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Prevalence, pathogenesis, and causes of chronic cough
Abstract
Cough is a reflex action of the respiratory tract that is used to clear the upper airways. Chronic cough lasting for more than 8 weeks is common in the community. The causes include cigarette smoking, exposure to cigarette smoke, and exposure to environmental pollution, especially particulates. Diseases causing chronic cough include asthma, eosinophilic bronchitis, gastro-oesophageal reflux disease, postnasal drip syndrome or rhinosinusitis, chronic obstructive pulmonary disease, pulmonary fibrosis, and bronchiectasis. Doctors should always work towards a clear diagnosis, considering common and rare illnesses. In some patients, no cause is identified, leading to the diagnosis of idiopathic cough. Chronic cough is often associated with an increased response to tussive agents such as capsaicin. Plastic changes in intrinsic and synaptic excitability in the brainstem, spine, or airway nerves can enhance the cough reflex, and can persist in the absence of the initiating cough event. Structural and inflammatory airway mucosal changes in non-asthmatic chronic cough could represent the cause or the traumatic response to repetitive coughing. Effective control of cough requires not only controlling the disease causing the cough but also desensitisation of cough pathways.
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An inability to efficiently cough, for instance due to fatigue or breathlessness, can cause increased susceptibility to infection due to secretion retention.
“On the other hand, an inability to efficiently cough, for instance, due to fatigue or breathlessness, can cause increased susceptibility to infection due to secretion retention. 66”
From Prioritizing symptom management in the treatment of chronic heart failure (2020) · cites this paper as [66]
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COVID-19 cough classification using machine learning and global smartphone recordings
Pahar, M., Klopper, M., Warren, R., & Niesler, T. (2021) · Computers in Biology and Medicine · doi:10.1016/j.compbiomed.2021.104572 · Cited by 290
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“Dyspnoea is often ranked numerically or with ‘Likert’ scales based on how it impacts activities of daily living and thereby QoL.10,51 The commonly utilized NYHA class has variable sensitivity in gauging dyspnoea and classifying patients.54 Assessment of dyspnoea is challenging because patient activity level affects th…”
BackgroundInfluentialGhoshal, A. G., Ravindran, G. D., Gangwal, P., Rajadhyaksha, G., Cho, S.-H., Muttalif, A. R. B. A., Lin, H.-C., Thanaviratananich, S., Bagga, S., Faruqi, R., et al. (2016) · Lung India · doi:10.4103/0970-2113.192878 · Cited by 31
Metadata
- Authors
- Chung, K. F., & Pavord, I. D.
- Affiliations
- Royal Brompton Hospital (GB)
- Glenfield Hospital (GB)
- Corresponding author
- Chung, Kian Fan
- Venue
- The Lancet
- Publisher
- Elsevier BV
- Published
- 2008-04
- Volume
- 371
- Issue
- 9621
- Pages
- 1364-1374
- ISSN
- 0099-5355 (ISSN-L)
- 0140-6736
- OpenAlex
- W2088140593
- Cited by
- 665
- References
- 155
- Citations by year
- 2026: 23 · 2025: 37 · 2024: 51 · 2023: 50 · 2022: 45 · 2021: 53 · 2020: 41 · 2019: 42 · 2018: 29 · 2017: 38 · 2016: 33 · 2015: 47 · 2014: 31 · 2013: 31 · 2012: 25
- FWCI
- 4.70
- Type
- journal article
- Language
- en
- Open access
- closed
- Locations
- The Lancet (publishedVersion)
- PubMed (publishedVersion)
- Topics
- Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Respiratory and Cough-Related Research
- Health Sciences › Medicine › Physiology (medical) › Pathogenesis and Treatment of Hiccups
- Health Sciences › Medicine › Pulmonary and Respiratory Medicine › Asthma and respiratory diseases
- Keywords
- chronic cough, asthma, eosinophilic bronchitis, gastroesophageal reflux disease, postnasal drip syndrome, sinusitis, chronic obstructive pulmonary disease, pulmonary fibrosis, bronchiectasis, cigarette smoke exposure, capsaicin challenge, cough reflex
- MeSH terms
- Adult, Air Pollutants, Bacterial Infections, Child, Chronic Disease, Cough, Humans, Reflex, Respiratory Sounds, Smoking, Prevalence
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