Pulmonology focuses on diagnosing and treating lung and airway conditions such as asthma, COPD, and pneumonia, as well as overall respiratory health.

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Common Cold: Symptoms and Risk Factors

The symptoms of a common cold usually follow a set pattern, but each person’s experience can be different. Symptoms often start one to three days after catching the virus, usually with a sore or scratchy throat. Next, people often get a stuffy or runny nose. A cough may develop as the cold goes on. Most people feel only mildly unwell, but it can still affect daily life. At Liv Hospital, we make sure to tell the difference between cold symptoms and those of allergies or sinus infections when we assess patients.

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The Nasal Phase

PULMONOLOGY

The nasal symptoms are the most prominent and bothersome features of the common cold. They evolve through distinct stages as the immune response matures.

  • Rhinorrhea: Initially, the nasal discharge is clear and watery. This is due to the increased permeability of the blood vessels and glandular secretion.
  • Nasal Congestion: The swelling of the nasal turbinates obstructs the airflow, leading to a sensation of stuffiness. This is caused by vasodilation and edema in the nasal mucosa.
  • Thickening of Discharge: Over a few days, nasal mucus typically thickens and may turn yellow or green. This color change is due to the presence of leukocytes (white blood cells) and does not necessarily indicate a bacterial infection.
  • Sneezing: Irritation of the nasal lining triggers the sneeze reflex, which expels the irritant but also aerosolizes the virus.
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Throat and Laryngeal Symptoms

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Throat discomfort is often the sentinel symptom signaling the start of a cold.

  • Sore Throat: This is caused by direct viral invasion of the pharyngeal epithelium and the subsequent release of inflammatory mediators, such as bradykinin. It is usually described as scratchy or raw rather than the severe, sharp pain associated with strep throat.
  • Hoarseness: If the inflammation extends to the larynx (voice box), it can cause laryngitis. The vocal cords become swollen, altering their vibration and leading to a raspy or hoarse voice.
  • Cough: A cough often develops as the nasal symptoms begin to subside. It can be triggered by post-nasal drip irritating the throat or by upper airway inflammation, increasing the sensitivity of the cough reflex. The cough is usually non-productive initially but may become productive later in the course.

Systemic Manifestations

Although the common cold mainly affects the nose and throat, it can also cause general symptoms throughout the body because of the immune response.

  • Low-Grade Fever: Fever is relatively uncommon in adults with a cold, but it is frequently seen in infants and young children. It is usually mild and resolves quickly.
  • Malaise and Fatigue: A general feeling of being unwell and tired is familiar. This is due to the energy expenditure required by the immune system to fight the infection.
  • Myalgia: Mild muscle aches may occur, although severe body aches are more indicative of influenza.
  • Headache: Headaches can result from sinus pressure due to congestion or from systemic effects of cytokines.
PULMONOLOGY

Risk Factors: Age and Immunity

Age is the biggest factor in how likely someone is to catch a cold. Children are the main group who carry and spread these viruses.

  • Pediatric Susceptibility: Children under six years of age are at the highest risk, averaging six to eight colds per year. This is due to their developing immune systems, which have not yet built up resistance to the many viruses circulating, and to their close contact with other children in daycare or school settings.
  • Adult Immunity: As individuals age, they develop immunity to many of the cold viruses they have encountered. Consequently, adults typically experience fewer colds, averaging two to three per year.
  • Immunosenescence: In the elderly, while the frequency of colds may not increase, the severity and risk of complications, such as pneumonia, can be higher due to an aging immune system.

Environmental and Lifestyle Factors

Different outside factors can make it more likely for someone to catch a cold or have worse symptoms.

  • Smoking: Smokers are more likely to catch colds and have more severe symptoms than non-smokers. Smoke damages the cilia in the respiratory tract, impairing the clearance of viruses and mucus.
  • Chronic Stress: Long-term psychological stress elevates cortisol levels, which can suppress the immune system and lower resistance to infection.
  • Sleep Deprivation: Insufficient sleep impairs immune function, making individuals more susceptible to viruses upon exposure.
  • Sedentary Lifestyle: Moderate regular exercise boosts immune function, while a sedentary lifestyle may leave the body less prepared to defend against pathogens.

Comorbidities and Chronic Conditions

Individuals with pre-existing health conditions face unique risks when contracting a common cold.

  • Asthma and COPD: For people with chronic respiratory diseases, a cold is a significant trigger for exacerbations. The viral inflammation can cause airway constriction and increased mucus production, leading to severe breathing difficulties.
  • Immunocompromise: Patients with weakened immune systems due to chemotherapy, HIV, or immunosuppressive medications may experience prolonged viral shedding and a higher risk of the infection spreading to the lower respiratory tract.
  • Structural Abnormalities: Conditions like a deviated septum or nasal polyps can impair sinus drainage during a cold, increasing the risk of secondary bacterial sinusitis.

Seasonal and Climatic Variables

The environment also affects how likely someone is to get a cold.

  • Humidity: Low indoor humidity, common in winter due to heating systems, dries out the nasal mucous membranes. This compromises mucociliary clearance, allowing viruses to adhere more readily.
  • Crowding: The increased time spent indoors in crowded, poorly ventilated spaces during cold weather facilitates the rapid transmission of airborne droplets.
  • Vitamin D Deficiency: Reduced sunlight exposure in winter can lead to lower Vitamin D levels, which play a role in immune regulation, potentially increasing susceptibility.

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Assoc. Prof. MD. Engin Aynacı Assoc. Prof. MD. Engin Aynacı Pulmonology Overview and Definition
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FREQUENTLY ASKED QUESTIONS

Why does my nose run when I have a cold?

Your nose runs because the virus causes inflammation of the nasal lining, leading to swelling and increased fluid production to help flush the virus out.

In adults, a fever is rare and usually mild; however, in babies and young children, it is a common symptom of a cold.

Green mucus indicates that white blood cells have rushed to the area to fight the infection; enzymes released by these cells cause the color change, not necessarily bacteria.

Yes, chronic stress releases hormones that can suppress your immune system, making you more vulnerable to viral infections if you’re exposed.

Children have not yet built up immunity to the hundreds of different cold viruses, and they are frequently in close contact with other children who are carriers.

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