Allergy Asthma Immunol Res.  2019 Sep;11(5):622-631. 10.4168/aair.2019.11.5.622.

Cough-Related Laryngeal Sensations and Triggers in Adults With Chronic Cough: Symptom Profile and Impact

Affiliations
  • 1Department of Allergy and Clinical Immunology, Airway Sensation and Cough Research Laboratory, Asan Medical Center, University of Ulsan College of Medicine, Seoul, Korea. swj0126@amc.seoul.kr
  • 2Department of Internal Medicine, Veterans Health Service Medical Center, Seoul, Korea.
  • 3Department of Internal Medicine, Gachon University Gil Medical Center, Incheon, Korea.
  • 4Department of Internal Medicine, Pusan National University School of Medicine, Pusan National University Hospital, Busan, Korea.
  • 5Department of Internal Medicine, Kangwon National University School of Medicine, Chuncheon, Korea.
  • 6Department of Internal Medicine, College of Medicine, Ewha Womans University, Seoul, Korea.
  • 7Department of Internal Medicine, Pusan National University Yangsan Hospital, Yangsan, Korea.
  • 8Department of Internal Medicine, Seoul National University Bundang Hospital, Seongnam, Korea.
  • 9Department of Internal Medicine, Hanyang University Hospital, Seoul, Korea.
  • 10Department of Internal Medicine, Eulji Hospital, Eulji University School of Medicine, Seoul, Korea.
  • 11Division of Allergy, Department of Medicine, Samsung Medical Center, Sungkyunkwan University School of Medicine, Seoul, Korea.
  • 12Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea.
  • 13Centre for Human & Applied Physiological Sciences, School of Basic & Medical Biosciences, Faculty of Life Sciences & Medicine, King's College London, London, UK.

Abstract

PURPOSE
Recent evidence suggests that cough hypersensitivity may be a common feature of chronic cough in adults. However, the clinical relevance remains unclear. This study evaluated the cough-related symptom profile and the clinical relevance and impact of cough hypersensitivity in adults with chronic cough.
METHODS
This cross-sectional multi-center study compared cough-related laryngeal sensations and cough triggers in patients with unexplained chronic cough following investigations and in unselected patients newly referred for chronic cough. A structured questionnaire was used to assess abnormal laryngeal sensations and cough triggers. Patients with unexplained cough were also evaluated using the Leicester Cough Questionnaire (LCQ) and a cough visual analogue scale (VAS), and these scores were assessed for correlations with the number of triggers and laryngeal sensations.
RESULTS
This study recruited 478 patients, including 62 with unexplained chronic cough and 416 with chronic cough. Most participants reported abnormal laryngeal sensations and cough triggers. Laryngeal sensations (4.4 ± 1.5 vs. 3.9 ± 1.9; P = 0.049) and cough triggers (6.9 ± 2.6 vs. 5.0 ± 2.8; P < 0.001) were more frequent in patients with unexplained chronic cough than in those with chronic cough. The number of triggers and laryngeal sensations score significantly correlated with LCQ (r = −0.51, P < 0.001) and cough VAS score (r = 0.53, P < 0.001) in patients with unexplained chronic cough.
CONCLUSIONS
Cough hypersensitivity may be a common feature in adult patients with chronic cough, especially those with unexplained chronic cough. Cough-related health status and cough severity were inversely associated with the number of triggers and laryngeal sensations, suggesting potential relevance of assessing cough hypersensitivity in chronic cough patients.

Keyword

Cough; hypersensitivity; symptom assessment

MeSH Terms

Adult*
Cough*
Humans
Hypersensitivity
Sensation*
Symptom Assessment
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