COPD With Chronic Cough Linked to Increased Healthcare Utilization

Patients with chronic obstructive pulmonary disease (COPD) with comorbid chronic cough experienced more wheezing, dyspnea, chest pain, acute pneumonias, and provider visits than those without, according to the results of a recent study published in CHEST.

Respiratory symptoms, healthcare utilization, lung function, and inflammatory biomarkers from participants in the Copenhagen General Population Study with COPD were recorded. Participants were divided into 2 groups (with or without comorbid cough), and differences between groups were evaluated.

Of the 43,271 participants in the Copenhagen General Population Study, 8181 (19%) had COPD and 796 (10%) had chronic cough. A total of 1585 (5%) patients without COPD had chronic cough. Individuals with COPD were more likely to be older, more like to use airway medications, more likely to be smokers, and have higher cumulative tobacco use compared with individuals without COPD.

Individuals with chronic cough vs those without more often had sputum production, wheezing, dyspnea, chest pain or tightness, episodes of acute bronchitis or pneumonia during the past 10 years, and ≥3 general practitioner visits during the past 12 months. When blood inflammatory markers were analyzed, patients with chronic cough had higher levels of high-sensitive C-reactive protein, fibrinogen, leukocytes, neutrophils, eosinophils, and immunoglobulin E. In addition, individuals with COPD with chronic cough had lower forced expiratory volume in 1 second (FEV₁) percent predicted compared with individuals without chronic cough (81% vs 89%, respectively). Forced vital capacity (FVC) percent predicted and the ratio of FEV₁/FVC were also lower in patients with COPD and chronic cough vs those without chronic cough (100% vs 106% and 0.64 vs 0.66, respectively).

These findings indicate that “…chronic cough in individuals with COPD is associated with a more severe disease phenotype, which could be helpful for stratifying management of COPD in the future,” the researchers wrote.

Disclosure: Several study authors declared affiliations with the pharmaceutical industry. Please see the original reference for a full list of authors’ disclosures.

Reference

Landt E, Çolak Y, Lange P, Laursen LC, Nordestgaard BG, Dahl M. Chronic cough in individuals with COPD: a population-based cohort study [published online January 24, 2020]. CHEST. doi:10.1016/j.chest.2019.12.038