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. These membranes produce mucus that trap irritants in the airways and help your body expel them through coughing.
Wet coughProductive coughChesty coughChest congestion
The COVID-19 infection can inflame 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 coughTrouble breathingChest 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). Dry cough can become a wet cough over time in the later stages of the illness.
When the COVID virus enters the lungs, inflammation leads to increased phlegm that collects in the airways. Depending on the individual, this phlegm could cause a more severe COVID case, including damaged lung tissue and secondary bacterial infection.
In severe COVID-19 cases, this could bring pneumonia, an infection in one or both of the lungs. This is usually what causes breathing difficulties in COVID-19 infections as the pneumonia causes swelling and fluid build-up in the lungs. It may require treatment in the hospital with oxygen or a ventilator to take over breathing.
With COVID, these severe cases can cause lasting lung damage and lingering cough or breathing difficulties that can take months to recover from.
Other common symptoms of COVID-19 include:
Some other cough-related symptoms that should prompt an evaluation include:
Consistent pain or pressure on the chest Coughing up blood Confusion Extreme sleepiness and inability to stay awake Pale, blue, or gray skin, lips, nail beds Cough lasts for more than three weeks A high fever over 104 degrees F
A fever or chills, night sweatsAches and pains, including headache and sore throatLosing the ability to taste and smellRunny noseDigestive issues, including diarrhea, nausea, and vomiting
Long COVID
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) can be difficult to live with.
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:
Place one hand on your upper belly and the other on your chest to feel your breathing movements. Breathe in deeply through your nose and feel your belly expand outward. Breathe out slowly through pursed lips, emptying your lungs and sucking in your belly. 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:
Push all the breath out of your body. Take in a small breath and hold until you need more air. Take another small breath without breathing out. Repeat small breaths in without exhaling until you can’t breathe in anymore. Hold this breath for up to five seconds. 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
Lie down on your back. Keep your head flat and bend your knees. Prop your hips up with pillows so they’re higher than your chest. Hold this position for at least five minutes. Try taking some deep breaths if you feel up to it.
Side Lying Exercise
Lie down on your side. Keep your head flat, supporting it with your hands as needed. Prop up your hips with a pillow to be higher than your chest. Hold this position for at least five minutes. Take deep breaths if you can. 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.
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.
