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

Hwa Young Lee¹, Youngsoo Lee², Ji-Hyang Lee^{3

4}, Seung-Eun Lee⁵, Da Woon Sim⁶, Noeul Kang⁷, Joo-Hee Kim⁸, Sung-Yoon Kang⁹, Kyoung-Hee Sohn¹⁰, Young Hee Nam¹¹, Sujeong Kim¹², Chan Sun Park¹³, So Ri Kim¹⁴, Jin An¹⁵, Byung-Keun Kim¹⁶, Hyun Jung Jin¹⁷, So-Young Park¹⁸, Byung-Jae Lee⁷, Sook Young Lee¹, Hae-Sim Park², You Sook Cho³, Sang-Heon Kim¹⁹, Woo-Jung Song²⁰; KoSAR investigators

Affiliations

¹ Division of Allergy, Department of Internal Medicine, Seoul St Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea.
² Department of Allergy and Clinical Immunology, Ajou University School of Medicine, Suwon, Korea.
³ Department of Allergy and Clinical Immunology, Asan Medical Center, University of Ulsan College of Medicine, 88, Olympic-Ro 43-Gil, Songpa-Gu, Seoul, 05505, Korea.
⁴ Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea.
⁵ Department of Internal Medicine, Pusan National University Yangsan Hospital, Yangsan, Korea.
⁶ Department of Allergy and Clinical Immunology, Chonnam National University Hospital, Chonnam National University Medical School, Gwangju, Korea.
⁷ Division of Allergy, Department of Medicine, Samsung Medical Center, Sungkyunkwan University College of Medicine, Seoul, Korea.
⁸ Department of Internal Medicine, Hallym University College of Medicine, Anyang, Korea.
⁹ Department of Internal Medicine, Gachon University Gil Medical Center, Incheon, Korea.
¹⁰ Division of Pulmonology and Allergy, Department of Internal Medicine, Kyung Hee University School of Medicine, Seoul, Korea.
¹¹ Department of Internal Medicine, Dong-A University College of Medicine, Busan, Korea.
¹² Department of Internal Medicine, Kyungpook National University School of Medicine, Daegu, Korea.
¹³ Department of Internal Medicine, Inje University Haeundae Paik Hospital, Busan, Korea.
¹⁴ Division of Respiratory Medicine and Allergy, Department of Internal Medicine, Chonbuk National University Medical School, Jeonju, Korea.
¹⁵ Department of Pulmonary, Allergy and Critical Care Medicine, Kyung Hee University Hospital at Gangdong, College of Medicine, Kyung Hee University, Seoul, Korea.
¹⁶ Division of Pulmonology, Allergy and Critical Care Medicine, Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea.
¹⁷ Division of Pulmonology and Allergy, Department of Internal Medicine, Yeungnam University Medical Center, College of Medicine, Yeungnam University, Daegu, Korea.
¹⁸ Department of Internal Medicine, Chung-Ang University College of Medicine, Gwangmyeong, Korea.
¹⁹ Division of Pulmonary Medicine and Allergy, Department of Internal Medicine, Hanyang University College of Medicine, Seoul, Korea.
²⁰ Department of Allergy and Clinical Immunology, Asan Medical Center, University of Ulsan College of Medicine, 88, Olympic-Ro 43-Gil, Songpa-Gu, Seoul, 05505, Korea. swj0126@amc.seoul.kr.

PMID: 38847887
DOI: 10.1007/s00408-024-00710-5

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

Hwa Young Lee et al. Lung. 2024 Aug.

. 2024 Aug;202(4):405-414.

doi: 10.1007/s00408-024-00710-5. Epub 2024 Jun 7.

Authors

Affiliations

¹ Division of Allergy, Department of Internal Medicine, Seoul St Mary's Hospital, College of Medicine, The Catholic University of Korea, Seoul, Korea.
² Department of Allergy and Clinical Immunology, Ajou University School of Medicine, Suwon, Korea.
³ Department of Allergy and Clinical Immunology, Asan Medical Center, University of Ulsan College of Medicine, 88, Olympic-Ro 43-Gil, Songpa-Gu, Seoul, 05505, Korea.
⁴ Department of Internal Medicine, Seoul National University College of Medicine, Seoul, Korea.
⁵ Department of Internal Medicine, Pusan National University Yangsan Hospital, Yangsan, Korea.
⁶ Department of Allergy and Clinical Immunology, Chonnam National University Hospital, Chonnam National University Medical School, Gwangju, Korea.
⁷ Division of Allergy, Department of Medicine, Samsung Medical Center, Sungkyunkwan University College of Medicine, Seoul, Korea.
⁸ Department of Internal Medicine, Hallym University College of Medicine, Anyang, Korea.
⁹ Department of Internal Medicine, Gachon University Gil Medical Center, Incheon, Korea.
¹⁰ Division of Pulmonology and Allergy, Department of Internal Medicine, Kyung Hee University School of Medicine, Seoul, Korea.
¹¹ Department of Internal Medicine, Dong-A University College of Medicine, Busan, Korea.
¹² Department of Internal Medicine, Kyungpook National University School of Medicine, Daegu, Korea.
¹³ Department of Internal Medicine, Inje University Haeundae Paik Hospital, Busan, Korea.
¹⁴ Division of Respiratory Medicine and Allergy, Department of Internal Medicine, Chonbuk National University Medical School, Jeonju, Korea.
¹⁵ Department of Pulmonary, Allergy and Critical Care Medicine, Kyung Hee University Hospital at Gangdong, College of Medicine, Kyung Hee University, Seoul, Korea.
¹⁶ Division of Pulmonology, Allergy and Critical Care Medicine, Department of Internal Medicine, Korea University College of Medicine, Seoul, Korea.
¹⁷ Division of Pulmonology and Allergy, Department of Internal Medicine, Yeungnam University Medical Center, College of Medicine, Yeungnam University, Daegu, Korea.
¹⁸ Department of Internal Medicine, Chung-Ang University College of Medicine, Gwangmyeong, Korea.
¹⁹ Division of Pulmonary Medicine and Allergy, Department of Internal Medicine, Hanyang University College of Medicine, Seoul, Korea.
²⁰ Department of Allergy and Clinical Immunology, Asan Medical Center, University of Ulsan College of Medicine, 88, Olympic-Ro 43-Gil, Songpa-Gu, Seoul, 05505, Korea. swj0126@amc.seoul.kr.

PMID: 38847887
DOI: 10.1007/s00408-024-00710-5

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.

PubMed Disclaimer

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

Publication types

Actions

MeSH terms

Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions
Actions

Grants and funding

LinkOut - more resources

Full Text Sources
- Springer
Medical
- MedlinePlus Consumer Health Information
- MedlinePlus Health Information
Miscellaneous
- NCI CPTAC Assay Portal

Save citation to file

Email citation

Add to Collections

Add to My Bibliography

Your saved search

Create a file for external citation management software

Your RSS Feed

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

Affiliations

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

Authors

Affiliations

Abstract

References

Publication types

MeSH terms

Grants and funding

LinkOut - more resources

Full Text Sources

Medical

Miscellaneous