Recent progress in the management of chronic cough

Abstract

Chronic cough is a common clinical condition with significant impact on quality of life and for which effective therapy remains an unmet clinical need. Over the past decade, there has been a major shift in how we approach this problem, driven by better appreciation of the clinical manifestation of chronic cough and an improved understanding of the associated neurobiology. "Cough hypersensitivity syndrome" has been proposed as a new diagnostic term for chronic cough, encompassing different phenotypes of the condition. Accumulating evidence suggests that this new concept is clinically relevant. However, while it is gaining widespread endorsement within the allergy and respiratory community, raising its profile in routine clinical practice is a priority. Thus, the present paper reviews recent progress in our understanding and management of chronic cough, with focus on mechanistic and clinical studies. It also provides detail on knowledge gaps and future research directions.

Understanding the Impact of Chronic Cough on the Quality of Life in the General Population

“…The concept of chronic cough is now changing from a consequent symptom due to underlying diseases to a clinical entity called cough hypersensitivity syndrome (CHS), which usually shows a long-lasting course that is refractory to currently available treatments. 4 5 …”

WAO-ARIA consensus on chronic cough – Part III: Management strategies in primary and cough-specialty care. Updates in COVID-19

“…In the lower airways, key principles in pharmacotherapy of chronic cough using bronchodilators and inhaled corticosteroids (ICS) are to treat obstructive lung disease (classic asthma [CA]/ chronic obstructive pulmonary disease [COPD]) and eosinophilic airway inflammation. [41][42][43][44][45][46][47][48][49][50][51] However, it should be noted that clear data on the role of pharmacotherapy in chronic cough originating from the lower airways are unclear. 43 For example, in clinical trials of chronic cough patients with asthma, cough was not studied independently of other asthma symptoms.…”

Long lasting symptoms of dyspnea, cough and fatigue after COVID-19 – narrative review of epidemiological studies

“…Song i wsp. [12] w analizie 14 badań obejmujących hospitalizowanych chorych na COVID-19 u 18% (95% CI: 12-24) stwierdzili występowanie przewlekłego kaszlu w okresie od 6 tygodni do 4 miesięcy. Autorzy zwrócili uwagę, że częstość jego występowania różniła się znacznie w zależności od charakterystyki pacjentów, stosowanego leczenia, okresu obserwacji i przyjętej definicji.…”