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. 2024 Aug;202(4):405-414.
doi: 10.1007/s00408-024-00710-5. Epub 2024 Jun 7.

Association of Cough Severity with Asthma Control and Quality of Life in Patients with Severe Asthma

Hwa Young Lee  1 , Youngsoo Lee  2 , Ji-Hyang Lee  3   4 , Seung-Eun Lee  5 , Da Woon Sim  6 , Noeul Kang  7 , Joo-Hee Kim  8 , Sung-Yoon Kang  9 , Kyoung-Hee Sohn  10 , Young Hee Nam  11 , Sujeong Kim  12 , Chan Sun Park  13 , So Ri Kim  14 , Jin An  15 , Byung-Keun Kim  16 , Hyun Jung Jin  17 , So-Young Park  18 , Byung-Jae Lee  7 , Sook Young Lee  1 , Hae-Sim Park  2 , You Sook Cho  3 , Sang-Heon Kim  19 , Woo-Jung Song  20 ; KoSAR investigators
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Association of Cough Severity with Asthma Control and Quality of Life in Patients with Severe Asthma

Hwa Young Lee et al. Lung. 2024 Aug.

Abstract

Purpose: Symptoms are important components in determining asthma control and in the adjustment of treatment levels. However, clinical relevance of cough in severe asthma is not well-understood. This study aimed to evaluate the severity and association of cough with patient-reported outcomes (PROs) in patients with severe asthma.

Methods: This study analyzed cross-sectional data from the Korean Severe Asthma Registry. The severity of coughing and wheezing symptoms was assessed using a Visual Analog Scale (VAS) ranging from 0 to 100 for each symptom. Additionally, PROs included the Asthma Control Test (ACT), the Severe Asthma Questionnaire (SAQ), and the EuroQoL 5-Dimension (EQ-5D) index. Multivariate linear regression analysis was employed to explore the relationship between cough severity and other PRO scores.

Results: A total of 498 patients with severe asthma (age: 57.9 ± 13.1 years, females: 60.2%) were analyzed. The cough VAS score was higher than the wheeze score (median 30, [interquartile range 10-50] vs. 20 [0-50]; P < 0.001). Additionally, 22.5% of patients ranked in a higher tertile for cough severity compared to wheezing, while 18.5% ranked higher for wheezing severity than cough. Significant correlations were observed between cough and wheeze VAS scores (r = 0.61, P < 0.05) and between each symptom's VAS score and the SAQ (cough: r = -0.41, P < 0.001; wheeze: r = -0.52, P < 0.001), ACT scores (cough: r = -0.50, P < 0.001; wheeze: r = -0.63, P < 0.001) and EQ-5D index (cough: r = -0.40, P < 0.001; wheeze: r = -0.45, P < 0.001). In univariate regression analysis, the cough VAS score had weaker descriptive power (R2) values than the wheeze VAS score in relation to the PRO measures. Nevertheless, cough severity remained significantly associated with ACT, SAQ scores and EQ-5D index in multivariate analyses adjusted for wheeze severity and other confounders.

Conclusion: Cough frequently presents as a severe symptom in patients with severe asthma and could have distinct impact on asthma control and quality of life.

Keywords: Asthma; Cough; Patient reported outcome measures.

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    Dicpinigaitis PV. Dicpinigaitis PV. Lung. 2025 Jan 22;203(1):29. doi: 10.1007/s00408-025-00785-8. Lung. 2025. PMID: 39841240 No abstract available.

References

    1. Global initiative for Asthma: Global strategy for the diagnosis, management and prevention strategy document: Updated 2023. Available from: https://ginasthma.org/ , Assessed 02 Oct 2023.
    1. Song WJ, Lee JH, Kang Y, Joung WJ, Chung KF (2019) Future risks in patients with severe asthma. Allergy Asthma Immunol Res 11(6):763–778 - DOI - PubMed - PMC
    1. Louis G, Schleich F, Louis R, Guillaume M, Sousa-Pinto B, Bousquet J, Petre B (2023) How respiratory symptoms impact asthma-related quality of life in mild asthmatics. Respir Med 207:107098 - DOI - PubMed
    1. Martinez-Rivera C, Crespo A, Pinedo-Sierra C, Garcia-Rivero JL, Pallares-Sanmartin A, Marina-Malanda N, Pascual-Erquicia S, Padilla A, Mayoralas-Alises S, Plaza V, Lopez-Vina A, Picado C (2018) Mucus hypersecretion in asthma is associated with rhinosinusitis, polyps and exacerbations. Respir Med 135:22–28 - DOI - PubMed
    1. Louis G, Schleich F, Guillaume M, Kirkove D, Nekoee Zahrei H, Donneau AF, Henket M, Paulus V, Guissard F, Louis R, Petre B (2023) Development and validation of a predictive model combining patient-reported outcome measures, spirometry and exhaled nitric oxide fraction for asthma diagnosis. ERJ Open Res 9(1):00451-2022 - DOI - PubMed - PMC

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