Prevalence and burden of chronic cough in China: a national cross-sectional study

Kewu Huang; Xiaoying Gu; Ting Yang; Jianying Xu; Lan Yang; Jianping Zhao; Xiangyan Zhang; Chunxue Bai; Jian Kang; Pixin Ran; Huahao Shen; Fuqiang Wen; Yahong Chen; Tieying Sun; Guangliang Shan; Yingxiang Lin; Sinan Wu; Ruiying Wang; Zhihong Shi; Yongjian Xu; Xianwei Ye; Yuanlin Song; Qiuyue Wang; Yumin Zhou; Wen Li; Liren Ding; Chun Wan; Wanzhen Yao; Yanfei Guo; Fei Xiao; Yong Lu; Xiaoxia Peng; Dan Xiao; Xiaoning Bu; Hong Zhang; Xiaolei Zhang; Li An; Shu Zhang; Zhixin Cao; Qingyuan Zhan; Yuanhua Yang; Lirong Liang; Huaping Dai; Bin Cao; Jiang He; Kian Fan Chung; Chen Wang

doi:10.1183/23120541.00075-2022

Prevalence and burden of chronic cough in China: a national cross-sectional study

ERJ Open Res. 2022 Jul 25;8(3):00075-2022. doi: 10.1183/23120541.00075-2022. eCollection 2022 Jul.

Authors

Kewu Huang^{1

2}, Xiaoying Gu^{3

4

5}, Ting Yang^{3

4

5

6}, Jianying Xu⁷, Lan Yang⁸, Jianping Zhao⁹, Xiangyan Zhang¹⁰, Chunxue Bai¹¹, Jian Kang¹², Pixin Ran¹³, Huahao Shen¹⁴, Fuqiang Wen¹⁵, Yahong Chen¹⁶, Tieying Sun^{17

18}, Guangliang Shan¹⁹, Yingxiang Lin^{1

2}, Sinan Wu^{3

4

5}, Ruiying Wang⁷, Zhihong Shi⁸, Yongjian Xu⁹, Xianwei Ye¹⁰, Yuanlin Song¹¹, Qiuyue Wang¹², Yumin Zhou¹³, Wen Li¹⁴, Liren Ding¹⁴, Chun Wan¹⁵, Wanzhen Yao¹⁶, Yanfei Guo^{17

18}, Fei Xiao¹⁸, Yong Lu^{1

2}, Xiaoxia Peng²⁰, Dan Xiao^{3

4

5

21}, Xiaoning Bu^{1

2}, Hong Zhang^{1

2}, Xiaolei Zhang^{3

4

5}, Li An^{1

2}, Shu Zhang^{1

2}, Zhixin Cao^{1

2}, Qingyuan Zhan^{3

4

5

6}, Yuanhua Yang^{1

2}, Lirong Liang^{1

2}, Huaping Dai^{3

4

5

6}, Bin Cao^{3

4

5

6}, Jiang He²², Kian Fan Chung²³, Chen Wang^{3

4

5

6

21

24}

Affiliations

¹ Beijing Key Laboratory of Respiratory and Pulmonary Circulation Disorders, Dept of Pulmonary and Critical Care Medicine, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China.
² Beijing Institute of Respiratory Medicine, Beijing, China.
³ National Center for Respiratory Medicine, National Clinical Research Center for Respiratory Diseases, Beijing, China.
⁴ Dept of Pulmonary and Critical Care Medicine, China-Japan Friendship Hospital, Beijing, China.
⁵ Institute of Respiratory Medicine, Chinese Academy of Medical Sciences, Beijing, China.
⁶ Dept of Respiratory Medicine, Capital Medical University, Beijing, China.
⁷ Dept of Pulmonary and Critical Care Medicine, Shanxi Bethune Hospital, Taiyuan, China.
⁸ Dept of Pulmonary and Critical Care Medicine, The First Affiliated Hospital of Xi'an Jiaotong University, Xi'an, China.
⁹ Dept of Pulmonary and Critical Care Medicine, Tongji Hospital, Tongji Medical College, Huazhong University of Science and Technology, Wuhan, China.
¹⁰ Dept of Pulmonary and Critical Care Medicine, Guizhou Provincial People's Hospital, Guiyang, China.
¹¹ Dept of Pulmonary and Critical Care Medicine, Zhongshan Hospital, Fudan University, Shanghai, China.
¹² Dept of Pulmonary and Critical Care Medicine, The First Hospital of China Medical University, Shenyang, China.
¹³ State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Diseases, Guangzhou Institute of Respiratory Diseases, The First Affiliated Hospital, Guangzhou Medical University, Guangzhou, China.
¹⁴ Dept of Respiratory and Critical Care Medicine, The Second Affiliated Hospital of Zhejiang University, School of Medicine, Hangzhou, China.
¹⁵ State Key Laboratory of Biotherapy of China and Dept of Respiratory and Critical Care Medicine, West China Hospital of Sichuan University, Chengdu, China.
¹⁶ Dept of Respiratory and Critical Care Medicine, Peking University Third Hospital, Beijing, China.
¹⁷ Dept of Respiratory and Critical Care Medicine, Beijing Hospital, Beijing, China.
¹⁸ National Center of Gerontology, Beijing Hospital, Beijing, China.
¹⁹ Institute of Basic Medical Sciences, Chinese Academy of Medical Sciences; School of Basic Medicine, Peking Union Medical College, Beijing, China.
²⁰ Center for Clinical Epidemiology and Evidence-based Medicine, Beijing Children's Hospital, Capital Medical University, National Center for Children's Health, Beijing, China.
²¹ WHO Collaborating Center for Tobacco Cessation and Respiratory Diseases Prevention, Beijing, China.
²² Department of Epidemiology, Tulane University School of Public Health and Tropical Medicine, New Orleans, LA, USA.
²³ National Heart & Lung Institute, Imperial College London, and Royal Brompton & Harefield NHS Trust, London, UK.
²⁴ Chinese Academy of Medical Sciences and Peking Union Medical College, Beijing, China.

Abstract

Background: Chronic cough is a common complaint, but there are no population-based data on its burden in China. We determined the prevalence of chronic cough and its impact on health status in adults stratified by sex, age and the diagnosis of COPD or the presence of small airway dysfunction (SAD).

Methods: A representative sample of 57 779 Chinese adults aged 20 years or older was recruited and pulmonary function test was measured. Chronic cough was defined as cough lasting for >3 months in each year. Quality of life was assessed by the 12-item Short Form Health Survey (SF-12), and self-reported history of hospital visits was recorded.

Results: Chronic cough was found in 3.6% (95% CI 3.1-4.1) of Chinese adults, 2.4% (95% CI 1.9-3.1) of those aged 20-49 years and 6.0% (95% CI 5.3-6.8) of those aged 50 years or older. Individuals with chronic cough had an impaired physical component summary (PCS) score of the SF-12 (p<0.0001) and more emergency visits (p=0.0042) and hospital admissions (p=0.0002). Furthermore, the impact of chronic cough on PCS score was more significant in those aged 50 years or older, or with COPD (p=0.0018 or 0.0002, respectively), with the impact on hospital admission being more significant in those with COPD or with SAD (p=0.0026 or 0.0065, respectively).

Conclusions: Chronic cough is prevalent in China and is associated with a poorer health status, especially in individuals aged 50 years or older and those with the diagnosis of COPD or SAD.