Prevalence and burden of chronic cough in China: a national cross-sectional study

Abstract

BackgroundChronic cough is a common complaint but there is no population-based data on its burden in China.Objectives: We determined the prevalence of chronic cough and its impact on health status in adults stratified by sex, age and the diagnosis of chronic obstructive pulmonary disease (COPD) or the presence of small airway dysfunction (SAD).MethodsA representative sample of 57,779 Chinese adults aged 20 years or older was recruited and pulmonary function test was measured. Chronic cough was defined as cough lasting for more than 3 months in each year. Quality of life was assessed by the 12-item Short Form Health Survey (SF-12) and self-reported history of hospital visits was recorded.ResultsChronic cough was found in 3.6% (95% CI 3.1–4.1) of Chinese adults, 2.4% (95% CI 1.9–3.1) of those aged 20–49 age old, and 6.0% (95% CI 5.3–6.8) of those aged 50 years or older. Individuals with chronic cough had an impaired physical component summary (PCS) score of the SF-12 (p<0.0001), more emergency visits (p=0.0042) and hospital admissions (p=0.0002). Furthermore, the impact of chronic cough on PCS score was more significant in those aged 50 years or older, or with COPD (p=0.0018 or 0.0002, respectively), with the impact on hospital admission being more significant in those with COPD or with SAD (p=0.0026 or 0.0065, respectively).ConclusionsChronic cough is prevalent in China and is associated with a poorer health status, especially in individuals aged 50 years or older and those with the diagnosis of COPD or SAD.

Worldwide prevalence, risk factors and burden of chronic cough in the general population: a narrative review

“…Landt and colleagues (32) reported there was a dose-response relationship between body mass index (BMI) and chronic cough, and chronic cough risk was two-to three-fold higher in obese individuals from the general population from the Copenhagen General Population Study, and this increased risk was partly mediated by GORD, low vegetable intake and occupational exposure. However, the CPH study (19) demonstrated that BMI was not associated with the prevalence of chronic cough in the general adult population, and these results were consistent with another study conducted in Korea. Using the data from the 2019 KNHANES, Kim and colleagues (33) reported there was no significant relationship between BMI and the occurrence of chronic cough using a multivariate analysis.…”

“…Therefore, this reported prevalence may not represent the real prevalence of chronic cough in China. The China Pulmonary Health (CPH) ( 19 ), a national cross-sectional study enrolled 57,779 Chinese adults aged 20 years or older, which defined chronic cough as lasting for >3 months each year, and found that its prevalence was 3.6%, increasing with age from 2.4% in individuals aged 20–49 years to 6.0% in those aged 50 years or older. They also observed a higher prevalence of 4.6% in men compared to 2.6% in women, while the higher prevalence of chronic cough in men was likely to be partly due to the much higher smoking rate of 47.2% in men compared to only 2.7% in women ( 29 ).…”

“…Women are always over-represented in specialist cough clinics (6,37). Although some studies have shown opposite results in univariate analysis (10,19,20,26), the positive association between male and chronic cough is statistically insignificant after adjustment for smoking status (20), suggesting that it is not appropriate to analyze the influence of gender on the risk of chronic cough separately from the smoking status of the population.…”

“…Most studies report that smoking is an important risk factor for chronic cough (2,17,18,26,27,(43)(44)(45). The CPH study reported that ever-smokers defined as having smoked equal to or more than 100 cigarettes in the lifetime had double to triple the risk of chronic cough compared with neversmokers (OR 2.61, 95% CI: 2.10-3.25) (19). Similarly, the Copenhagen General Population Study (23) showed that smoking was not only a risk factor of chronic cough at the level of the individuals (OR 1.5, 95% CI: 1.2-1.8), but also was the first ranked risk factor for the chronic chough at the level of the community with a 20% of attributable risks (PARs).…”

Antitussive efficacy of the current treatment protocol for refractory chronic cough: our real-world experience in a retrospective cohort study

“…In a recent national cross-study conducted in China, CC was found in 3.6% of adults. 1 Currently, in approximately 12–42% of CC patients, the guideline-recommended aetiology-targeted treatments have been of little help, or no underlying aetiology was found after thorough investigations. 2 As an important sub-phenotype of CC, this persistent and intractable coughing has been defined as refractory chronic cough (RCC) or unexplained chronic cough (UCC).…”