A cough is a symptom of an illness such as a cold, flu or COVID-19, but is considered a cough when it lasts for more than eight weeks chronic cough There is almost always a specific cause for this condition, say experts from the Barcelona Respiratory Network (BRN), which promotes collaborative research in the field of respiratory health. In Spain, a recent study showed that chronic cough affects approximately 5.5% of the population.
Next year, in 2024, first medicine With specific indications for chronic cough, it may be prescribed in the hospital by a pulmonologist who specializes in this condition, so people with a cough that persists for more than eight weeks should consult their primary care physician for initial diagnostic studies of chronic cough. If this If this condition persists, consider referring the patient to Pulmonologist Complete your research.
This necessitates the establishment of adequate communication among professionals to support a multidisciplinary approach to these patients, emphasizing Dr. Astrid CrespoAssociate Physician, Department of Pulmonary Medicine, Hospital Saint-Croix, Barcelona, and Researcher, Barcelona Respiratory Network (BRN). “Cough has a very significant impact on patients’ quality of life and their home environment, but people don’t realize it.” Traditionally, chronic cough has been considered a symptom, when in fact it should be considered a disease , and its treatments are diverse and should be addressed from different levels of care.
How to Diagnose and Treat Chronic Cough
According to the Pulmonary Society, coughs are divided into three categories based on duration: acute cough, which lasts less than three weeks; subacute cough, which lasts three to eight weeks; and chronic cough, which lasts more than eight weeks. Thoracic Surgery (SEPAR), indicating that acute coughs are benign and may be due to infectious causes, such as viruses affecting the upper respiratory tract, sinusitis – This is the cause of acute cough in 10% of cases – and pneumonia8%.
But according to the BRN, the most common cause of chronic cough is post-infectious pathology, as is the case with COVID-19, as a subgroup of patients who are infected with the coronavirus and suffer from it The new coronavirus epidemic lingers They have been coughing for more than eight weeks, so they have a chronic cough. This cough secondary to COVID-19 infection will not be contagious, but the patient will not completely eliminate the virus from a serological perspective.
There is no specific diagnostic test Diagnosing chronic cough, instead the patient undergoes a series of tests to rule out possible causes – a so-called diagnosis of exclusion – which varies according to the patient’s age, since in younger patients it is necessary to rule out allergies, rhinitis or asthma. In older patients, the cough should be checked to see if it is related to gastroesophageal reflux or taking antihypertensive medications (especially ACE inhibitors), which is common.
Currently, there are no specific drugs for chronic cough, but in the past 5-10 years, specific drugs have been developed for patients with chronic cough. Among them, it is worth emphasizing that P2X3 receptor antagonist Unlike current treatments, which have side effects and do not target the cough reflex, it acts on new peripheral pathways, Inhibit cough reflexthrough a mechanism that inhibits the activation of ATP channels present in peripheral nerves.
The first drug specifically to treat chronic cough will be available in 2024 and achieved a response rate of more than 75% in clinical trials
The first drug specifically designed to treat chronic cough will be available in 2024.The drug has been approved by the FDA Response rate exceeds 75% In Phase II and III clinical trials, it may be indicated for refractory chronic cough (cough that persists despite treatment of the underlying chronic disease) and idiopathic chronic cough (where the underlying cause has not been identified after thorough diagnosis).
Currently, there are no tools for measuring cough severity in clinical practice. To this end, the Catalan Society of Pneumology (SOCAP) is working on a project to harmonize the stratification criteria for chronic cough so that it can be divided into different levels of severity (mild, moderate and severe). “We must agree on when patients should be referred to experts on the subject and increase interest in this pathology, giving it importance given its impact on patients’ quality of life,” insists Dr. Crespo think.
In the research field, some diseases that appear at a later age and may appear as chronic cough 40 years ago are being studied, e.g. Ataxia type Specifically called CANVAS (Cerebellar Ataxia Syndrome with Neuropathy and Bilateral Vestibular Areflexia) (joint study with the Neurology, Genetics, Gastroenterology and Pulmonary Services of the Hospital de Saint-Paul de Saint-Croix) .
fountain: Barcelona Respiratory Network (BRN)