Etiology Analysis of Chronic Cough After COVID-19 Infection and Research on the Efficacy of ICS or ICS/LABA

The subjects of this study were patients with chronic cough who were admitted to the Department of Respiratory and Critical Care Medicine, Xiangya Hospital, Central South University from March 1, 2023 to March 31, 2024. Patients are registered if they meet all of the following criteria: (1) ≥18 years of age; (2) A clear history of COVID-19 infection with a positive nucleic acid or antigen test before chronic cough;(3) Persistent cough for more than 8 weeks after the acute phase of COVID-19 infection has disappeared; (4) Chest X-ray and/or chest CT without significant evidence of lung disease; (5) No history of chronic cough (>8 weeks) prior to COVID-19 infection. Patients who met any of the following criteria were excluded: (1) Patients refused pulmonary function, blood tests; (2) The patient has previously been diagnosed with respiratory diseases with cough as one of the main symptoms, including cough variant asthma, allergic bronchitis, eosinophilic bronchitis, gastroesophageal reflux disease, chronic obstructive pulmonary disease, chronic bronchitis, bronchiectasis, interstitial lung disease, pulmonary/tracheobronchial tuberculosis, etc.; (3) Patients who are pregnant or breastfeeding; (4) The patient's medical records are incomplete; (5) Patients lost to follow-up. In the prospective part of this study, all enrolled patients with post-COVID chronic cough received pharmacotherapy as determined by the attending physicians (such as antitussive medications, ICS/LABA, montelukast, etc.), without protocol-driven modifications to treatment regimens. Baseline cough VAS and cough evaluation test (CET) scores were recorded. After one month of treatment, follow-up assessments of VAS and CET scores were conducted through either in-clinic visits or telemedicine.

Inclusion criteria

• Age ≥18 years old;
• A clear history of COVID-19 infection with a positive nucleic acid or antigen test before chronic cough;
• Persistent cough for more than 8 weeks after the acute phase of COVID-19 infection has disappeared;
• Chest X-ray and/or chest CT without significant evidence of lung disease;
• No history of chronic cough (>8 weeks) prior to COVID-19 infection.

Exclusion criteria

• The patient refused pulmonary function and blood tests;
• The patient has previously been diagnosed with respiratory diseases with cough as one of the main symptoms, including cough variant asthma, allergic bronchitis, eosinophilic bronchitis, gastroesophageal reflux disease, chronic obstructive pulmonary disease, chronic bronchitis, bronchiectasis, interstitial lung disease, pulmonary/tracheobronchial tuberculosis, etc.;
• Patients who are pregnant or breastfeeding;
• The patient's medical records are incomplete;
• Patients lost to follow-up.