Background: Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) is one of the deadly viruses first reported in Wuhan City, Hubei province, China, and is responsible for causing the pandemic. The World Health Organization (WHO) declared a health emergency worldwide on January 30th and a pandemic on March 11th, 2020. Persistent respiratory symptoms of COVID-19 can vary significantly between individuals, including respiratory symptoms like dyspnea, chronic cough, chest pain, fatigue, sore throat, bronchitis, sleep disturbance, etc. Objectives: This study aimed to determine the frequency of persistent respiratory symptoms after COVID-19 infection. Methods: A cross-sectional study was conducted from December, 2022 to April, 2023, to assess the frequency of respiratory symptoms post-COVID-19 infection among the medical and non-medical students who were infected with COVID-19, whether vaccinated or not. Results and Discussion: The study included 382 medical students from the Al-Kindy College of Medicine, University of Baghdad, who participated in this study. Most were females, i.e., 72 %, and the rest were males, which were 28 %. Most of the students were vaccinated (95.3 %) with Pfizer/BioNTech COVID-19 vaccines (71.7 %) with two doses (71.2 %). The students were infected with COVID-19 and some of them were infected before vaccination (62.6 %) and the rest (21.7 %) after vaccination. After their recovery from COVID-19, whether vaccinated or not, they had respiratory symptoms and other clinical manifestations. Regarding respiratory symptoms, intermittent cough (47.4%), dry cough (46.6%), and chronic cough (40.6%) were the most common respiratory symptoms that persisted for sixty days. Among other symptoms, headache was the most common one (39.5%), followed by fever (22.5%). Conclusion: The most common respiratory symptoms were intermittent cough, dry cough, and chronic cough that persisted for sixty days.

Elicitation of allergic airway inflammation modulates the cough response via increased prostaglandin I₂ in ovalbumin-sensitized guinea pigs.

Corticosteroid treatment has no effect in patients without sputum eosinophilia. Sputum neutrophils and lymphocytes contribute to chronic cough hypersensitivity. The characteristics of chronic cough patients without sputum eosinophilia have not been investigated. This study included a total of 1061 patients at the First Affiliated Hospital of Guangzhou Medical University between July 2021 and June 2024 (Approval number: ES-2024-K117-02). We analyzed clinical characteristics, sputum cell profiles, spirometry, and pulmonary lesions across four groups: chronic cough patients with normal sputum (n = 180), lymphocytotic sputum (n = 270), neutrophilic sputum (n = 349), and mixed leukocytotic sputum (n = 262). Gastroesophageal reflux cough was the most prevalent disease in chronic cough patients with normal sputum. Atopic cough was more common in patients with lymphocytotic sputum. COPD and bronchiectasis were more prevalent in both neutrophilic and leukocytotic sputum groups. Advanced age was a characteristic of patients with neutrophilic or leukocytotic sputum. Patients with neutrophilic sputum had a higher prevalence of smoking history and a longer smoking duration. Pulmonary lesions were less severe in patients with lymphocytotic sputum but more severe in those with neutrophilic or leukocytotic sputum. Compared to patients with normal sputum, both neutrophilic and leukocytotic sputum groups exhibited marked reductions in overall lung function (FVC% of predicted, FEV1% of predicted, FEV1/FVC% of predicted, and PEF% of predicted) and small airway function (MMEF% of predicted, FEF75% of predicted, and FEF50% of predicted). Associations were observed among age, smoking history, sputum neutrophil percentages, pulmonary lesions, and declined lung functions. Elevated sputum neutrophils were independently associated with reduced lung function across multiple parameters (FVC% of predicted, FEV1/FVC% predicted, FEV1/VCmax% predicted, PEF% predicted, MMEF% of predicted, and FEF50% of predicted), despite robust adjustment for age and the presence of COPD, bronchiectasis, and interstitial lung disease. Advanced age and smoking history are risk factors for elevated sputum neutrophils in chronic cough patients. Neutrophil-mediated airway inflammation is associated with pulmonary lesions and declined lung functions in chronic cough patients.

Chronic nonspecific cough in children is a common and challenging clinical problem. Flexible bronchoscopy plays a crucial role in identifying underlying etiologies when non-invasive investigations are inconclusive. This study aimed to assess bronchoscopy and related diagnostic findings in children presenting with chronic cough. This prospective cross-sectional study included 64 children aged 3 months to 18 years who presented with chronic nonspecific cough lasting more than four weeks. All patients underwent a standardized evaluation that included clinical assessment, laboratory tests, chest X-ray, and high-resolution CT. Pulmonary function testing was performed in children older than five years. Flexible bronchoscopy was conducted, and bronchoalveolar lavage samples were examined for cytological and microbiological analysis. This prospective study included 64 children (32 males) with a median age of 8 months (IQR 36-84) with chronic cough, classified as dry (n = 38), wet (n = 21), or barking (n = 5) cough. Bronchoscopy revealed abnormalities in 87.5% of cases, most commonly purulent secretions and congenital airway anomalies. BAL showed neutrophilia in 95.3%, and cultures were positive in 20.3%, mainly for Haemophilus influenzae and Streptococcus pneumoniae. For predicting PBB, the combined multivariable model demonstrated good discriminative ability (AUC = 0.809, P = 0.004). Increasing age (OR = 1.038, P = 0.024) and tobacco smoke exposure (OR = 4.15, P = 0.04) were significant independent predictors. For congenital airway anomalies, the combined model demonstrated excellent predictive performance (AUC = 0.912, P < 0.001), outperforming individual clinical variables. Flexible bronchoscopy demonstrated a high diagnostic yield in children with chronic cough that remained unexplained following comprehensive noninvasive evaluation. However, a definitive assessment of its clinical utility requires direct comparison with other diagnostic modalities, which is addressed in the subsequent analysis.

Prevalence and Types of Esophageal Motility Disorders in Patients with Chronic Cough

Primary ciliary dyskinesia in pediatric persons: A microscopic movement malady.

Moving Beyond Responders: A post-hoc Analysis Identifying Criteria for Chronic Cough Control.

The number of patients taking glucagon-like peptide-1 receptor agonists (GLP-1RAs) is increasing. Beyond diabetes and weight management, these medications have various effects within the head and neck with both beneficial and potentially adverse clinical implications. Delayed gastric emptying may contribute to reflux, chronic cough, and potential aspiration in the perioperative setting; as such, physicians should be aware of anesthetic guidelines (duration of pre-operative cessation, pre-operative fasting or liquid diet) to improve safety and avoid operative delay. GLP-1RAs have shown benefit in treating obstructive sleep apnea in those with obesity or overweight and may become increasingly relevant in multimodal treatment of sleep disorders. GLP-1 receptor signaling is involved in sinopulmonary inflammatory cascades and recent evidence suggests clinical implications for chronic sinusitis and olfactory disorders. Previously reported neuroprotective effects have led to investigation regarding potential benefit in neurotoxicity-associated hearing loss. Muscle atrophy with weight loss may contribute to a gaunt, aged appearance leading patients to seek facial rejuvenation, or to a patulous eustachian tube and changes in conductive hearing. Animal studies suggested an increased risk of thyroid cancer, but population studies have been inconclusive and will require long-term investigation to determine any causal relationship.

Cystic fibrosis (CF) is considered to be extremely rare in India, but over the past few decades, multiple reports suggest that CF occurs in India and clinical features may be different. Reports on clinical features are limited to case series. In this multisite nationwide prospective study, we report the clinical profile of CF in Indian children. Children below 18 years of age presenting with suggestive symptoms were enrolled at all the sites using a uniform protocol over a 5-year period at four sites across India. Diagnosis of CF was based on either elevated sweat chloride levels or the presence of two pathogenic CF-causing mutations, together with a clinical phenotype suggestive of the disease. Data collection included demographic, clinical, laboratory profiles, results of the aquagenic wrinkling test and overall outcomes of children diagnosed with CF. A total of 811 children were enrolled and 313 were diagnosed as CF during the study period. The median age at symptom onset and diagnosis was 2.25 months and 2.58 years, respectively. The common presenting symptoms included chronic cough (280, 89.5%), poor growth (213, 76.9%) and chronic diarrhoea (195, 62.3%). At the time of diagnosis, bronchiectasis on chest CT was present in 233 (90%) patients. Airway cultures grew Pseudomonas aeruginosa in 63 (36.8%), and Staphylococcus aureus in 32 (18.7%) patients. The common mutation was delta F508del, present in 31.3% of patients. CF is prevalent across all the geographic regions of India. Delay in diagnosis remains a significant challenge and contributes to the development of severe complications.

Pulmonary Ewing Sarcoma Presenting As Chronic Cough

Refractory or unexplained chronic cough (RUCC) represents an unmet clinical need. This study aimed to explore the components constituting the disease burden in patients with RUCC by comparing clinical features, healthcare use, and patient-reported outcomes with those of chronic cough (CC) of recent onset (< 1 year). A total of 200 individuals were prospectively enrolled from seven referral clinics in South Korea, including 100 with RUCC and 100 with CC of recent onset (< 1 year). Data were obtained through structured interviews and medical record reviews. Measures included general and cough-specific quality-of-life, mood, cough hypersensitivity symptoms, work productivity, and healthcare utilization. Individuals with RUCC were significantly older than those with CC (57.5 ± 15.1 vs. 48.9 ± 17.6 years) and had markedly longer cough duration (median 80 vs. 4 months). The RUCC group demonstrated higher out-of-pocket costs, more healthcare facility visits, and greater numbers of diagnostic tests and prescribed medications. However, cough-specific and general health-related quality of life scores showed no significant differences. Correlation analysis revealed comparable but stronger associations between cough-specific quality-of-life and general health outcomes in RUCC than in CC. RUCC imposes a substantial and multidimensional burden that extends beyond symptom severity. Chronicity, healthcare complexity, and psychosocial impact appear to be central features. Future evaluation tools should incorporate time and lived experience to more accurately capture the true burden of chronic cough.

This study was aimed at exploring the prevalence of somatic symptom disorder (SSD) in patients with chronic cough and comparing SSD comorbid (SSD+) and non-comorbid (SSD-) groups, including sociodemographic, clinical, psychological, and neuroimaging characteristics. A total of 463 patients with chronic cough were enrolled. The structured clinical interview from the fifth edition of the Diagnostic and Statistical Manual of Mental Disorders was used for SSD diagnosis. Clinical features, cough-related assessment and psychological assessment were used to compare the SSD+ and SSD- groups, while functional magnetic resonance imaging (fMRI) was performed in 24 patients (12 SSD+ and 12 SSD-) for neuroimaging comparisons. SSD was diagnosed in 13.8% (64/463) of all enrolled patients. The prevalence of SSD was greater in patients with refractory chronic cough (27.7%) than those with non-refractory chronic cough (7.8%). The SSD+ group had higher levels of capsaicin cough sensitivity (P = 0.016), anxiety (P < 0.001), and depression (P < 0.001), and lower cough-related quality of life scores (P < 0.001), than the SSD- group. Binary logistic stepwise regression indicated that higher anxiety level, female sex, lower cough-related quality of life, and more doctor visits were predictors of SSD diagnosis. Notably, SSD- patients demonstrated enhanced regional neural activity synchronization in the right cerebellum and mid-cingulate cortex, whereas SSD+ patients exhibited diminished spontaneous neural activity in the lingual gyrus (voxel P < 0.001, cluster P < 0.05, FWE corrected). SSD was identified in 13.8% of chronic cough patients and in approximately 28% of those with refractory chronic cough. Comprehensive evaluation of psychological in chronic cough patients is essential for early identification and management of SSD comorbidity. Interdisciplinary collaboration, including psychosomatic medicine, may enhance diagnostic accuracy and treatment outcomes in this population. This study was registered in the Chinese Clinical Trials Register (http://www.chictr.org.cn/) (ChiCTR2400079808). Registration date: January 12, 2024.

Sex and Gender Differences in Expiratory Central Airway Collapse: A Retrospective Cohort Study.

Background and Objectives: Idiopathic pulmonary fibrosis (IPF) is frequently accompanied by chronic cough, which may negatively affect sleep quality. However, the relationship between cough burden and sleep disturbances in patients undergoing antifibrotic therapy remains inadequately defined. This study aimed to investigate the association between cough and sleep quality in patients with IPF and to evaluate the potential effects of antifibrotic treatment on these outcomes. Materials and Methods: This cross-sectional analytical study was conducted at a tertiary care center in Türkiye between January 2019 and December 2024. Patients with a diagnosis of IPF who were receiving antifibrotic therapy (nintedanib or pirfenidone) were consecutively recruited from the pulmonology outpatient clinic. Sleep quality was assessed using the Pittsburgh Sleep Quality Index (PSQI), and cough-related quality of life was evaluated with the Leicester Cough Questionnaire (LCQ). Pre-treatment data were obtained retrospectively based on patient recall, and follow-up assessments were conducted during ongoing therapy. Correlation analyses and multivariable linear regression models were used to identify factors associated with sleep quality. Results: The study included 74 patients, with a mean age of 68.6 ± 6.8 years. At baseline, 87.8% of patients had poor sleep quality (PSQI ≥ 5). During antifibrotic therapy, PSQI scores significantly improved (median 9 [IQR: 6–12] vs. 6 [IQR: 5–8], p < 0.001), accompanied by a clinically meaningful increase in LCQ total score (13.28 ± 2.86 vs. 16.06 ± 2.58, p < 0.001). Significant inverse correlations were observed between PSQI and LCQ scores at both baseline and follow-up. In multivariable analysis, LCQ score was an independent predictor of sleep quality during treatment (β = −0.453, p < 0.001), whereas demographic and physiological parameters showed no significant independent associations. No significant differences were detected between nintedanib and pirfenidone in terms of PSQI or LCQ outcomes. Conclusions: Cough-related quality of life is independently associated with sleep quality in patients with IPF receiving antifibrotic therapy. These findings highlight cough burden as a key determinant of patient-centered outcomes beyond traditional physiological measures. Targeted assessment and management of cough may represent an important strategy to improve sleep quality and overall quality of life in this population.

Ascending aortic thrombus is an uncommon entity that may mimic primary aortic tumors. When aortic masses coexist with suspected coronary stenosis, conventional coronary angiography may increase the risk of thrombus embolization. We describe a case in which an ascending aortic thrombus produced imaging features suggestive of both aortic tumor and coronary disease, and demonstrate the diagnostic value of intraoperative direct coronary angiography. A 60-year-old man presented with a two-year history of chronic dry cough. Transthoracic echocardiography revealed a mildly mobile 1.5 × 2.5cm weakly echogenic mass on the anterior ascending aorta. Transesophageal echocardiography confirmed a 1.6 × 2.8cm homogeneous, smooth-surfaced mass with a broad attachment to the aortic intima and no intimal tear or vascularity. Coronary computed tomography angiography showed a severe mid-left anterior descending artery stenosis, though the mass was distant from coronary ostia. Preoperative coronary angiography was avoided because of the high risk of thrombus embolization during angiography. During surgery, intraoperative direct coronary angiography via a cardiopulmonary perfusion needle excluded significant coronary artery disease. The mass was excised intact; pathology revealed an organized thrombus with myxoid degeneration. Recovery was uneventful, and the patient remained asymptomatic at follow-up. Diagnosis of an ascending aortic mass relies on careful multimodality imaging, and surgical excision can be performed safely. When conventional coronary angiography is not feasible, intraoperative direct angiography provides a reliable alternative for assessing coronary anatomy.

The Approach to Chronic Cough in Dogs and Cats.

Acute and Chronic Cough in Children.

Occupational, Environmental, and Irritant-induced Cough.

Association between air pollution and chronic cough: Evidence from a systematic review and meta-analysis of observational studies.

Behavioral Cough Suppression Therapy: The Speech-Language Pathologist's Role in Assessment and Treatment of Chronic Cough.