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PubMed2003

The common cold.

Despite great advances in medicine, the common cold continues to be a great burden on society in terms of human suffering and economic losses. Of the several viruses that cause the disease, the role of rhinoviruses is most prominent. About a quarter of all colds are still without proven cause, and the recent discovery of human metapneumovirus suggests that other viruses could remain undiscovered. Research into the inflammatory mechanisms of the common cold has elucidated the complexity of the virus-host relation. Increasing evidence is also available for the central role of viruses in predisposing to complications. New antivirals for the treatment of colds are being developed, but optimum use of these agents would require rapid detection of the specific virus causing the infection. Although vaccines against many respiratory viruses could also become available, the ultimate prevention of the common cold seems to remain a distant aim.

Adult↗
PubMed2006

Effect of vitamin C on common cold: randomized controlled trial.

OBJECTIVE: To investigate the relationship between the common cold and vitamin C supplementation. DESIGN: A double-blind, 5-year randomized controlled trial. SETTING: A village in Akita prefecture, one of the regions in Japan with the highest mortality from gastric cancer. SUBJECTS: Participants in annual screening programs for circulatory diseases conducted under the National Health and Welfare Services Law for the Aged, and diagnosed as having atrophic gastritis. Of the 439 eligible subjects, 144 and 161 were assigned to receive 50 or 500 mg of vitamin C, respectively, after protocol amendment. During the supplementation phase, 61 dropped out, and 244 completed the trial. INTERVENTION: Daily vitamin C supplementation of 50 mg (low-dose group) or 500 mg (high-dose group). RESULTS: Total number of common colds (per 1000 person-months) was 21.3 and 17.1 for the low- and high-dose groups, respectively. After adjustment for several factors, the relative risks (95% confidence interval (CI)) of suffering from a common cold three or more times during the survey period was 0.34 (0.12-0.97) for the high-dose group. No apparent reduction was seen for the severity and duration of the common cold. CONCLUSION: A randomized, controlled 5-year trial suggests that vitamin C supplementation significantly reduces the frequency of the common cold but had no apparent effect on the duration or severity of the common cold. However, considering several limitations due to protocol amendment, the findings should be interpreted with caution.

Adult↗
PubMed2001

Prolonged nasal eosinophilia in allergic patients after common cold.

BACKGROUND: Viral respiratory tract infections may cause both harmless common colds and severe asthma exacerbations; the differences in disease expression probably depend on the allergic status of the patient. To determine whether altered immunologic mechanisms underlie these differences, we investigated nasal inflammation during naturally acquired common cold. METHODS: In a group of 16 patients (eight allergic), nasal brush samples were taken, and nasal symptoms were recorded during common cold, 2 weeks later (convalescence), and at baseline (>4 weeks without nasal symptoms). Nasal brush cells were stained immunohistochemically for Langerhans cells, T cells, monocytes, neutrophils, B cells, macrophages, natural killer (NK) cells, mast cells, eosinophils, eotaxin, and RANTES. RESULTS: Four rhinovirus, four coronavirus, three RSV, one Mycoplasma pneumoniae, and one influenza A/enterovirus double infection were confirmed. Increased numbers of T cells, monocytes, macrophages, NK cells, eosinophils, and RANTES- and eotaxin-positive cells, but not neutrophils, were observed during common cold in allergic and nonallergic patients, and increased numbers of mast cells in allergic patients. Compared to nonallergic patients, in allergic patients eosinophil influx persisted into convalescence. CONCLUSION: Prolonged nasal eosinophil influx was observed in allergic patients after common cold. What immunologic factors can induce prolonged eosinophil influx and whether this may increase the risk of subsequent allergen-induced hypersensitivity reactions must be studied further.

Adult↗
PubMed1996

Zinc gluconate lozenges for treating the common cold. A randomized, double-blind, placebo-controlled study.

BACKGROUND: The common cold is one of the most frequent human illnesses and is responsible for substantial morbidity and economic loss. No consistently effective therapy for the common cold has been well documented, but evidence suggests that several possible mechanisms may make zinc an effective treatment. OBJECTIVE: To test the efficacy of zinc gluconate lozenges in reducing the duration of symptoms caused by the common cold. DESIGN: Randomized, double-blind, placebo-controlled study. SETTING: Outpatient department of a large tertiary care center. PATIENTS: 100 employees of the Cleveland Clinic who developed symptoms of the common cold within 24 hours before enrollment. INTERVENTION: Patients in the zinc group (n = 50) received lozenges (one lozenge every 2 hours while awake) containing 13.3 mg of zinc from zinc gluconate as long as they had cold symptoms. Patients in the placebo group (n = 50) received similarly administered lozenges that contained 5% calcium lactate pentahydrate instead of zinc gluconate. MAIN OUTCOME MEASURES: Subjective daily symptom scores for cough, headache, hoarseness, muscle ache, nasal drainage, nasal congestion, scratchy throat, sore throat, sneezing, and fever (assessed by oral temperature). RESULTS: The time to complete resolution of symptoms was significantly shorter in the zinc group than in the placebo group (median, 4.4 days compared with 7.6 days; P < 0.001). The zinc group had significantly fewer days with coughing (median, 2.0 days compared with 4.5 days; P = 0.04), headache (2.0 days and 3.0 days; P = 0.02), hoarseness (2.0 days and 3.0 days; P = 0.02), nasal congestion (4.0 days and 6.0 days; P = 0.002), nasal drainage (4.0 days and 7.0 days; P < 0.001), and sore throat (1.0 day and 3.0 days; P < 0.001). The groups did not differ significantly in the resolution of fever, muscle ache, scratchy throat, or sneezing. More patients in the zinc group than in the placebo group had side effects (90% compared with 62%; P < 0.001), nausea (20% compared with 4%; P = 0.02), and bad-taste reactions (80% compared with 30%; P < 0.001), CONCLUSION: Zinc gluconate in the form and dosage studied significantly reduced the duration of symptoms of the common cold. The mechanism of action of this substance in treating the common cold remains unknown. Individual patients must decide whether the possible beneficial effects of zinc gluconate on cold symptoms outweigh the possible adverse effects.

Administration, Oral↗
PubMed1994

Computed tomographic study of the common cold.

BACKGROUND: Colds are common, but the abnormalities they produce in the nasal passages and sinus cavities have not been well defined. METHODS: We studied healthy adult volunteers with self-diagnosed colds of 48 to 96 hours' duration and obtained the following data: information on symptoms, computed tomographic (CT) studies of the nasal passages and sinuses, mucosal-transport times, measures of nasal-airway resistance, and viral-culture studies. Thirty-one subjects (mean age, 24 years) had complete evaluations, including CT scans, which were read without knowledge of the clinical data. An additional 79 subjects underwent the same evaluations, except the CT scans. RESULTS: Of the 31 subjects with CT scans, 24 (77 percent) had occlusion of the ethmoid infundibulum; 27 (87 percent) had abnormalities of one or both maxillary-sinus cavities; 20 (65 percent) had abnormalities of the ethmoid sinuses; 10 (32 percent) had abnormalities of the frontal sinuses; and 12 (39 percent) had abnormalities of the sphenoid sinuses. Infraorbital air cells were present in 14 subjects (45 percent), and pneumatization of the middle turbinate (concha bullosa) was noted in 11 subjects (35 percent). Also common were engorged turbinates (in 7 subjects) and thickening of the walls of the nasal passages (in 13). After two weeks, the CT studies were repeated in 14 subjects, none of whom received antibiotics. In 11 of these subjects (79 percent) the abnormalities of the infundibula and sinuses had cleared or markedly improved. Nasal-airway resistance was abnormal in 29 (94 percent) and mucosal transport in 19 (61 percent) of the 31 subjects who had CT scans. Rhinovirus was detected in nasal secretions from 24 (27 percent) of 90 subjects. CONCLUSIONS: The common cold is associated with frequent and variable anatomical involvement of the upper airways, including occlusion and abnormalities in the sinus cavities.

Adult↗
PubMed1990

[Hardening against the common cold--is it possible?].

The common cold has great socio-economic impact. To date, no prophylaxis has been scientifically shown to be effective. A number of older reports implied that visits to the sauna and other thermotherapeutic measures might provide a certain degree of protection. More recent data suggest that this supposition is probably true. Nevertheless, there are a number of important questions still to be answered in this area.

Cold Climate↗
PubMed1991

Anencephaly and maternal common cold.

To study the risk of anencephaly related to common cold during pregnancy, a case-control study was made. The series comprised 393 Finnish mothers of anencephalic children and their time-area-matched controls in the period 1964 through 1982. Seventy mothers of anencephalic infants and 17 controls had reported common cold in the first trimester [adjusted odds ratio 4.5; 95% confidence interval (2.2-9.1)]. Reported common cold in the second trimester was not associated with anencephaly. As suggested by our previous cohort study in the same population, a true viral influenza resembling "common cold" might not explain the observed association.

Anencephaly↗
PubMed2003

Antihistamines for the common cold.

BACKGROUND: Although antihistamines are prescribed in large quantities for the common cold, there is little evidence to whether these drugs are effective. OBJECTIVES: To assess in patients with a common cold the effects of antihistamines in alleviating nasal symptoms, or in shortening of illness duration. SEARCH STRATEGY: We searched the Cochrane Acute Respiratory Infections Group Specialized Register and EMBASE up to December 2002; Cochrane Central Register of Controlled Trials (CENTRAL) and MEDLINE up to February 2003. We also followed up references in identified papers. We appealed for further articles at a major international conference on Acute Respiratory Infections (1997). We corresponded with experts and got in touch with pharmaceutical companies. SELECTION CRITERIA: Randomised, placebo-controlled trials on treatment of common cold with antihistamines, used either singly or in combination, in adults or children. DATA COLLECTION AND ANALYSIS: Data were extracted by two reviewers and authors were contacted for further data. Trials were subdivided into monotherapy and combination therapy. Data on general recovery, nasal obstruction, rhinorrhea, sneezing, and side-effects were extracted and summarized in a systematic review. MAIN RESULTS: We included thirty two papers describing 35 comparisons; 22 trials studied monotherapy, 13 trials a combination of antihistamines with other medication. A total of 8930 people suffering from the common cold were included. There were large differences in study designs, participants, interventions, and outcomes. There was no evidence of any clinically significant effect - in children or in adults - on general recovery of antihistamines in monotherapy. First generation - but not non-sedating - antihistamines have a small effect on rhinorrhea and sneezing. In trials with first generation antihistamines the incidence of side effects (especially sedation) is significantly higher with active treatment. Two trials, studying a combination of antihistamines with decongestives in small children, both failed to show any effect. Of the eleven trials on older children and adults, the majority show an effect on general recovery and on nasal symptom severity. REVIEWER'S CONCLUSIONS: Antihistamines in monotherapy - in children as well as in adults - do not alleviate to a clinical extend nasal congestion, rhinorrhoea and sneezing, or subjective improvement of the common cold. First generation antihistamines also cause more side-effects than placebo, in particular they increase sedation in cold sufferers. Combinations of antihistamines with decongestives are not effective in small children. In older children and adults most trials show a beneficial effect on general recovery as well as on nasal symptoms. It is however not clear whether these effects are clinically significant.

Common Cold↗
PubMed1997

Epidemiology, pathogenesis, and treatment of the common cold.

OBJECTIVE: Reading this article will reinforce the reader's knowledge of the pathogenesis of the common cold. The rationale for current and potential therapies for the common cold are reviewed in the context of current concepts of the pathogenesis of these illnesses. DATA SOURCES AND STUDY SELECTION: A MEDLINE literature search was done using the search terms common cold, rhinovirus, and viral respiratory infection. The search was restricted to the English language. Articles were selected for review if the title and/or abstract suggested the content was relevant to the subject of this review. The bibliographies of selected articles were used as a source of additional literature. RESULTS: Recent studies suggest that the host response to the virus is an important contributor to the pathogenesis of the common cold. Inflammatory mediators, especially the pro-inflammatory cytokines, appear to be an important component of this response and present an attractive target for new interventions for common cold therapies. Currently available treatments for the common cold have limited efficacy against specific symptoms. These therapies should be selected to treat the specific symptoms that are perceived to be the most bothersome by the patient.

Adult↗
PubMed2005

[Questionnaire survey of the relationship between the common cold and acute asthma exacerbation].

Using questionnaires for 281 healthy subjects and 139 asthmatic patients in 5 medical institutes, we investigated the relationship between the common cold and acute asthma. The frequency of the common cold, duration to recovery and absences from work were slightly higher in asthmatics than healthy subjects. Acute asthma occurred in a few days following common cold and subsided at the end of or after the common cold. Evaluation of the types of common cold revealed that the cold, which causes upper respiratory symptoms, frequently induced acute asthma. Bronchodilators seemed to be less effective for cold-induced asthma. Collectively, these results suggested that the common cold induces acute asthma not through virus-induced direct inflammatory responses but through indirect immunological responses. Through these questionnaires, we realized that it is important to prevent the common cold, a trigger of asthma attacks. As the guidelines of asthma therapy recommended, the use of corticosteroid must be considered when acute asthma attacks occur.

Acute Disease↗
PubMed2005

Association of leukocyte activation, but not the common cold, with restenosis after percutaneous coronary intervention in patients with angina pectoris.

We investigated the relationship between the common cold and restenosis after percutaneous coronary intervention (PCI) in Japanese patients with angina pectoris, because suffering from a common cold during the follow-up period after PCI may be involved in the development of restenosis. In addition, we measured the soluble (s) L-selectin level early after PCI in patients with and without restenosis. The study group included 104 effort angina pectoris patients. We examined whether or not they had had a common cold in the 6 months following angioplasty. Finally, 88 patients, whose common cold status was known, were selected as the study subjects. Twelve patients caught a common cold after PCI. All of these patients were given antibiotics and/or anti-inflammatory agents and recovered within 2 weeks. None had clinically detectable influenza infection. Thirty-three patients suffered from restenosis and 55 did not. There was no significant difference in the restenosis frequency between effort angina pectoris patients with and without a common cold. The sL-selectin level was significantly increased in patients with restenosis early after PCI, whereas in patients without restenosis, sL-selectin remained unchanged. These findings suggest that restenosis development after PCI in patients with effort angina pectoris may involve leukocyte activation early after PCI, while suffering from a common cold during the follow-up period after PCI has no effect.

Aged↗
PubMed1992

Vitamin C and the common cold.

The effect of vitamin C on the common cold has been the subject of several studies. These studies do not support a considerable decrease in the incidence of the common cold with supplemental vitamin C. However, vitamin C has consistently decreased the duration of cold episodes and the severity of symptoms. The benefits that have been observed in different studies show a large variation and, therefore, the clinical significance may not be clearly inferred from them. The biochemical explanation for the benefits may be based on the antioxidant property of vitamin C. In an infection, phagocytic leucocytes become activated and they produce oxidizing compounds which are released from the cell. By reacting with these oxidants, vitamin C may decrease the inflammatory effects caused by them. Scurvy, which is caused by a deficiency in vitamin C, is mostly attributed to the decreased synthesis of collagen. However, vitamin C also participates in several other reactions, such as the destruction of oxidizing substances. The common cold studies indicate that the amounts of vitamin C which safely protect from scurvy may still be too low to provide an efficient rate for other reactions, possibly antioxidant in nature, in infected people.

Antioxidants↗
PubMed1996

Effect of topical adrenergic decongestants on middle ear pressure in infants with common colds.

BACKGROUND: Otitis media is frequently a complication of the common cold. Obstruction of the eustachian tube ostia by nasopharyngeal edema has been suggested as a cause of this complication. OBJECTIVE: To determine the effect of a topical adrenergic decongestant on middle ear pressure in infants with common cold symptoms. METHODS: The study was conducted with a randomized, double blinded, placebo-controlled design. Middle ear pressure was determined in infants 6 to 18 months old who had common cold symptoms. Infants with abnormal middle ear pressure (< or = -100 mm H2O) in either ear were treated with intranasal phenylephrine drops or placebo. The effect of the treatment on middle ear pressure in ears with abnormal pressure at baseline was determined 1 h later. RESULTS: Twenty-three of 44 infants with abnormal middle ear pressures received intranasal phenylephrine drops and 21 received placebo. Middle ear pressure remained abnormal after treatment with phenylephrine in 29 of 33 (88%) ears and after treatment with placebo in 26 of 34 (76%). The mean change in middle ear pressure after treatment was +23 mm H2O in the active group and +40 mm H2O in the placebo group. CONCLUSIONS: Treatment of nasal obstruction with topical adrenergic decongestants does not improve abnormal middle ear pressures during the common cold.

Administration, Intranasal↗
PubMed2002

Intake of wine, beer, and spirits and the risk of clinical common cold.

To examine whether intakes of wine, beer, spirits, and total alcohol are associated with the risk of common cold, in 1998-1999 the authors analyzed data from a cohort study carried out in a population of 4,272 faculty and staff of five Spanish universities. Usual alcohol intake was assessed at baseline by means of a standardized frequency questionnaire that was validated in a random sample of the population. The authors detected 1,353 cases of common cold. Total alcohol intake and beer and spirits consumption were not related to the occurrence of common cold, whereas consumption of wine was inversely associated with the risk of common cold. When drinkers of >14 glasses of wine per week were compared with teetotalers, the relative risk was 0.6 (95% confidence interval: 0.4, 0.8) after adjustment for age, sex, and faculty/staff status. The association was stronger for red wine. These results remained unaltered after adjustment for total alcohol intake and for other potential risk factors for common cold. Findings suggest that wine intake, especially red wine, may have a protective effect against common cold. Beer, spirits, and total alcohol intakes do not seem to affect the incidence of common cold.

Alcohol Drinking↗
PubMed2006

Cough and the common cold: ACCP evidence-based clinical practice guidelines.

OBJECTIVE: To review the literature on cough and the common cold. METHODS: MEDLINE was searched through May 2004 for studies published in the English language since 1980 on human subjects using the medical subject heading terms "cough" and "common cold." Selected case series and prospective descriptive clinical trials were reviewed. Additional references from these studies that were pertinent to the topic were also reviewed. RESULTS: Based on extrapolation from epidemiologic data, the common cold is believed to be the single most common cause of acute cough. The most likely mechanism is the direct irritation of upper airway structures. It is also clear that viral infections of the upper respiratory tract that produce the common cold syndrome frequently produce a rhinosinusitis. In the setting of a cold, the presence of abnormalities seen on sinus roentgenograms or sinus CT scans are frequently due to the viral infection and are not diagnostic of bacterial sinus infection. CONCLUSION: Cough due to the common cold is probably the most common cause of acute cough. In a significant subset of patients with "postinfectious" cough, the etiology is probably an inflammatory response triggered by a viral upper respiratory infection (ie, the common cold). The resultant subacute or chronic cough can be considered to be due to an upper airway cough syndrome, previously referred to as postnasal drip syndrome. This process can be self-perpetuating unless interrupted with active treatment.

Acute Disease↗
PubMed1996

Day-night differences in mucosal plasma proteins in common cold.

Aggravation of symptoms in inflammatory airway diseases is common in the early morning hours, but little is known about day-night differences in the occurrence of plasma exudate on the airway surface. We have therefore examined the plasma macromolecules on the nasal mucosa at different time points. The study comprised 20 subjects who had been inoculated (day 0) with coronavirus intranasally. Ten subjects remained healthy and 10 developed common cold with significant symptoms from day 2 to day 6. Starting on day 3 at 8.00 h and repeated at 4 h intervals until 4.00 h on day 4, nasal lavages were carried out by employment of a nasal pool-device which fills the entire unilateral nasal cavity and gently but effectively irrigates its surface. Lavage fluid levels of albumin (Mw 69,000 D) and fibrinogen (Mw 340,000 D) were determined. In the healthy subjects the levels of albumin and fibrinogen remained low throughout the experiment, however, with mean peak values of the two proteins occurring at 4.00 h (p < 0.05 compared to daytime nadir at 16.00 h). In subjects with common cold both albumin (p < 0.05) and fibrinogen (p < 0.01) exhibited marked variation with individual and mean peak levels recorded at 8.00 h day 3, and 4.00 h day 4. These mean peak values were 5-20 times higher (p < 0.01 - p < 0.05) than the mean levels recorded in these subjects at the other time periods. The present data indicate a marked day-night difference in the occurrence of plasma proteins on the airway surface in common cold, whereas in health the difference is much less. We conclude that different-sized plasma proteins may accumulate on the mucosa in healthy airways during late night hours and that in common cold this nocturnal accumulation may be considerably increased.

Adult↗
PubMed2001

Efficacy of Echinacea purpurea in patients with a common cold. A placebo-controlled, randomised, double-blind clinical trial.

Common colds are one of the most frequent acute illnesses with major economical impact. Echinaceae purpureae herba (Echinacin, EC31J0) has shown promising results in the relief of common cold symptoms and the time taken to improvement compared to placebo. This study was aimed to confirm these findings by performing a randomised, double-blind, placebo-controlled clinical trial. A total of 80 adult male or female patients with first signs of a cold were recruited. The number of days of illness with a complete picture of the common cold (defined by the modified Jackson score of at least 5 points and experience of rhinorrhea and/or a subjective sensation of having a cold) was the primary end-point. In the verum group the median time of illness was 6.0 days compared to 9.0 days in the placebo group, assigning zero time for patients without a complete picture (one-sided p = 0.0112). EC31J0 was well tolerated and clinically effective in alleviating symptoms more rapidly than placebo in patients with a common cold.

Adult↗
PubMed2005

[Does common cold increase perioperative respiratory complications in adults?].

BACKGROUND: We investigated whether perioperative respiratory complications increase in adults with common cold symptom. METHODS: Thirty patients who had had a common cold (nasal congestion, rhinorrhea, sneeze, cough, sputa, or fever) in two weeks before general anesthesia and other 30 patients without any symptoms were enrolled in this study. All the patients were anesthetized with intravenous or inhalation anesthetics and were intubated. The incidences of bronchospasm, laryngospasm, dry or moist rale on lung field, increase in sputa or cough, and fever were checked during and for 5 days after, surgery. RESULTS: More patients with common cold showed dry or moist rale, increase in sputa or cough, and fever than those without common cold. Even though these were not statistically significant, three severe complications, respiratory as well as cardiac arrest, pneumonia, and prolonged intubation due to increased sputa, were observed. CONCLUSIONS: General anesthesia with oro-tracheal intubation should be postponed at least two weeks after common cold in adults.

Adult↗