A previously healthy 4-year-old female presented for a cough that was not responsive to treatment of inhaled corticosteroid (ICS). Pertinent history included meconium aspiration with no respiratory support required and a course of confirmed SARS-CoV-2 with fever and mild respiratory symptoms of a cough, that resolved in 2-3 weeks. Child was seen in Allergy clinic 2 months before first Pulmonary clinic appointment with a compliant of cough that redeveloped. Cough was dry, associated with strenuous activity, and noticeably present at night. She was started on albuterol 2 puffs every 4 hours, as needed.