromodulators such as gabapentin or opioids might be considered for acute and chronic COVID-19 cough, we discuss the possible mechanisms of COVID-19-associated cough and the promise of new anti-inflammatories or neuromodulators that might successfully target both the cough of COVID-19 and the post-COVID syndrome.
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