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. 2024 Oct 7;39(38):e273.
doi: 10.3346/jkms.2024.39.e273.

Sex Differences in Chronic Cough Epidemiology: The Korean Cough Study Group

Jiyeon Kang #  1 , Woo Jung Seo #  1 , Jieun Kang  1 , Jung Gon Kim  2 , Sung Jun Chung  1 , Hyung Koo Kang  1 , Sung-Soon Lee  1 , Tai Joon An  3 , Hyonsoo Joo  4 , Hyun Lee  5 , Youlim Kim  6 , Ina Jeong  7 , Jinkyeong Park  8 , Sung-Kyoung Kim  9 , Jong-Wook Shin  10 , Chin Kook Rhee  11 , Yee Hyung Kim  8 , Kyung Hoon Min  12 , Ji-Yong Moon  13 , Deog Kyeom Kim  14 , Seung Hun Jang  15 , Kwang Ha Yoo  6 , Jin Woo Kim  4 , Hyoung Kyu Yoon  3 , Hyeon-Kyoung Koo  16
Affiliations

Sex Differences in Chronic Cough Epidemiology: The Korean Cough Study Group

Jiyeon Kang et al. J Korean Med Sci. .

Abstract

Background: Chronic cough is a common symptom encountered by healthcare practitioners. The global prevalence of chronic cough is 9.6%, with a female predominance. The aim of our study is to reveal the sex differences in prevalence and severity of chronic cough in South Korea, stratified by age and etiology.

Methods: This study included adult patients with chronic cough who were recruited from 19 respiratory centers in South Korea. Patients completed the cough numeric rating scale (NRS) and COugh Assessment Test (COAT) questionnaire to assess the severity and multidimensional impact of cough.

Results: Among the 625 patients, 419 (67.0%) were females, with a male-to-female ratio of 1:2.03. The mean age was 49.4 years, and the median duration of cough was 12 weeks. The mean NRS and COAT scores were 5.5 ± 1.8 and 9.5 ± 3.6, respectively. Female patients were older (45.3 ± 15.4 vs. 51.6 ± 15.2, P < 0.001) and more likely to have asthma/cough variant asthma (CVA) (26.7% vs. 40.8%, P = 0.001) than male patients. There was no difference in the duration or severity of cough between sexes, regardless of the cause. The male-to-female ratio was lower for upper airway cough syndrome (UACS), asthma/CVA, and gastro-esophageal reflux disease (GERD), but not for eosinophilic bronchitis (EB) or unexplained cough. The mean age of female patients was higher in UACS and asthma/CVA, but not in EB, GERD, or unexplained cough. The majority (24.2%) fell within the age category of 50s. The proportion of females with cough increased with age, with a significant rise in the 50s, 60s, and 70-89 age groups. The severity of cough decreased in the 50s, 60s, and 70-89 age groups, with no significant sex differences within the same age group.

Conclusion: The sex disparities in prevalence and severity of cough varied significantly depending on the age category and etiology. Understanding the specific sex-based difference could enhance comprehension of cough-related pathophysiology and treatment strategies.

Keywords: Chronic Cough; Etiology; Female; Prevalence; Severity; South Korea.

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Conflict of interest statement

The authors have no potential conflicts of interest to disclose.

Figures

Fig. 1
Fig. 1. Prevalence of each etiology of chronic cough stratified by sex. The 287 patients (45.9%) were diagnosed with UACS, 226 (36.2%) with asthma/CVA, 45 (7.2%) with EB, and 84 (13.4%) with GERD. The proportion of females is significantly higher in the asthma/CVA population.
UACS = upper airway cough syndrome, CVA = cough variant asthma, EB = eosinophilic bronchitis, GERD = gastro-esophageal reflux disease. aIndicates statistically significant differences in the female proportion.
Fig. 2
Fig. 2. Venn diagram of etiologies stratified by sex.
UACS = upper airway cough syndrome, CVA = cough variant asthma, GERD = gastro-esophageal reflux disease.
Fig. 3
Fig. 3. Proportion of male-to-female sex by age category in each etiology. The proportion of females with (A) UACS serially has increased from the age group of 50–59 years. The proportion of females in (B) asthma/CVA increased similarly and was significantly higher in the 60–69 year age group. The proportion of females with (C) eosinophilic bronchitis, (D) GERD, and (E) unexplained cough showed no significant pattern. In patients with (F) multiple causes, the proportion of females decreased from the 30–39 year age group, reaching the lowest point in the 40–49 year age group, and subsequently began to increase in the 50-59 year age group, resembling a U-shaped pattern.
UACS = upper airway cough syndrome, CVA = cough variant asthma, GERD = gastro-esophageal reflux disease.
See this image and copyright information in PMC

References

    1. Joo H, Moon JY, An TJ, Choi H, Park SY, Yoo H, et al. Revised Korean cough guidelines, 2020: recommendations and summary statements. Tuberc Respir Dis (Seoul) 2021;84(4):263–273. - PMC - PubMed
    1. Rhee CK, Jung JY, Lee SW, Kim JH, Park SY, Yoo KH, et al. The Korean cough guideline: recommendation and summary statement. Tuberc Respir Dis (Seoul) 2016;79(1):14–21. - PMC - PubMed
    1. Morice AH, Fontana GA, Sovijarvi AR, Pistolesi M, Chung KF, Widdicombe J, et al. The diagnosis and management of chronic cough. Eur Respir J. 2004;24(3):481–492. - PubMed
    1. Chung KF, Pavord ID. Prevalence, pathogenesis, and causes of chronic cough. Lancet. 2008;371(9621):1364–1374. - PubMed
    1. Brignall K, Jayaraman B, Birring SS. Quality of life and psychosocial aspects of cough. Lung. 2008;186(Suppl 1):S55–S58. - PubMed