COVID-19 Cough With Mucus

About one-third of people with COVID-19 experience a cough with mucus (phlegm). This is due to lung congestion that can occur during the infection and persist even after it resolves.

Your lungs and airways can start to produce extra phlegm when you catch a virus like COVID-19. This mucus, which the body responds to with a cough that can help expel it, is meant to help rid the body of the infection.

Chest pressure or heaviness in the chest and a rattling sound or feeling when breathing can accompany the globby mucus that you cough up.

This article provides an overview of coughing up mucus with COVID. It reviews what it means if you have a cough with phlegm, as well as what medications, home remedies, and exercises you can use to help clear lung congestion.

How COVID-19 Impacts Lungs

COVID-19 is the illness caused by the SARS-CoV-2 virus. It infects the cells that line the airways, specifically the mucous membranes. The infection inflames the lung tissues, including the tissues where oxygen and carbon dioxide pass between the blood and the air.

When these tissues (the alveoli) swell up and fill with fluid, the lungs have a harder time doing their job—getting oxygen to your body and removing waste.

Symptoms of COVID-19 that are directly related to the lungs include:

• A dry or wet cough
• Trouble breathing
• Chest congestion

A dry cough with COVID-19 is more common than a cough with mucus (about 50% to 70% of patients have a dry cough). It is possible for a dry cough to become a wet cough over time, however.

In patients with long-lasting COVID symptoms, a cough may be present months after infection.

Other common symptoms of COVID-19 include:

• A fever or chills, night sweats
  
• Aches and pains, including headache and sore throat
• Losing the ability to taste and smell 
• Runny nose
• Digestive issues, including diarrhea, nausea, and vomiting
  

When a COVID-19 infection becomes severe, the lungs swell and fill up with fluid, a condition called pneumonia. This is usually what causes breathing difficulties in COVID-19 infections. In severe cases, it may require treatment in the hospital with oxygen or a ventilator to take over breathing.

When COVID-19 pneumonia is severe, it can cause lasting lung damage and lingering symptoms that can take months or even up to a year to recover from.

The infection and inflammation of lung tissues, including the airways, can cause excessive mucus production that then leads to a wet, productive cough.

Causes of Wet Cough with Mucus

Wet cough occurs because of an inherent biological response to expel fluid that has built up in the lungs. Whenever any kind of respiratory fluid or debris fills up in your lungs, your brain sends a message to your respiratory system to expel it as quickly as possible to facilitate breathing and airflow. When bacteria or microorganisms find their way into the respiratory system, it produces a wet or “productive” cough to get them out.

Your respiratory system contains membranes that produce mucus for multiple reasons, including lubricating airways and protecting your lungs from irritating and potentially harmful substances that can obstruct breathing.

Even in response to milder health issues, such as temporary cold, cough, fever, or minor infection, the body produces more mucus than usual. In the context of COVID-19, the virus has been linked to a variety of mild to severe respiratory issues, including: 

• Bronchitis 
• Chronic obstructive pulmonary disease (COPD)
• Pneumonia 
• Acute respiratory distress syndrome (ARDS)
• Cold or flu 
• Asthma 

More serious causes of wet or productive cough can include cystic fibrosis, asthma, pulmonary embolism, and others. It’s important to realize that while the biological mechanisms that cause wet cough are generally the same for all related conditions, wet cough can be the sign of something more serious than everyday respiratory irritation. Seek help from your healthcare provider if your wet cough persists longer than two weeks.  

How to Clear Phlegm When You Have COVID-19

While the mucus your body produces when you're sick has a purpose, you should still try to get some of it moving while you’re battling COVID-19. Clearing mucus out won’t make your infection go away, but it can help you breathe better and increase quality of life.

Here are a few ways to treat excess mucus in the lungs.

Prescription Medications

If you’re having trouble with mucus and a wet, productive cough when you have a COVID-19 infection, a doctor can prescribe one of two prescription drugs called mucolytics. These thin the mucus in your lungs, making it easier to cough up.

• N-acetylcysteine is often prescribed to break up chest mucus.
• Bromhexine may be prescribed. Studies indicate it may reduce symptom severity in hospitalized COVID-19 patients.

Both of these drugs thin mucus and help you cough it up, but work through different mechanisms than over-the-counter (OTC) expectorants containing guaifenesin, so they might be helpful if OTC medications aren’t working. 

If your COVID-19-related cough is long lasting or your chest congestion is causing breathing issues, you may need physical therapy to improve your lung health and strength. 

Over-the-Counter Treatments 

Expectorants (like Mucinex or anything with the active ingredient guaifenesin) thin mucus and make it easier to cough up. This won’t make you cough less, but it will make the coughs more productive and make it easier to clear the airways.

Decongestants (like Sudafed or anything with pseudoephedrine) shrink blood vessels in the mucous membranes, especially in the sinuses, slowing mucus production. They work best for nasal congestion.

You do not want to take a cough suppressant when you have a wet cough. The cough is essential to moving mucus out of your lungs, where it’s interfering with breathing. Taking a cough suppressant when you have a wet cough may increase your risk of developing pneumonia, as it keeps the dirty mucus in your lungs and airways.

Home Remedies for Congestion

Outside of medications, there are other home remedies you can try to clear up your chest congestion. 

• Stay hydrated. Mucus is 90% water and can get thicker when you’re dehydrated.
• Use a humidifier, face steamer, or vaporizer.
• Soothe your face with a warm, moist washcloth or breathe in with your face over a bowl of hot water.
• Try deep breathing and positional exercises.
• Try rinsing your sinuses with a nasal irrigation device or nasal spray.
• Prop yourself up when sleeping or lying down.

Breathing Exercises

Breathing exercises use your breath to strengthen your lungs and help you expel mucus. Here are a few to try.

Deep Breathing Exercise 

This exercise will expand your lungs and help clear mucus from them. You can be lying down or sitting up to do this exercise, just keep your chest and shoulders relaxed in a comfortable position:

1. Place one hand on your upper belly and the other on your chest to feel your breathing movements.
2. Breathe in deeply through your nose and feel your belly expand outward.
3. Breathe out slowly through pursed lips, emptying your lungs and sucking in your belly.
4. Repeat slowly three to five times, multiple times a day.

Breath Stacking Exercise

This exercise can help expand your lungs, keep your muscles moving and flexible, and help strengthen your cough to clear mucus.

You can do this exercise multiple times a day, but make sure you’ve waited at least an hour after eating or drinking, and stop if you experience pain:

1. Push all the breath out of your body.
2. Take in a small breath and hold until you need more air.
3. Take another small breath without breathing out.
4. Repeat small breaths in without exhaling until you can’t breathe in anymore.
5. Hold this breath for up to five seconds.
6. Breathe all of the air out of your lungs forcefully.

Postural Exercises

Postural exercises use gravity to help move mucus out of your lungs. Back lying and side lying are two that are often recommended.

Before doing postural or positioning exercises, wait at least an hour after meals. Stop if you’re feeling sick or if the position is aggravating your heartburn.

Back Lying Exercise

1. Lie down on your back.
2. Keep your head flat and bend your knees.
3. Prop your hips up with pillows so they’re higher than your chest.
4. Hold this position for at least five minutes.
5. Try taking some deep breaths if you feel up to it.
   

Side Lying Exercise

1. Lie down on your side.
2. Keep your head flat, supporting it with your hands as needed.
3. Prop up your hips with a pillow to be higher than your chest.
4. Hold this position for at least five minutes.
5. Take deep breaths if you can.
6. Repeat lying on your other side.
   

Summary

People with COVID-19 and other respiratory infections may experience a cough with mucus as a symptom of their illness. Phlegm is mucus produced within the respiratory tract.

Your doctor may recommend over-the-counter or home remedies or prescription medication to make you more comfortable and help you clear your lungs. Breathing exercises may also be beneficial.

A Word From Verywell

Estimates suggest that about 10% of those infected with SARS-CoV-2 become long-haul COVID-19 patients. One of the common symptoms of long COVID-19 is a cough. You’re no longer contagious when you test negative for the virus, but having symptoms long after the infection has waned (sometimes weeks or months) is difficult to live with.

Talk to your doctor about how you can treat your long COVID-19 symptoms. If they dismiss your worries, consider seeking a second opinion or looking for local hospitals that have set up research centers for long COVID-19 patients. Experts are still learning about this new complication of COVID-19 and why it happens.

The information in this article is current as of the date listed. As new research becomes available, we’ll update this article. For the latest on COVID-19, visit our coronavirus news page.