Patients with asthma and/or asthma, who experience frequent productive cough are at higher risk of exacerbations and more likely to be require hospital admission, according to a study reported in the journal Respiratory Medicine.¹

In this study, researchers sought to determine the occurrence of productive cough and disease outcomes in 7125 patients with physician-assigned asthma and/or COPD from the NOVELTY study. The self-administered St Georges Respiratory Questionnaire (SGRQ) was used to assess the frequency of productive cough, which was quantified as cough and sputum production on most days or several days in a week in the preceding 3 months. Patients were followed for a period of one year.

Results showed that 31.3% of the study subjects had frequent productive cough. The frequency was higher in patients who had coexistent asthma and COPD at 38.8% compared to patients who had either COPD (38.1%) or asthma (25.0%). Current smokers were more likely to have frequent productive cough than former and never smokers. Patients who had severe disease, as evaluated by the physician, also reported productive cough more often. Patients who had frequent cough also reported worsening of their symptoms compared to those who did not have frequent productive cough.

The probability of experiencing ≥1 exacerbation requiring hospitalization or systemic corticosteroids, over the study period was higher in patients who had repeated productive cough at the time of their enrollment in the study with odds ratio of 1.71. In all patients, history of occupational exposure to pollution at exposure to pollutants at home was associated with frequent productive cough (OR 1.50). Similarly reduced post-bronchodilator FEV1 was also associated with frequent productive cough. The odds ratio was 1.14 for every 10% decline in post-bronchodilator FEV1.

 Presence of chronic cough and chronic sputum production are key indicators of COPD along with dyspnea. This study has characterized the symptom of cough in these patients and illustrates that frequent productive cough in a patient with COPD and/or asthma is indicative of adverse clinical outcomes in terms of hospitalizations and use of steroids. It is associated with reduced FEV1 and exposure to pollution. As the severity of disease increased, the  prevalence of productive cough also increased.

Reference

1. Hughes R, et al. Frequent productive cough: Symptom burden and future exacerbation risk among patients with asthma and/or COPD in the NOVELTY study. Respiratory Medicine. 2022 June 19. DOI:https://doi.org/10.1016/j.rmed.2022.106921.