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      Characterization and clinical outcomes of outpatients with subacute or chronic post COVID-19 cough: a real-world study

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      , , , ,
      PeerJ
      PeerJ Inc.
      COVID-19, Cough, Regimens, Real-world study, Outpatients

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          Abstract

          Background

          Limited research exists on the features and management of post-COVID cough. This real-world study investigates outpatients with subacute or chronic post-COVID cough, aiming to delineate characteristics and regimen responses within the population.

          Method

          We enrolled eligible patients from our outpatient unit between August 2023 and February 2024. Comprehensive clinical data, prescriptions, and patient-reported cough severity were collected during the primary visit and subsequent follow-ups.

          Result

          A total of 141 patients, aged: 42 ± 14 years old, were included, with 70% being female. The median cough duration was 8 weeks (interquartile range 4–12 weeks). Sixty percent presented with a dry cough, while the rest had coughs with phlegm. Over half reported abnormal laryngeal sensations (54%). Twenty-one percent coughed during the day, while 32% coughed constantly, and 48% experienced nocturnal episodes. Compound methoxyphenamine capsules were the most prescribed, but our study found ICS/LABA to be the most effective, followed by compound methoxyphenamine capsules, montelukast, and Chinese patent drugs.

          Conclusion

          Females exhibit a higher prevalence of post-COVID cough, and our study recommends ICS/LABA as the preferred treatment. These findings warrant validation through larger, prospectively designed studies.

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          Most cited references26

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          The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) statement: guidelines for reporting observational studies.

          Much biomedical research is observational. The reporting of such research is often inadequate, which hampers the assessment of its strengths and weaknesses and of a study's generalizability. The Strengthening the Reporting of Observational Studies in Epidemiology (STROBE) Initiative developed recommendations on what should be included in an accurate and complete report of an observational study. We defined the scope of the recommendations to cover 3 main study designs: cohort, case-control, and cross-sectional studies. We convened a 2-day workshop in September 2004, with methodologists, researchers, and journal editors, to draft a checklist of items. This list was subsequently revised during several meetings of the coordinating group and in e-mail discussions with the larger group of STROBE contributors, taking into account empirical evidence and methodological considerations. The workshop and the subsequent iterative process of consultation and revision resulted in a checklist of 22 items (the STROBE Statement) that relate to the title, abstract, introduction, methods, results, and discussion sections of articles. Eighteen items are common to all 3 study designs and 4 are specific for cohort, case-control, or cross-sectional studies. A detailed Explanation and Elaboration document is published separately and is freely available at http://www.annals.org and on the Web sites of PLoS Medicine and Epidemiology. We hope that the STROBE Statement will contribute to improving the quality of reporting of observational studies.
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            R:A Language and Environment for Statistical Computing

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              ERS guidelines on the diagnosis and treatment of chronic cough in adults and children

              These guidelines incorporate the recent advances in chronic cough pathophysiology, diagnosis and treatment. The concept of cough hypersensitivity has allowed an umbrella term that explains the exquisite sensitivity of patients to external stimuli such a cold air, perfumes, smoke and bleach. Thus, adults with chronic cough now have a firm physical explanation for their symptoms based on vagal afferent hypersensitivity. Different treatable traits exist with cough variant asthma (CVA)/eosinophilic bronchitis responding to anti-inflammatory treatment and non-acid reflux being treated with promotility agents rather the anti-acid drugs. An alternative antitussive strategy is to reduce hypersensitivity by neuromodulation. Low-dose morphine is highly effective in a subset of patients with cough resistant to other treatments. Gabapentin and pregabalin are also advocated, but in clinical experience they are limited by adverse events. Perhaps the most promising future developments in pharmacotherapy are drugs which tackle neuronal hypersensitivity by blocking excitability of afferent nerves by inhibiting targets such as the ATP receptor (P2X3). Finally, cough suppression therapy when performed by competent practitioners can be highly effective. Children are not small adults and a pursuit of an underlying cause for cough is advocated. Thus, in toddlers, inhalation of a foreign body is common. Persistent bacterial bronchitis is a common and previously unrecognised cause of wet cough in children. Antibiotics (drug, dose and duration need to be determined) can be curative. A paediatric-specific algorithm should be used.
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                Author and article information

                Contributors
                Journal
                PeerJ
                PeerJ
                PeerJ
                PeerJ
                PeerJ Inc. (San Diego, USA )
                2167-8359
                11 December 2024
                2024
                : 12
                : e18705
                Affiliations
                Department of Respiratory and Critical Care Medicine, the Second Affiliated Hospital of Soochow University , Suzhou, Jiangsu, China
                Article
                18705
                10.7717/peerj.18705
                11645979
                39677958
                97647221-65e9-4ebd-a7cd-73ed97d817e0
                © 2024 Yao et al.

                This is an open access article distributed under the terms of the Creative Commons Attribution License, which permits unrestricted use, distribution, reproduction and adaptation in any medium and for any purpose provided that it is properly attributed. For attribution, the original author(s), title, publication source (PeerJ) and either DOI or URL of the article must be cited.

                History
                : 20 June 2024
                : 22 November 2024
                Funding
                Funded by: Second Affiliated Hospital of Soochow University
                Award ID: XKTJ-XK202007
                Funded by: Science and Technology Program of Suzhou
                Award ID: SKY2021006
                This work was supported by the Competitive discipline lift project of the Second Affiliated Hospital of Soochow University (grant number XKTJ-XK202007) and the Science and Technology Program of Suzhou (grant number SKY2021006). The funders had no role in study design, data collection and analysis, decision to publish, or preparation of the manuscript.
                Categories
                Evidence Based Medicine
                Infectious Diseases
                Internal Medicine
                COVID-19

                covid-19,cough,regimens,real-world study,outpatients
                covid-19, cough, regimens, real-world study, outpatients

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