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Original Research: Signs and Symptoms of Chest Diseases |

A Prospective, Multicenter Survey on Causes of Chronic Cough in ChinaCauses of Chronic Cough in China

Kefang Lai, MD, PhD; Ruchong Chen, MD, PhD; Jiangtao Lin, MD, FCCP; Kewu Huang, MD, PhD; Huahao Shen, MD, PhD, FCCP; Lingfei Kong, MD, PhD; Xin Zhou, MD, FCCP; Zhiyang Luo, MD; Lan Yang, MD; Fuqiang Wen, MD, PhD; Nanshan Zhong, MD, FCCP
Author and Funding Information

From the State Key Laboratory of Respiratory Diseases (Drs Lai, Chen, and Zhong), Guangzhou Institute of Respiratory Diseases, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, Guangdong; the China-Japan Friendship Hospital (Dr Lin), Beijing; the Beijing Institute of Respiratory Medicine (Dr Huang), Beijing Chao-Yang Hospital, Capital Medical University, Beijing; The Second Affiliated Hospital of Zhejiang University School of Medicine (Dr Shen), Hangzhou, Zhejiang; The First Affiliated Hospital (Dr Kong), China Medical University, Shenyang, Liaoning; the Shanghai First People’s Hospital (Dr Zhou), Shanghai Jiaotong University, Shanghai; The First People’s Hospital of Foshan (Dr Luo), Foshan, Guangdong; the First Affiliated Hospital of Medical College of Xi’an Jiaotong University (Dr Yang), Xi’an, Shanxi; and the West China Hospital (Dr Wen), West China School of Medicine, Sichuan University, Chengdu, Sichuan, China.

Correspondence to: Nanshan Zhong, MD, FCCP, State Key Laboratory of Respiratory Diseases, Guangzhou Institute of Respiratory Diseases, The First Affiliated Hospital of Guangzhou Medical University, 151 Yanjiang Rd, Guangzhou, Guangdong, 510120, China; e-mail: nanshan@vip.163.com


Drs Lai and Chen contributed equally to this paper.

Funding/Support: This study was supported in part by an unrestricted research grant from Merck Sharp & Dohme (China) Ltd.

Reproduction of this article is prohibited without written permission from the American College of Chest Physicians. See online for more details.


Chest. 2013;143(3):613-620. doi:10.1378/chest.12-0441
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Background:  The causes of chronic cough in China and its relations with geography, seasonality, age, and sex are largely uncertain.

Methods:  A prospective, multicenter survey was conducted to evaluate patients with chronic cough across five regions in China by using a modified diagnostic algorithm. The effects of geography, seasonality, age, and sex on spectrum of chronic cough were also investigated.

Results:  The current study evaluated 704 adult patients, including 315 men (44.7%) and 389 women (55.3%). The causes of chronic cough were determined in 640 subjects (90.9%). Common causes included cough variant asthma (CVA) (32.6%), upper airway cough syndrome (UACS) (18.6%), eosinophilic bronchitis (EB) (17.2%), and atopic cough (AC) (13.2%). Collectively, these four causes accounted for 75.2% to 87.6% across five different regions without significant difference (P > .05), although there was variation on single causes. Gastroesophageal reflux-related cough was identified in 4.6% of causes. Seasonality, sex, and age were not associated with the spectrum of chronic cough (all P > .05).

Conclusion:  CVA, UACS, EB, and AC were common causes of chronic cough in China. Geography, seasonality, age, and sex were not associated with the spectrum of chronic cough.

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