viral cold



OVERVIEW

Definition

A viral cold is a common cold caused by a viral infection.

It mainly causes discomfort in the upper respiratory tract, manifested by nasal congestion, runny nose, sneezing, cough, dry throat and sore throat. It may also be accompanied by systemic symptoms such as fever.

Incidence

Viral colds can occur throughout the year, but are more common in winter and spring.

Most of them are distributed, and can cause local or widespread epidemic when the temperature changes suddenly.

Transmission is mainly through droplet transmission of the virus, but also through contact with contaminated hands and utensils.

The pathogen can be transmitted from person to person, and is most contagious from 24 hours before to 2 days after the onset of the disease.

The disease can occur in people of any age, gender, occupation and region.

People who are weak, immunocompromised or have chronic respiratory diseases (e.g. sinusitis, tonsillitis) are more likely to develop the disease.

Rain, cold, sudden changes in climate, overwork, etc. can reduce the local defense function of the respiratory tract, which can easily trigger the disease.

Causes

Causes

Viral colds are caused by viral infections.

Common viruses include rhinovirus, coronavirus, adenovirus, influenza virus, respiratory syncytial virus, echovirus and coxsackievirus.

Pathogenesis

Viral infection is the direct external factor that causes viral colds.

Rain, cold, sudden climate change, and overwork can lead to a decrease in the local defense function of the respiratory tract, making it more susceptible to infection.

After the virus infects the mucosal cells of the upper respiratory tract, it replicates within the cells and damages the cells, leading to congestion and increased secretion of the mucosa of the upper respiratory tract, as well as the release of inflammatory factors into the bloodstream, resulting in the appearance of the corresponding symptoms.

Symptoms

Main Symptoms

The onset of viral cold is rapid.

The main manifestations are upper respiratory tract symptoms, such as sneezing, nasal congestion, and watery nasal discharge.

Discomfort such as cough, dry, itchy or burning throat, or even postnasal drip sensation may occur.

After 2 to 3 days, the nasal mucus becomes thicker and may be accompanied by sore throat, headache, tearing, dullness of taste, dyspnea in severe cases, hoarseness, and sometimes hearing loss.

More severe patients have systemic symptoms, including fever, chills, and malaise.

Other symptoms

Some patients have predominantly gastrointestinal symptoms such as nausea, vomiting and diarrhea, known as gastrointestinal type.

Complications

Otitis media, sinusitis

If the lesion spreads to the neighboring organs and tissues, it can cause otitis media, which is common in infants and children, and can be manifested as hearing loss, tinnitus, etc. Repeated infections can easily lead to sinusitis, with symptoms such as nasal congestion, runny nose, impaired sense of smell, and nosebleed.

Tracheobronchitis, Pneumonia

Rarely, if the infection spreads downward, it can lead to viral tracheobronchitis, viral pneumonia, etc. Elderly people, children under 2 years old or patients with chronic underlying diseases are prone to it, which can be manifested as coughing, coughing up sputum and fever.

Secondary bacterial infection

Patients with decreased resistance may have secondary bacterial infections, especially in children and the elderly. Cold symptoms worsen or persist without relief.

Viral myocarditis

A small number of patients may have myocardial damage and develop viral myocarditis, which may manifest as chest tightness, chest pain, palpitation, weakness, nausea and dizziness.

Others

Occasionally, other pathologic immune defenses and autoimmune disorders associated with viral infection may occur, such as viral encephalitis and Guillain-Barré syndrome.

Consultation

Department of Medicine

Respiratory medicine

Prompt medical consultation is recommended for adults or older children with symptoms such as nasal congestion, runny nose, pharyngeal discomfort, cough, and fever.

Pediatrics

Infants and young children are advised to consult the doctor when they develop high fever, irritability, refusal of milk or spitting up.

Preparation

Consultation: registration, preparation of documents, common problems

Tips

Avoid taking fever-reducing medication or antibiotics by yourself before going to the doctor, so as not to influence the doctor’s judgment of the condition. For patients with fever, physical cooling can be used first, such as applying cold compresses to the forehead and wiping the hands, feet and armpits with lukewarm water.

Chest X-rays or chest CTs are often needed, so avoid wearing clothing made of metal. Those who are pregnant or planning to become pregnant should inform the doctor.

Preparation Checklist

Pay particular attention to the time of onset of symptoms and special manifestations.

Is there fever? What is the highest degree?

Is there a cough? How long has the cough lasted?

Is there any sputum? What kind of phlegm?

Is there nasal congestion or runny nose?

How long have the symptoms been present?

Have you had a cold or been overworked recently?

Have you been in close contact with anyone with a viral cold?

Test results in the last 6 months to bring to the doctor

Laboratory tests: blood test and C-reactive protein

Imaging tests: Chest X-ray, CT scan of chest

Medication in the last 3 months, if available in boxes or packages, bring with you to the doctor’s office

Antivirals: ribavirin, acyclovir, oseltamivir

Antipyretics: ibuprofen, acetaminophen

Nasal decongestants: pseudoephedrine drops

Cough expectorants: Ambroxol, Dextromethorphan

Diagnosis

Diagnosis is based on

A clinical diagnosis can be made based on the patient’s history, epidemiologic profile, clinical presentation, and laboratory and chest X-ray findings.

Medical history

There may be a history of close contact with patients with upper respiratory tract infections.

Onset of the disease may occur after overexertion, exposure to cold, rain, or sudden drop in temperature.

Clinical manifestations

Sneezing, nasal congestion, watery nasal discharge, cough, fever, headache and other symptoms.

Physical examination mostly shows nasal mucosa congestion, edema, secretion, pharyngeal congestion.

In some patients, enlarged submandibular and cervical lymph nodes can be palpated, accompanied by pressure pain.

Laboratory examination

A normal or low white blood cell count and an elevated lymphocyte ratio may be found.

In combination with bacterial infection, there may be an increase in the total number of white blood cells and the proportion of neutrophils and a leftward shift of the nucleus.

C-reactive protein reflects the degree of inflammation and severity of the infection.

The higher the C-reactive protein, the more severe the inflammatory response.

Calcitoninogen test can be used to differentiate viral infections from bacterial infections.

Typically, calcitonin is not elevated in viral infections and is elevated in bacterial infections.

Imaging

Chest X-ray/CT examination: it can reflect the involvement of the lungs, and the involvement of the lungs by infection can be seen as signs of solid lesions such as increased lung texture, infiltrating nodules or lamellar shadows.

Differential diagnosis

allergic rhinitis

Similarities: continuous sneezing, itchy nose, nasal congestion, and copious runny nose.

Differences: Allergic rhinitis can occur every time, every day, while viral colds have a process of recovery and are usually most frequent monthly. At the same time, allergic rhinitis has no fever and less cough. If the allergens are removed, the symptoms disappear within minutes to 1-2 hours.

Acute tracheobronchitis

Similarities: Fever and cough are common.

Differences: Acute trachea-bronchitis has mild nasal symptoms, cough and sputum, and X-ray chest radiographs may be normal or may show increased lung texture and coarsening. Identified by laboratory tests, such as routine blood tests and bacterial culture of secretions.

Cough variant asthma

Similarities: Both may present with coughing symptoms.

Differences: Cough variant asthma has the characteristics of bronchial asthma, with coughing episodes related to irritants. The duration of the disease is more than 3 months, and the cough is obvious at night or in the early morning, with occasional chest tightness and shortness of breath. No fever, dry throat, sore throat and other symptoms, inhalation of bronchodilators can quickly relieve symptoms, can be identified.

Other acute respiratory infectious disease prodromal symptoms

Similarities: Fever, cough, nasal congestion, runny nose and other symptoms may occur.

Differences: Influenza, pneumonia, measles, mumps, chickenpox, scarlet fever and other diseases can have similar symptoms at the beginning of viral influenza, but there is a clear aggregation of the onset of the disease. Epidemiological history and the characteristic manifestations of the disease are the main basis of differential diagnosis, and the confirmation of the diagnosis relies on the pathogenicity of viral nucleic acid and other tests.

Treatment

Aims of treatment

Improve symptoms and prevent secondary bacterial infection.

Treatment method

General treatment

Isolation: isolate suspected and confirmed patients and avoid close contact with others as much as possible.

Rest: Patients with fever, serious condition or old and weak patients should rest in bed, avoid exertion and reduce strenuous exercise.

Reasonable diet: Take in light and easy-to-digest food and drink plenty of water.

Keep indoor air circulation, prevent cold.

Medication

Suitable for people with symptoms such as headache, fever and muscle pain around the body.

Acetaminophen, aspirin, ibuprofen, etc. are available. Aspirin is contraindicated in children to prevent Reye’s syndrome. Aspirin is contraindicated in patients with a history of asthma to avoid triggering an acute asthma attack.

Common adverse reactions include gastrointestinal irritation.

For patients with symptoms such as frequent sneezing and profuse runny nose.

It can be used as second-generation antihistamine loratadine or first-generation antihistamine chlorpheniramine maleate.

It is suitable for patients with more obvious coughing symptoms, which seriously affects work and sleep, or some of the sputum is sticky and not easy to cough out.

Dextromethorphan, Pentoxyverine, Cough Capsules, Cough Syrup, Carbocistein, Myrtle Oil, etc. can be chosen.

Drugs can be given orally and by nebulized inhalation. Nebulized inhalation is through the mouth, nose and other inhalation containing liquid aerosol, so that the drug directly on the throat, trachea mucosa, play the role of cough suppression, phlegm and other therapeutic methods.

Applicable to nasal mucosa congestion, edema, severe nasal congestion affecting breathing, sleep.

Pseudoephedrine hydrochloride and other drugs can be selected for nasal drops.

Avoid prolonged application, easy to cause nasal mucosa atrophy.

Patients with no fever and normal immune function need not apply antiviral drugs. Patients with immunodeficiency can use antiviral drugs early.

Ribavirin and other antiviral drugs can be used as appropriate, and oseltamivir, zanamivir and paramivir can be applied for clear influenza virus infection.

Chinese medicines such as Banlangen Chongtian and Lianhua Qingdian capsule need to be used as prescribed by the doctor.

It is suitable for patients with bacterial infections such as elevated white blood cells, pus and moss in the pharynx, and coughing up yellow sputum.

Oral penicillins, first and second generation cephalosporins, macrolides or quinolones can be used.

Quinolone antimicrobials are contraindicated under 18 years of age.

Physiotherapy

Physical therapy utilizes heat to promote vasodilatation, increase blood circulation, and promote the absorption of inflammation.

It is suitable for patients with upper respiratory tract infection complicated by tracheobronchitis and pneumonia during the recovery period. It can promote physical recovery.

Often choose ultrashort wave therapy, magnetic therapy and other methods.

Chinese medicine treatment

According to the diagnosis and treatment to take Chinese medicine treatment.

May choose ephedra soup, gui zhi soup, small blue dragon soup, big blue dragon soup and so on.

Prognosis

Cure

Most patients can be cured by themselves.

Effective treatment can reduce the symptoms and improve the quality of life.

Harmfulness

It is contagious: viral infection can be spread by droplets, which can easily cause small-scale aggregation of disease. Influenza can cause a large-scale epidemic.

Trigger the aggravation of existing diseases: patients with underlying diseases such as chronic obstructive pulmonary disease and asthma, bronchial dilatation, nephritis, etc., can trigger acute exacerbation. Patients with cardiac insufficiency may experience exacerbation of heart failure.

Reduce the quality of life: nasal congestion and cough can affect work and life when it is severe.

Daily

Daily management

Dietary management

Choose a diet high in protein, vitamins, low fat, salt and refined carbohydrates, avoid spicy and allergy-prone foods, and drink plenty of water.

High protein: Choose foods such as eggs, milk, beans, fish and poultry, and lean meat.

High vitamin: such as whole grains (e.g. oats, millet), fresh green leafy vegetables and fruits.

Low fat: avoid fried and deep-fried foods, and no more than one palmful of nuts per day.

Low salt: consume about a fingernail-sized amount of salt per day, and avoid eating seasonings and pickled foods such as dashi and soy sauce.

Low refined carbohydrate diet: control the intake of white rice and white flour.

Avoid spices and stimuli; abstain from alcohol, strong tea and coffee; avoid raw garlic, ginger, chili peppers and curry.

Drink plenty of water: Ensure adequate water intake daily.

Life management

Ensure sufficient sleep, avoid exertion and staying up late.

Rest mainly during the period of illness and avoid strenuous exercise.

Strictly quit smoking and avoid exposure to “second-hand smoke”.

Listen to soft music and read books to relieve emotions.

Others

If symptoms worsen or new symptoms appear, consult a doctor.

Prevention

Avoid contact with patients: Avoid contact with patients with upper respiratory tract infections when going out and avoid crowds.

Protect yourself: If you have to be in contact with people with upper respiratory tract infections, wear a mask and take personal precautions.

Improve living habits: Regular work and rest, avoiding triggering factors such as fatigue, bad mood and stress.

Maintain environmental hygiene and air circulation in the living room: open the windows and ventilate the room frequently.

Pay attention to cold and warmth: add clothes in time to avoid getting cold when the season or climate changes in fall and winter.

Improve dietary habits: Ensure balanced nutrition and reduce salt intake. Avoid strong tea, coffee and other beverages. Quit smoking and drinking.

Enhance physical fitness: Moderate exercise can be done according to your own situation, and it is recommended to do more aerobic exercise such as jogging, swimming, brisk walking, yoga, square dancing, etc. to improve physical fitness.

For patients with frequent and recurrent upper respiratory tract infections, immune preparations such as BCG, bacterial lysates, etc. can be applied as appropriate, and those with indications can be injected with respiratory polyvalent bacterial vaccine.

Maintain hand hygiene and wash hands frequently.