Lung Congestion and COVID

Roughly one-third of COVID patients have a productive cough with thick mucus

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While fever, fatigue, and a dry cough are the most common symptoms of a COVID-19 infection, you may also end up with a wet mucus-producing cough if you catch SARS-CoV-2. 

Dry coughs are a more common COVID-19 symptom, but about one-third of COVID patients cough up thick mucus and experience lung congestion. This may manifest as chest pressure or heaviness in the chest, a rattling sound or feeling when breathing, and globby mucus coming up when you’re coughing.

Your lungs and airways start to produce extra mucus to clear out infections when you catch a virus like SARS-CoV-2. A wet, productive cough is the body’s way of trying to clear this extra mucus out of the airways.

This article will provide a comprehensive overview of coughing up mucus with COVID. It will review what it means if you have a productive cough, as well as what medications, home remedies, and exercises you can use to clear lung congestion.

Congestion Treatment and Home Remedies for Covid-19

Verywell / Katie Kerpel

What Is Mucus? 

Mucus is the thick liquid that is produced by your airways to keep them clear and moist. It also serves as a protective barrier to keep germs out. It’s often called snot or phlegm. Mucus is important in keeping your body functioning and keeping germs from getting you sick.

Mucous membranes, the tissues that make mucus, are found in many places in the body. They line the respiratory tract, including your nose, throat, and lungs, and your digestive tract, including your mouth, esophagus, stomach, and intestines. They are also found in the female reproductive tract and the eyeballs.

In the respiratory system (mouth, nose, throat, and lungs), the mucus traps germs that you breathe in all day and helps the body get rid of them. Tiny hair-like projections called cilia on the mucous membranes move the dirty mucus up and out of the lungs.

Mucus is usually clear, but can be whitish, yellowish, or other colors. It can vary from thick like molasses to much thinner and runnier. It can change consistency, for example when infection or inflammation prompts the body to make thicker and stickier mucus to keep the infection from spreading and growing.

You usually swallow this dirty mucus without knowing. But when your body is trying to fight off an invading germ, your mucous membranes make even more of it. You end up coughing and sneezing with post-nasal drip and a runny nose as your body flushes the mucus and germs from your respiratory tract.

A wet cough, which brings up fluid, is also called a productive cough, a chesty cough, or chest congestion. A cough is defined as acute when it lasts less than three weeks, subacute when it lasts between three and eight weeks, and chronic if it lasts more than eight weeks.

When healthy, mucus is usually clear. If you have an infection, it may be white or yellow and cloudy with proteins and white blood cells released by the body as its fighting off germ invaders. There are even times it might have tinges of other colors.

These include:

  • Greenish mucus may signal a bacterial infection, though it’s not a definite signal. Your doctor should do further testing if they suspect a bacterial infection and want to prescribe antibiotics.
  • Mucus may have a pink color from a bit of blood if coughing or inflammation has damaged the sinuses or airways.
  • Brownish mucus may mean you’ve been playing in the dirt.
  • Black or dark brown mucus may occur if you’re a heavy smoker or have lung disease.

How COVID-19 Impacts Lungs

COVID-19 is the illness caused by the SARS-CoV-2 virus, which first appeared in China in November of 2019. 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 making it harder to breathe, the lungs have a harder time doing their job—getting oxygen to your body and removing waste.

The most common symptoms of COVID-19 include:

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

Various Symptoms

Symptoms of COVID-19 vary in patients. And some hints suggest that variants of COVID-19 seem to have slightly different symptoms than the original strain. Some doctors are saying that the Delta variant presents with more cold-like symptoms, including runny nose, headache, and sore throat.

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, and in severe cases it may require treatment in the hospital with oxygen or a ventilator to breathe for them.

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.

A dry cough is a more common symptom of COVID-19. Somewhere between 50% and 70% of patients with COVID-19 have a dry cough.

A wet, productive cough is less common but could make up about a quarter to a third of patients. It’s possible for a dry cough to become a wet cough over time. In patients with long-lasting COVID symptoms, a cough may be present months after infection.

When to See a Doctor

You’ll want to visit a health professional or clinic if you’re having trouble breathing. 

Some other cough-related symptoms to watch out for 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 F

Treatment

The mucus our bodies are producing while we’re sick has a purpose, but you’ll still probably want to try to get some of it moving while you’re still battling an infection. 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. These drugs work best for helping cough up chest congestion.

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 to Clear COVID Lungs

If you’re having trouble clearing mucus from your lungs after a respiratory infection, these exercises may help. There are two types of exercise here. 

The first two are breathing exercises that use your breath to strengthen your lungs and help you expel mucus. The second two are postural exercises that use gravity to help move mucus out of your lungs.

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.

Back Lying Exercise

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. 

This position can help expel mucus from the lungs using gravity:

  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

Wait at least an hour after meals before doing this exercise, and stop if you’re feeling sick or having heartburn. This exercise can help push mucus out of the lungs using gravity:

  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

Mucus is produced by mucous membranes in the respiratory tract and elsewhere. People with COVID-19 and other respiratory infections may have a wet cough in which they cough up mucus. 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 help.

A Word From Verywell

Cough is one of the symptoms that can persist in post-COVID syndrome (also known as long COVID). For some COVID-19 patients, their cough, fatigue, pain, and brain fog stay with them for weeks or even months after an initial COVID-19 infection.

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. We 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.

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