Eosinophilic airway inflammation is common in subacute cough following acute upper respiratory tract infection

Abstract

Background and objective: Patients presenting with refractory postinfectious cough may respond to glucocorticosteroids but it is unclear whether airway eosinophilic inflammation exists in those patients. We aimed to determine the airway inflammation and causes of subacute cough following acute upper respiratory tract infection (AURTI). Methods: One hundred and sixteen patients with persistent cough lasting 3-8 weeks after upper respiratory tract infection were evaluated with differential cell count in induced sputum, spirometry and methacholine bronchial challenge testing. Results: In patients with subacute cough, sputum eosinophilia (median 8.5%,3.0-73.0%) was identified in 35 (33.6%) patients, 22 (18.5%) without bronchial hyperresponsiveness (BHR) were diagnosed as nonasthmatic eosinophilic bronchitis (NAEB), 13 (14.3%) of whom with BHR were diagnosed as cough variant asthma (CVA). Cough in patients with sputum eosinophilia improved after treatment with corticosteroids. Compared with postinfectious cough (PIC) and NAEB, CVA had significantly higher median eosinophil count in induced sputum (0.5% vs 7.5% vs 20.0%, P < 0.01). MMEF in CVA was significantly lower than PIC and NAEB (P < 0.05). The common causes of subacute cough following acute upper respiratory tract infection (AURTI) were PIC (37.8%), NAEB (18.5%), CVA (14.3%) and upper airway cough syndrome (UACS) (10.1%). Atopic cough (AC) (5.2%) and gastroesophageal refluxrelated cough (GERC) (3.4%) were less common in subacute cough following AURTI, while 9 (7.8%) patients had unexplained cough. Conclusion: Subacute cough following AURTI can be attributed to different entities, eosinophilic airway inflammation is common. Induced sputum should be considered when evaluating patients with subacute cough following acute upper respiratory tract infection.

Association between fractional exhaled nitric oxide and clinical characteristics and outcomes in patients with subacute cough

“…Lai et al 9 recent report suggests that eosinophilic airway inflammation is common in subacute cough (33.6%) by sputum induction for differential cell count. Lai et al 9 recent report suggests that eosinophilic airway inflammation is common in subacute cough (33.6%) by sputum induction for differential cell count.…”

“…In the present study, we found that 53 patients with high-FENO accounted for 28% of the total 189 patients with subacute cough. Lai et al 9 recent report suggests that eosinophilic airway inflammation is common in subacute cough (33.6%) by sputum induction for differential cell count. In the same study, the authors found that the common causes of subacute cough were post-infectious cough, eosinophilic bronchitis, coughvariant asthma, and upper airway cough syndrome.…”

“…9 The LCQ score at enrollment was based on manifestations during the previous 2 weeks. The diagnosis of URI was determined based on a selfreport history, such as runny nose, nasal obstruction, sneezing, sore throat, and fever.…”

“…The diagnosis of URI was determined based on a selfreport history, such as runny nose, nasal obstruction, sneezing, sore throat, and fever. 9 The LCQ score at enrollment was based on manifestations during the previous 2 weeks.…”

Gender difference in the association between cough severity and quality of life among patients with postinfectious cough

“…Patients who complain a persistent cough lasting >3 weeks after experiencing the acute symptoms of an upper respiratory tract infection may have a postinfectious cough. It is the most common cause of subacute cough, accounting for 30%-50% of patients with subacute symptoms [22,23]. We recently demonstrated that QingfengGanke granule improved clinical symptoms and cough speci c QoL over placebo in patients with postinfectious cough [24].…”