I’m a sick boy, nigga, when I cough I hope you catch it
My germs in your system, now you coughin’ like asthmatic

from Childish Gambino – The Real Lyrics on Rap Genius

Meaning

When he raps, he hopes you hear/understand it and that his music spreads like a disease. Now his music is all you hear and you coughing it back up (singing it) spreading the disease

Sick Boi is also the name of his first EP and his clique.

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