Multiple comorbidities, triggers associated with chronic cough
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Key takeaways:
- BMI was statistically significant for patients classified as having overweight, obesity or extreme obesity.
- Cigarette smoke was the most common trigger for patients with severe chronic cough.
WASHINGTON — Asthma was the most common comorbidity associated with chronic cough in the findings of a poster presented at the American Academy of Allergy, Asthma & Immunology Annual Meeting.
These comorbidities may make diagnosis of chronic cough difficult, Alisa Gnaensky, BS, a master’s student in biomedical sciences at the University of Manchester, and colleagues wrote.
“This poster was about a self-reported survey from patients about chronic cough,” Gnaensky told Healio.
The researchers administered the Leicester Cough Questionnaire to 150 adults (53% men; 32% women; 15% unknown sex; mean age, 60.5 ± 16.7 years; age range, 22-88 years) with chronic cough.
The median BMI was 28.7 kg/m2 for women and 27.7 kg/m2 for men. The researchers called BMI statistically significant for the 35 (23.3%) men and 55 (36.7%) women classified as having overweight (BMI 25 kg/m2 to 29.9 kg/m2), obesity (BMI 30 kg/m2 to 39.9 kg/m2) or extreme obesity (BMI 40 kg/m2).
After asthma, which 60 (40%) of the patients in the cohort reported, the most common comorbidities included gastroesophageal reflux disease (n = 57; 39.3%), allergic rhinitis (n = 56; 38%) and hypertension (n = 47; 33%). Sixteen of the respondents reported that they did not have any other comorbidities.
Respondents also reported multiple comorbidities, including both asthma and GERD (n = 29), asthma and allergic rhinitis (n = 38), allergic rhinitis and hypertension (n = 19) and hypertension and GERD (n = 28). Fourteen respondents said they had asthma, GERD, allergic rhinitis and hypertension all in addition to their chronic cough.
Twelve respondents said they used angiotensin-converting enzyme inhibitors for these comorbidities, and eight said they experienced improvements in their chronic cough after they had stopped taking this medication.
The most common environmental trigger for the respondents whose chronic cough was mild was perfume (13%; P = .006). Cold air was the most common environmental trigger for patients with moderate cough (15.6%; P = .007). The respondents with severe cough said that cigarette smoke was their most common trigger (19%; P = .05).
“The main factors that we found to be associated with severe chronic cough were female gender, high BMI, African American ethnicity, cold air and cigarette smoke,” Gnaensky said.
Respondents who were previous smokers reported improvements in their chronic cough symptoms and severity after they had ceased smoking as well, she continued.
This survey may provide insight for physicians treating these patients, Gnaensky said.
“Hopefully, this can increase diagnostic accuracy,” she said. “It puts them in the right direction to actually diagnose chronic cough, which has been really difficult to diagnose because it has such comorbidities.”
In addition to continued examination of factors such as BMI and gender as well as common triggers, Gnaensky said that she and her colleagues will continue to explore quality of life, family history, patient history and what patients believe they have as well in their research.
These results also may inform possible interventions, Gnaensky continued, particularly regarding triggers such as cold air and cigarette smoke. Specifically, the researchers said, novel therapies are needed to manage refractory and unexplained chronic cough, which they called difficult to treat.