Asthma Cough Research Articles

Effects of yupingfeng granules combined with pediatric lung heat cough asthma on serum inflammatory factors and T lymphocyte subsets in children with Mycoplasma pneumonia.

Effects of yupingfeng granules combined with pediatric lung heat cough asthma on serum inflammatory factors and T lymphocyte subsets in children with Mycoplasma pneumonia.

Could cough hypersensitivity symptom profile differentiate phenotypes of chronic cough?

Recently, cough reflex hypersensitivity has been proposed as a common underlying feature of chronic cough in adults. However, symptoms and clinical characteristics of cough hypersensitivity have not been studied amongst phenotypes of chronic cough. This study aimed to compare symptom features, such as cough triggers and associated throat sensations, of cough hypersensitivity in patients with asthmatic chronic cough and those with refractory chronic cough (RCC). Patients with chronic cough from the Korean Chronic Cough Registry were prospectively evaluated over 6 months. Physicians determined the aetiological diagnosis based on clinical evaluations and responses to treatment at the 6-month follow-up visit. Symptoms of cough hypersensitivity and cough-specific quality of life were assessed using the Cough Hypersensitivity Questionnaire (CHQ) and the Leicester Cough Questionnaire (LCQ), respectively. The analysis included 280 patients who completed the follow-up: 79 with asthmatic cough (cough variant asthma or eosinophilic bronchitis) and 201 with RCC. Baseline CHQ scores were similar between the groups (8.3±3.7 in asthmatic cough versus 8.9±3.9 in RCC; p=0.215, adjusted for age, sex and LCQ score). There were no significant between-group differences in the LCQ and cough severity Visual Analog Scale scores. Both groups showed a similar negative correlation with LCQ scores (asthmatic cough: r=-0.427, p<0.001; RCC: r=-0.306, p<0.001). The symptoms of cough hypersensitivity may not distinguish between asthmatic cough and RCC. This suggests that chronic cough is the primary diagnosis in both phenotypes. It indicates a shared mechanism in their cough pathogenesis, despite having potentially different treatable traits.

The diagnostic impact of fractional exhaled nitric oxide for asthmatic cough in nontuberculous mycobacterial pulmonary disease.

Measurement of exhaled nitric oxide (FeNO) is a potentially useful diagnostic test for asthma. However, no study has explored the relationship between FeNO and respiratory symptoms of nontuberculous mycobacterial pulmonary disease (NTM-PD) complicated with asthma. The objective of this study was to assess the utility of measuring FeNO levels in patients with NTM-PD complicated by asthma. In this single-center retrospective cohort study, 140 NTM-PD patients with FeNO measured were enrolled. We selected NTM-PD patients who complicated with asthma as the NTM+BA group, defined using the following criteria: NTM patients with symptoms consistent with asthma, and NTM patients with symptomatic improvement after diagnostic therapy with ICS ± a long-acting beta 2-agonist (LABA). We then calculated a diagnostic cutoff point to distinguish between the NTM+BA groups and the NTM groups (all others). High-resolution computed tomography (HRCT) images were evaluated using the CT scoring system and their association with FeNO was examined. A total of 89 patients were included in the study. (31 in the NTM+BA group and 58 in the NTM group). Compared with the NTM group, the NTM+BA group had higher rates of allergic disease (51.6% vs. 22.4%; p=0.0085) and higher FeNO values (median, 23 [interquartile range {IQR}, 15.0-43.0] ppb vs. median, 17 [IQR, 11.8-23.0] ppb; p=0.015). With diagnostic asthma care using mainly ICS/LABA with reference to the FeNO, most patients (91.0%, 20/22) in the NTM-preceding subgroup in the NTM+BA group demonstrated a prompt improvement of their symptoms and AFB culture findings did not worsen (Culture positive rate (%): Pre-treatment: 59.1% vs. Post-treatment: 40.9%, p=0.3660) at 6 months after starting diagnostic therapy. The optimal diagnostic cutoff point of FeNO to distinguish between the two groups was calculated as 21.5 ppb by the ROC curve (sensitivity 75%, specificity 71.93%, p<0.0001; area under the curve: 0.7989). No significant correlation was observed between FeNO and the severity of CT images in the patients. A certain number of patients with NTM-PD showed exacerbated respiratory symptoms due to asthmatic complications. Elevated FeNO levels suggest asthma complications, even in patients with NTM.

Baiheqingjin formula reduces inflammation in mice with asthma by inhibiting the PI3K/AKT/NF-κb signaling pathway

Ethnopharmacological relevanceBaiheqingjin Decoction (BHQJ), which consists of 7 traditional Chinese herbs including Baibu (Stemona tuberosa Lour.), Hezi (Terminalia chebula Retz.), Mahuang (Ephedra sinica Stapf.), Ziwan (Aster tataricus L. f.), Dilong (Pheretima), Sangbaipi (Morus alba L.), and Xianhecao (Agrimonia pilosa Ledeb.). BHQJ is commonly used for treating cough asthma, and variant cough-variant asthma as it, is effective in improving asthma symptoms and reducing airway inflammation. Aim of the studyTo investigate the mechanisms of BHQJ in treating allergic asthma. Materials and methodsWe collected information about the components and targets of 6 Chinese medicines (excluding Pheretima) from the Traditional Chinese Medicine Systems Pharmacology Database and Analysis Platform (TCMSP). Additionally, we obtained genes associated with asthma from six disease databases. To create a protein-protein interaction network, we conducted an intersection analysis using differentially expressed genes derived from RNA transcriptome data. Subsequently, we carried out Gene Ontology and Kyoto Encyclopedia of Genes and Genomes enrichment analyses. To validate the findings from network pharmacology and transcriptomics, we established an allergic asthma mouse model induced by ovalbumin and conducted in vivo experiments. ResultsUsing network pharmacology and transcriptomics analyses, we identified the pathways including the PI3K/AKT signaling pathway, and NF-κB signaling pathway. Among these, the involvement of the PI3K/AKT/NF-κB signaling pathway in various pathological processes of asthma, such as airway inflammation, smooth muscle contraction, and excessive mucus production, are well-documented. Histopathological examinations indicated that BHQJ had the potential to mitigate inflammatory cell infiltration and the excessive growth of goblet cells in the airways of asthmatic mice, consequently reducing mucus secretion. Results from Western blot demonstrated that BHQJ could inhibit the activation of the PI3K/AKT/NF-κB pathway at the protein levels. Enzyme-linked immunosorbent assay findings revealed that BHQJ could reduce the production of typical “type 2 asthma” cytokines and immunoglobulin (Ig) E in the blood. These discoveries imply that BHQJ has the potential to reduce the release of inflammatory cytokines and suppress the overactivation of the PI3K/AKT/NF-κB signaling pathway, thus offering a therapeutic approach for asthma. ConclusionOur research offers initial insights into the fundamental mechanisms through which BHQJ treats asthma. This study reveals the potential mechanism of BHQJ in treating asthma, particularly its role in reducing inflammatory cytokines, mucus production, and cell infiltration, as well as inhibiting the expression of PI3K/AKT/P65 phosphorylated protein. These findings indicate the potential of BHQJ in treating asthma. In summary, our study provides preliminary insights into the asthma treatment mechanism of BHQJ and provides guidance for future research.

Cough in Severe Asthma

Asthma is a heterogeneous clinical syndrome that presents with variable symptoms, including cough, breathlessness, chest discomfort, and wheezing. Cough, a primary symptom of asthma, has distinct regulatory mechanisms and was associated with asthma severity, poor asthma control, diminished quality of life, and an increased risk of frequent future exacerbations. However, current tools for measuring asthma control do not include separate items for cough or other specific symptoms, and the true impact and clinical relevance of cough in asthma remains poorly understood. Consequently, current stepwise treatment algorithms based on asthma control may be overly simplistic and might not adequately address the heterogeneity of asthma or the mechanisms underlying its symptoms. Furthermore, this approach carries the risk of overestimating asthma severity and subsequent overtreatment. The concept of treatable traits is fundamental to precision medicine, wherein each symptom, especially cough, may serve as a treatable trait in its own right. In this paper, we aim to present evidence supporting the concept of cough as a treatable trait in asthma, addressing its three major components, which are clinical relevance, measurability, and treatability.

Evaluation of serum levels of interferon beta and nucleotide binding and oligomerization domain 2 gene polymorphism in children with cough asthma phenotype: a case–control study

BackgroundIndividuals with asthma are thought to suffer from a variety of distinct disorders, or phenotypes, each of which is characterized by a unique combination of genetic and environmental factors. Syndromes that are exacerbated by allergens, non-allergic factors, and aspirin, as well as syndromes that are best differentiated by pathologic findings, response to therapy, and natural history, fall into this category. The best course of treatment for an individual patient with asthma can be determined by first determining his or her specific asthma phenotype and its underlying pathophysiology.Aim of the workExplore clinical characteristics, serum INF-β in cough asthma phenotype and allergic march asthmatic children. Also, to assess the association of NOD2 (rs2066845) gene polymorphism among those asthma phenotypes in Egyptian asthmatic children.Patients and methodsThe study included 64 cough phenotypic asthmatic children and 60 allergic march phenotypic asthmatic children in addition to 39 healthy controls (control group). The included children were subjected to full clinical history taking, full clinical examination, assessment of (total serum IgE, CBC for peripheral eosinophil percentage, cytokine profile (serum levels of INF-B), and genetic analysis: SNPs of NOD2 (rs2066845).ResultsThere was a significant increase in G allele frequency, in both homozygous (GG) and heterozygous (GC) states, among asthmatic children of cough and allergic march phenotypes compared to healthy controls, with no significant difference between the two phenotypes. In addition, serum INF-β was significantly lower in cough and allergic march phenotypic asthmatics with GG genotypes versus healthy controls of the same genotype.ConclusionsNOD2 (rs2066845) gene polymorphism is associated with both cough and allergic march asthma phenotypes in Egyptian asthmatic children. It was also shown that G allele may be implicated in asthma pathophysiology.

Bronchial thermoplasty improves cough hypersensitivity and cough in severe asthmatics

BackgroundCough is a troublesome symptom of asthma because it is associated with disease severity and poor asthma control. Bronchial thermoplasty (BT) may be effective in improving cough severity and cough-related quality of life in severe uncontrolled asthma. ObjectiveTo evaluate the efficacy of BT for cough in severe uncontrolled asthma. MethodsTwelve patients with severe uncontrolled asthma were enrolled in this study between 2018 May and March 2021 and arbitrarily divided into cough-predominant [cough severity Visual Analog Scale (VAS) ≥ 40 mm, n = 8] and typical asthma (cough VAS <40 mm, n = 4) groups. Clinical parameters, such as capsaicin cough sensitivity [C-CS: the concentrations to inhaled capsaicin required to induce at least two (C2) and five (C5) coughs], lung function, and type-2–related biomarkers (fractional nitric oxides and absolute eosinophil counts) and cough-related indices [cough severity VAS and the Leicester Cough Questionnaire (LCQ)] were evaluated before and 3 months after performing BT. ResultsBT significantly improved both cough-related indices and C-CS in the cough-predominant group. Changes in C-CS were significantly correlated with changes in the LCQ scores (C5: r = 0.65, p = 0.02 for all patients, and r = 0.81, p = 0.01 for the cough-predominant group). ConclusionsBT may be effective for cough in severe uncontrolled asthma by improving C-CS. However, further larger cohort studies are necessary to confirm the effect of BT for cough in asthma. Clinical trial registrationThis study was registered in the UMIN Clinical Trials Registry (Registry ID UMIN: 000031982).

Identification of cough-variant asthma phenotypes based on clinical and pathophysiologic data

Cough variant asthma (CVA) may respond differently to anti-asthmatic treatment. There is limited data on the heterogeneity of CVA. We aimed to classify patients with CVA using cluster analysis based on clinico-physiological parameters and to unveil the underlying molecular pathways of these phenotypes with transcriptomic data of sputum cells. K-mean clustering was applied to 342 newly physician-diagnosed patients with CVA from a prospective, multicenter, observational cohort using 10 pre-specified baseline clinic-pathophysiological variables. The clusters were compared based on clinical features, treatment response and sputum transcriptomic data. Three stable CVA clusters were identified. Cluster 1 (n= 176) was characterized by female predominance, late-onset, normal lung function, and a low proportion of complete resolution of cough (60.8%) after anti-asthmatic treatment. Cluster 2 (n=105) presented with young, nocturnal cough, atopy, type 2-high inflammation, and a high proportion of complete resolution of cough (73.3%) with highly upregulated co-expression gene network that related to type 2 immunity. Cluster 3 (n= 61) had a high body mass index, long duration, family history of asthma, low lung function, and low proportion of complete resolution of cough (54.1%). Th17 immunity and type 2 immunity co-expression gene networks were both upregulated in clusters 1 and 3. Three clusters of CVA were identified with different clinical, pathophysiological, and transcriptomic features and responses to anti-asthmatics treatment, which may improve our understanding of pathogenesis and develop individualized treatment of cough in asthma.

Tiotropium for refractory cough in asthma via cough reflex sensitivity: A randomized, parallel, open-label trial

BackgroundWe previously reported in an uncontrolled study that tiotropium alleviated chronic cough in asthma refractory to inhaled corticosteroids and long-acting β2 agonists (ICS/LABA) by modulating capsaicin cough reflex sensitivity (C-CRS). ObjectiveWe sought to determine the antitussive effects of tiotropium for refractory cough in asthma in a randomized, parallel, open-label trial. MethodsA total of 58 patients with asthma having chronic cough refractory to ICS/LABA were randomized in a 2:1 ratio to add tiotropium 5 μg (39 patients) or theophylline 400 mg (19 patients) for 4 weeks. Patients underwent workups, including capsaicin cough challenge test and subjective measures such as cough severity visual analog scales (VAS). We adopted C5, the lowest capsaicin concentration to induce at least 5 coughs, as an index of C-CRS. We also performed a posthoc analysis to identify factors predicting tiotropium responders, who found an improvement of at least 15 mm in cough severity VAS. ResultsA total of 52 patients (tiotropium, 38; theophylline, 14) completed the study. Both tiotropium and theophylline significantly improved cough severity VAS and cough-specific quality of life. Tiotropium, but not theophylline, significantly increased C5, whereas pulmonary function did not change in either group. In addition, changes in cough severity VAS correlated with changes in C5 values in the tiotropium group. A posthoc analysis revealed that heightened C-CRS (C5 ≤1.22 µM) before the addition of tiotropium was an independent predictor for tiotropium responders. ConclusionTiotropium may alleviate chronic cough in asthma refractory to ICS/LABA by modulating C-CRS. Heightened C-CRS may predict responsiveness to tiotropium for refractory cough in asthma. Trial RegistrationClinical Trials Registry ID: UMIN000021064 (https://center6.umin.ac.jp/cgi-open-bin/ctr/ctr_view.cgi?recptno=R000024253).

Nighttime continuous contactless smartphone-based cough monitoring for the ward: A validation study.

Clinical deterioration can go unnoticed in hospital wards for hours. Mobile technologies such as wearables and smartphones enable automated, continuous, non-invasive ward monitoring and allow the detection of subtle changes in vital signs. Cough holds great potential for monitoring through mobile technologies on the ward as it is not only a symptom of prevalent respiratory diseases such as asthma, lung cancer, and COVID-19 but also a predictor of acute health deterioration. In past decades, many efforts have been made to develop an automatic cough counting tool. To date, however, there is neither a standardized, sufficiently validated method nor a scalable cough monitor that can be deployed on a consumer-centric device that reports cough counts continuously. These shortcomings limit the tracking of coughing and, consequently, hinder the monitoring of disease progression in prevalent respiratory diseases such as asthma, chronic obstructive pulmonary disease, and COVID-19 in the ward. This exploratory study involves the validation of an automated smartphone-based monitoring system for continuous cough counting in two different modes in the ward. Unlike previous studies that focused on evaluating cough detection models on unseen data, the focus of this work is to validate a holistic smartphone-based cough detection system operating in near real-time. Automated cough counts are measured consistently on-device and on-computer, and compared with cough and non-cough sounds counted manually over eight hours long nocturnal recordings in nine patients with pneumonia in the ward. The proposed cough detection system consists primarily of an Android app running on a smartphone that detects coughs and records sounds, and secondarily of a backend that continuously receives the cough detection information and displays the hourly cough counts. Cough detection is based on an ensemble Convolutional Neural Network developed and trained on asthmatic cough data. In this validation study, a total of 72 hours of recording from nine participants with pneumonia, four of whom were infected with SARS-CoV-2, were analyzed. All recordings were subjected to manual analysis by two blinded raters. The proposed system yielded sensitivity and specificity of 72% and 99% on-device and 82% and 99% on-computer, respectively, for detecting coughs. The mean difference between the automated and human rater cough counts were -1.0, CI 95% [-12.3, 10.2] and -0.9, CI 95% [-6.5, 4.8] coughs per hour within-subject for the on-device and on-computer mode, respectively. The proposed system thus represents a smartphone cough counter that can be used for continuous hourly assessment of cough frequency in the ward.

Wheezy and Cough Asthma Phenotypes in a cohort of Egyptian Children: Clinical features and CCR3 T51C Gene Polymorphism

Background: Asthma is a heterogenous disease with variable characteristic phenotypes. Correlating clinical asthma phenotypes with the underlying genotypes could pave the way for development of tailored asthma medications. Objective: The purpose of this study was to describe the clinical features of wheezy and cough asthma phenotypes and to assess the frequency of CCR3T51C gene polymorphism among Egyptian asthmatic children. Methods: A group of 60 Egyptian asthmatic children (40 wheezy phenotype and 20 cough phenotype) together with 100 controls were enrolled and analyzed for the genotypes of CCR3 T51C polymorphisms using PCR-RFLP. Serum IgE levels were determined by ELISA technique. Results: Regarding the clinical characteristics, associated allergic rhinitis and atopic dermatitis were found to be significantly higher among wheezy phenotype compared to cough phenotype. Also, most of the patients with wheezy phenotype had moderate to severe asthma while most of the patients with cough phenotype had mild asthma. Regarding the frequency of CCR3 T51C genotypes, the TT homozygote genotype was the most frequent genotype among cases and controls. However, no statistically significant differences were found between the two clinical phenotypes. Conclusion: In our studied population, wheezy asthma phenotype was characterized by higher frequency of associated allergic march and increased asthma severity. Yet, our results deny the value of CCR3T51C genetic polymorphism as a genetic marker for differentiating between wheezy and cough asthma phenotypes.

咳嗽型哮喘发病机制及治疗进展

咳嗽型哮喘发病机制及治疗进展

P2X3-P2X7 SNPs and Gene-Gene and Gene-Environment Interactions on Pediatric Asthma

ABSTRACT Background To investigate the relationship between polymorphisms of P2X3, P2X7 genes and environment interaction with susceptibility of childhood asthma. Methods We conducted a matched case-control study with 170 cases and 175 healthy controls. The rs10896611, rs2276038, rs3781899 in P2X3 and rs1718119, rs3751143 in P2X7 polymorphisms were genotyped using the technique of an improved multiplex ligation detection reaction. Gene-gene, gene-environment and haplotype-environment interactions were tested using the generalized multi-factor dimensionality reduction method. Results There were no differences between cases and controls in allele or genotype frequencies of P2X3 and P2X7. The C/C, G/C genotypes of rs10896611, and C/C, C/T genotypes of rs2276038 and G/G, G/A genotypes of rs3781899 were associated with asthmatic cough (p>0.05),. The haplotype GCT of P2X3 reduced the risk of asthma (OR = 0.48, p = 0.048), and the haplotypes AGT (OR = 0.45, p = 0.001) and GCC (OR = 2.16, p = 0.002) were associated with asthmatic cough. The haplotype AA of P2X7 increased risk of asthma severity (p<0.05). The three-locus model indicated a potential haplotype-environment interaction in GCT, ETS, and pet (p = 0.001). Conclusions The rs10896611, rs2276038 and rs3781899 of P2X3 minor alleles increased the risk of asthmatic cough. Haplotype GCT of P2X3 was a protective factor for asthma, the haplotype AGT was a protective factor and GCC was a risk factor for asthma with cough. In addition, the interactions of haplotype GCT of P2X3, ETS and pet may increase an individual’s susceptibility to asthma.

Narrative Review of the Mechanisms and Treatment of Cough in Asthma, Cough Variant Asthma, and Non-asthmatic Eosinophilic Bronchitis.

Chronic cough is a debilitating condition affecting 10-12% of the general population and is one of the leading causes for referral to secondary care. Many conditions have been associated with chronic cough, including asthma, gastro-esophageal reflux disease and upper airways cough syndrome. Inflammatory airway conditions including cough variant asthma (CVA) and non-asthmatic eosinophilic bronchitis (NAEB) contribute to a significant proportion of presentations with chronic cough, with differing diagnostic criteria and different responses to commonly used asthma therapy for their respective diagnoses. Mechanistic studies in both animal models and humans have identified increased neuronal sensitivity and subsequent central sensitization. These mechanisms include inflammatory-mediated nociceptor sensitization and alterations of afferent nerve terminal excitability, phenotypic changes in the vagal afferent neurons over time, and central neuroplasticity resulting from increased synaptic signalling from peripheral afferents. The aim of this review is to discuss the mechanisms, neurophysiology, and management approaches currently available for patients presenting with chronic cough with underlying asthma, CVA, and NAEB and to shed a light on areas of further research required to elucidate the mechanisms of cough in this patient population.

A multicenter survey on the current status of chronic cough and its impact on quality of life in Guangdong, China.

BackgroundChronic cough is a troublesome clinical problem with long-term impacts at the patient level. However, the burden of chronic cough in China is largely unknown. Thus, we performed a multicenter cross-sectional survey on the current status of chronic cough and its impact on quality of life in Guangdong, south China.MethodsUsing a standardized questionnaire, we extracted and analyzed the relevant data on demographics, number of visits to a doctor, previous diagnosis, previous medications used and initial diagnosis. Cough-specific quality of life was measured by the Mandarin Chinese version of the Leicester Cough Questionnaire (LCQ-MC).ResultsOf 933 patients from 13 tertiary medical centers in Guangdong, 52.2% were female, the median age was 40.0 [interquartile range (IQR), 31.0–52.0] years, and the median duration of chronic cough was 6.0 (IQR, 3.0–24.0) months. Over half (n=452, 54.0%) of the patients had visited physicians ≥3 times for cough. In terms of previous diagnosis, bronchitis (n=432, 46.5%) had been most frequently diagnosed, followed by pharyngitis (n=246, 26.5%) and asthmatic cough (n=98, 10.5%). A majority of patients with chronic cough had used antitussive agents (n=539, 58.5%), antibiotics (n=374, 40.6%) and traditional Chinese medicine (TCM) (n=294, 31.9%). Among the three subscales of the LCQ-MC, we observed lower scores in the mental health domain than in the physical and social domains (both P<0.001). Additionally, lower LCQ-MC scores were found in females and patients who saw the doctor >3 times for both the total and three subscale scores (all P<0.05).ConclusionsMisdiagnosis and inappropriate treatment are prevalent in patients with chronic cough and lead to considerable antibiotic abuse. Chronic cough markedly affects suffers’ quality of life, especially for women.

Usefulness of simultaneous impulse oscillometry and spirometry with airway response to bronchodilator in the diagnosis of asthmatic cough

Objective: Some of the most common causes of chronic cough include cough variant asthma (CVA), bronchial asthma (BA), and asthma–COPD overlap (ACO). Although there is some overlap in the etiology of these diseases, it is clinically important to attempt an early differential diagnosis due to treatment strategies and prognoses. Methods: Spirometry and impulse oscillometry (IOS) before and after bronchodilator inhalation were analyzed for clinically diagnosed CVA (cCVA, n = 203), BA (cBA, n = 222), and ACO (cACO, n = 61). Results: A significant difference in ΔFEV1 was observed between cBA and cCVA (ΔFEV1 improvement of 122.5 mL/5.4% and 65.7 mL/2.2%, respectively), but no difference was observed in ΔPEF, ΔV50, or ΔV25. Except for R20 (resistance at 20 Hz), significant differences between the three groups were observed in IOS. In IOS, cCVA and cBA showed comparable peripheral airway response to bronchodilator which was thought to be commensurate with changes in V50 and V25. cACO improved ΔFEV1 improvement of 81.0 mL/6.2% and was distinguished by a downward respiratory system reactance (Xrs) waveform with a limited bronchodilator response. FEV1/FVC, %FEV1, and %V25 had relatively strong correlations with the three IOS parameters, X5 (reactance at 5 Hz), resonant frequency (Fres), and low-frequency reactance area (ALX), in the correlation between IOS and spirometers. Conclusion: Changes in IOS parameters were more sensitive in this study than changes in FEV1 or the flow-volume curve. Considering the benefits and relevance of the two different tests, simultaneous IOS and spirometry testing were useful in the diagnosis of asthmatic cough.

Effect of Extended Nursing Application on the Disappearance Time of Cough�� Asthma and High Fever in Children with Pneumonia

Effect of Extended Nursing Application on the Disappearance Time of Cough�� Asthma and High Fever in Children with Pneumonia

Chronic cough in asthma is associated with increased airway inflammation, more comorbidities, and worse clinical outcomes.

Background: Cough is often the most prominent and intractable symptom reported by patients with asthma, but few studies have explored the characteristics of patients with asthma and with chronic cough (CC) in a real-world setting. Methods: In a prospective cohort study, patients ages ≥ 18 years with stable asthma were consecutively recruited at the West China Hospital, Sichuan University. The patients were classified as having asthma with CC (the CC group) or asthma with non-CC (the non-CC group) after 3 months of optimized asthma therapy according to standard guidelines. Multidimensional assessment was performed at baseline, followed by a 12-month follow-up to assess asthma exacerbations. Results: Of 323 patients with asthma, 127 patients were assigned to the CC group and 196 patients were assigned to the non-CC group. The participants with CC were older and had more airflow obstruction; worse asthma control and quality of life; increased airway inflammation; upper respiratory tract infection as a trigger; and more comorbidities, such as psychological dysfunction, rhinitis, chronic obstructive pulmonary disease, and bronchiectasis. They reported greater work productivity loss and daily activity impairment, and increased moderate-to-severe exacerbations. Conclusion: The participants with asthma and with CC had a significant disease burden, with increased exacerbations, health-care utilization, and impaired work productivity and daily activity. These observations indicated potential clinical implications in patients with asthma and with CC, and call for more attention to this aspect of asthma.

Audio texture analysis of COVID-19 cough, breath, and speech sounds

The coronavirus disease (COVID-19) first appeared at the end of December 2019 and is still spreading in most countries. To diagnose COVID-19 using reverse transcription - Polymerase chain reaction (RT-PCR), one has to go to a dedicated center, which requires significant cost and human resources. Hence, there is a requirement for a remote monitoring tool that can perform the preliminary screening of COVID-19. In this paper, we propose that a detailed audio texture analysis of COVID-19 sounds may help in performing the initial screening of COVID-19. The texture analysis is done on three different signal modalities of COVID-19, i.e. cough, breath, and speech signals. In this work, we have used 1141 samples of cough signals, 392 samples of breath signals, and 893 samples of speech signals. To analyze the audio textural behavior of COVID-19 sounds, the local binary patterns LBP) and Haralick’s features were extracted from the spectrogram of the signals. The textural analysis on cough and breath sounds was done on the following 5 classes for the first time: COVID-19 positive with cough, COVID-19 positive without cough, healthy person with cough, healthy person without cough, and an asthmatic cough. For speech sounds there were only two classes: COVID-19 positive, and COVID-19 negative. During experiments, 71.7% of the cough samples and 72.2% of breath samples were classified into 5 classes. Also, 79.7% of speech samples are classified into 2 classes. The highest accuracy rate of 98.9% was obtained when binary classification between COVID-19 cough and non-COVID-19 cough was done.

Objective and Subjective Measurement of Cough in Asthma: A Systematic Review of the Literature

BackgroundThe extent to which objective and subjective tools has been used to measure the characteristics and burden of cough in patients with asthma has not been reported.ObjectiveTo review the large and extensive body of literature in asthma with the specific hypothesis that the characteristics of cough and clinical impact in this disease has only occasionally been studied.MethodsFor this systematic review, we searched EMBASE and MEDLINE databases using a combination of MeSH terms for “cough” and “asthma” for studies published up to and including end of August 2021. Studies included for analysis were confined to those undertaken in adult patients (≥ 18 years) with asthma of any severity where any tool or method to specifically measure cough was employed.ResultsOf 12,090 citations identified after our initial search, 112 full-text articles met criteria for inclusion in our analysis. We found that a broad range of objective and subjective measures have been used albeit with a lack of consistency between studies. Clinically important levels of cough associated with impaired health status were identified in patients with asthma.ConclusionAlthough cough is a common symptom in asthma, the clinical features and accompanying healthcare burden have been studied infrequently. In studies where cough was measured, the methods employed varied considerably. A more consistent use of cough-specific measurement tools is required to better determine the nature and burden of cough in asthma.