Effect of congenital heart disease on the recurrence of cough variant asthma in children

B W Feng,C Y He,X Q Liu,S R He,Y S Chen

doi:10.1186/s12872-021-01940-8

Abstract

BackgroundThe research into the recurrence of cough variant asthma (CVA) in congenital heart disease (CHD) are few in number. The purpose of this study is to investigate the effect of CHD on the risk of the recurrence of CVA.MethodsThis study was a retrospective cohort study of 489 children with CVA aged between one and 14 years, of whom 67 had CHD complicated with CVA and 134 had CVA without CHD at a ratio of 1:2 according to age, sex and index year. The adjusted hazard ratio (aHR) of CVA recurrence in both the CHD cohort and the non-CHD cohort was determined by multivariate analysis using the Cox proportional hazard regression model.ResultsAdjusting for CHD classification, Mycoplasma pneumonia (MP) infection and immunoglobulin E (IgE) sensitization, the recurrence hazard of CVA in the complex congenital heart disease (CCHD) group (aHR = 3.281; 95% CI 1.648–6.530; P < 0.01) was significantly higher than that in the simple congenital heart disease group (aHR = 2.555; 95% CI 1.739–3.752; P < 0.01). Further, children with IgE sensitization (aHR = 2.172; 95% CI 1.482–3.184; P < 0.01) had a higher recurrence hazard of CVA than those without IgE sensitization, and children with MP infection (aHR = 1.777; 95% CI 1.188–2.657; P < 0.01) had a higher recurrence hazard of CVA than those without the MP infection.ConclusionThe hazard of recurrent CVA is higher in children with CHD, especially in the CCHD children. In addition, those children with IgE sensitization or a MP infection had an increased hazard of recurrent CVA.

Highlights

Asthma is a chronic airway inflammatory disease characterized by bronchial hyperresponsiveness and reversible airflow obstruction
The adjusted hazard ratio and 95% confidence interval (CI) of the cough variant asthma (CVA) recurrence were determined by multivariate analysis using the Cox proportional hazard regression model. with controls adjusted for congenital heart disease (CHD) classification, Mycoplasma pneumonia (MP) infection and immunoglobulin E (IgE) sensitization
CVA recurrence rate within 12 months of CHD group and non-CHD group the non-CHD cohort after adjusting for CHD classification, MP infection and IgE sensitization; while the recurrence hazard of CVA in the SCHD group was significantly higher than that in the non-CHD cohort

Summary

Introduction

Asthma is a chronic airway inflammatory disease characterized by bronchial hyperresponsiveness and reversible airflow obstruction. The Global Initiative on the Prevention and Treatment of Asthma (GINA) defines cough variant asthma (CVA) as a special type of asthma without wheezing or shortness of breath, where coughing is the sole or main symptom [1]. CVA in children is a particular type of asthma, predominantly characterized by a persistent cough. Children with CVA have no typical clinical symptoms and are easy to misdiagnose, resulting in their being unable to receive standardized treatment. The disease can develop into typical asthma, affecting the child’s growth. CVA in children can be prevented, but it is difficult to cure, and always causes repeated attacks. The research into the recurrence of cough variant asthma (CVA) in congenital heart disease (CHD) are few in number.

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