Bronchial asthma: what is different in patients with and without chronic cough?

<b>Background:</b> Cough is a well-recognized symptom of asthma, but the role and impact of chronic cough (&gt;8 weeks) in asthma patients has not been completely described. <b>Aim:</b> To compare clinical, functional and inflammatory characteristics of asthma patients with chronic cough (ACC) VS those without (ANCC). <b>Methods:</b> A cross-sectional study was conducted in an Italian reference asthma clinic: induced sputum and blood eosinophils were collected in stable asthma patients and stratified according to the presence of chronic cough. <b>Results:</b> 208 asthma patients were enrolled: 66 (31.7%) showed ACC. ACC patients were more frequently male (69.7% VS 54.9% P=0.04), non-atopic (47.0% VS 31.3% P=0.03); had more severe disease [median(IQR) GINA step 2020 5(4-5) VS 4(3-5) P=0.003], lower disease control [median(IQR) asthma control questionnaire score 0.8(0.2-1.7) VS 0.3(0.0-1.0) P=0.005]; higher healthcare utilization over the previous year [41(62.1%) VS 51(37.0%) P=0.001]. No differences were found in ACC VS ANCC for blood tests [median(IQR): eosinophils% 4.6(1.8-8.2) VS 3.8(2.0-6.1) P=0.51, total IgE U/L 122(59-257) VS 226.5(70.1-518) P=0.08, PCR 0.21(0.10-0.40) VS 0.21(0.10-0.55) P=0.86] and induced sputum [median(IQR): eosinophils% 5.8(1.0-34.5) VS 3.8(1.0-24.2) P=0.38, neutrophils% 50(15.2-73.8) VS 55.5(20.0-76.1) P=0.42]. Moreover no differences were found for FEV1% [mean(SD) 93.7(23.8) VS 89.8(24.3) P=0.27], age, smoking history, comorbidities, disease onset, antileucotrienic, oral corticosteroid and biological therapy, exacerbations. <b>Conclusion:</b> ACC differs from ANCC for disease severity, respiratory symptoms, health care utilizations, but not for systemic and bronchial inflammation, lung function and comorbidities.