Half of children with recurrent or chronic wet cough before three years of age were symptom‐free by age seven

Abstract

During the first years of life, airway infections commonly involve coughing, but the cough normally ceases within two to three weeks. 1-3 Some children experience recurrent episodes with cough or chronic cough, sometimes leading to the suspicion of an underlying disease. Chronic cough is defined as a cough that persists for more than four or eight weeks, 4-10 and in preschool children, the cough is mainly wet or productive due to mucus secretion. 4 An untreated chronic cough may last for months and lead to impaired sleeping, poor feeding, sick leave and reduced quality of life for the children and families affected. 4,5,7,10,11 Most children with recurrent episodic or chronic wet cough probably have a good prognosis, but for some children, the cough represents the first sign of chronic suppurative lung disease, which is important to diagnose and treat early. 5,10,12

Is prolonged wet cough underdiagnosed and improperly treated in preschool children?

“…Children with chronic wet cough were younger, and their symptoms deputed earlier compared to those with recurrent episodic wet cough. 2 The median age at onset of wet cough was six vs 10 months and on admission 16 vs 22 months, respectively. These figures fit well with those in the available literature.…”

“…In 2017-2018, questionnaires were sent to the parents of 840 identified patients, and 348 answered, and 291 cases were accepted for the final analyses. 2 These cases were divided after retrospective chart review into two groups, those 171 with recurrent episodic and those 120 with chronic wet cough. The annual age-specific prevalence of recurrent episodic or chronic wet cough, estimated from these figures, was around 1.5% in younger than 3-year-old children.…”

“…1 Antibiotics were prescribed to 21.6% of the children during 6 months before or at the first visit, the figure being higher, but only 33.3%, in those with chronic wet cough, compared to 13.3% in those with recurrent episodic wet cough. 2 These observations may reflect an avoidance of antibiotic prescription to diminish side effects in children and to restrain emergence of antibiotic resistance, which, of course, are important aspects to be taken into account especially in preschool-aged children. 6 Instead, asthma medicines were often used, the figures being 60.8% for beta2-agonists and 47.6% for inhaled corticosteroids (ICSs) during the last 6 months before admission, without any substantial differences between the groups.…”

“…Sørensen et al 2 published in this issue of the journal their interesting findings on recurrent episodic or chronic wet cough in Norwegian preschool‐aged children, with a special focus paid on presence of symptoms 5‐7 years later. The study subjects were collected retrospectively from electronic files of an academic hospital and comprised patients admitted for chronic or prolonged respiratory symptoms like cough to the outpatient clinic during three years in 2010‐2013 at younger than 3 years of age.…”

“…In 2017‐2018, questionnaires were sent to the parents of 840 identified patients, and 348 answered, and 291 cases were accepted for the final analyses 2 . These cases were divided after retrospective chart review into two groups, those 171 with recurrent episodic and those 120 with chronic wet cough.…”