Chen Yuehan, Zhang Xu, Zeng Xiansheng, Xu Tingting, Xiao Wei, Yang Xuejiao, Zhan Wenzhi, Zhan Chen, Lai Kefang
State Key Laboratory of Respiratory Disease, National Clinical Research Center for Respiratory Disease, Guangzhou Institute of Respiratory Health, The First Affiliated Hospital of Guangzhou Medical University, Guangzhou, China.
The First People's Hospital of Jingzhou, Jingzhou, China.
J Thorac Dis. 2022 Jun;14(6):2079-2088. doi: 10.21037/jtd-21-876.
Cough is one of the most common symptoms of coronavirus disease 2019 (COVID-19). However, the prevalence of persistent cough in recovered patients with COVID-19 during a longer follow-up remained unknown. This study aims to investigate the prevalence, and risk factors for postinfectious cough in COVID-19 patients after discharge.
We conducted a follow-up study for 129 discharged patients with laboratory-confirmed COVID-19 in two large hospitals located in Hubei Province, China from January 2020 to December 2020. Baseline demographics, comorbidities and smoking history were extracted from the medical record. Current symptoms and severity were recorded by a uniform questionnaire. Spirometry, diffuse function and chest computed tomography (CT) were performed on part of patients who were able to return to the outpatient department at follow-up.
The median (interquartile range) follow-up time was 8.1 (7.9-8.5) months after discharge. The mean (standard deviation) age was 51.5 (14.9) years and 57 (44.2%) were male. A total of 27 (20.9%) patients had postinfectious cough (>3 weeks), 6 patients (4.7%) had persistent cough by the end of follow-up, including 3 patients with previous chronic respiratory diseases or current smoking. Other symptoms included dyspnea (6, 4.7%), sputum (4, 3.1%), fatigue (4, 3.1%), and anorexia (4, 3.1%) by the end of follow-up. Thirty-six of 41 (87.8%) patients showed impaired lung function or diffuse function, and 39 of 50 (78.0%) patients showed abnormal CT imaging. Patients with postinfectious cough demonstrated more severe and more frequent cough during hospitalization (P<0.001), and more chronic respiratory diseases (P=0.01). In multivariate logistic regression analysis, digestive symptoms during hospitalization [odds ratio (OR) 2.95, 95% confidence interval (CI): 1.10-7.92] and current smoking (OR 6.95, 95% CI: 1.46-33.14) were significantly associated with postinfectious cough of COVID-19.
A small part of patients developed postinfectious cough after recovery from COVID-19, few patients developed chronic cough in spite of a higher proportion of impaired lung function and abnormal lung CT image. Current smoking and digestive symptoms during hospitalization were risk factors for postinfectious cough in COVID-19.
咳嗽是2019冠状病毒病（COVID-19）最常见的症状之一。然而，COVID-19康复患者在更长随访期内持续性咳嗽的发生率尚不清楚。本研究旨在调查COVID-19患者出院后感染后咳嗽的发生率及危险因素。
2020年1月至2020年12月，我们对中国湖北省两家大型医院129例实验室确诊的COVID-19出院患者进行了随访研究。从病历中提取基线人口统计学、合并症和吸烟史。通过统一问卷记录当前症状及严重程度。对部分随访时能够返回门诊的患者进行肺功能、弥散功能及胸部计算机断层扫描（CT）检查。
出院后中位（四分位间距）随访时间为8.1（7.9 - 8.5）个月。平均（标准差）年龄为51.5（14.9）岁，男性57例（44.2%）。共有27例（20.9%）患者出现感染后咳嗽（>3周），6例（4.7%）患者在随访结束时仍有持续性咳嗽，其中3例患者既往有慢性呼吸道疾病或当前仍在吸烟。随访结束时的其他症状包括呼吸困难（6例，4.7%）、咳痰（4例，3.1%）、乏力（4例，3.1%）和食欲不振（4例，3.1%）。41例患者中有36例（87.8%）肺功能或弥散功能受损，50例患者中有39例（78.0%）CT影像异常。感染后咳嗽的患者在住院期间咳嗽更严重、更频繁（P<0.001），且慢性呼吸道疾病更多（P = 0.01）。在多因素logistic回归分析中，住院期间的消化系统症状[比值比（OR）2.95，95%置信区间（CI）：1.10 - 7.92]和当前吸烟（OR 6.95，95% CI：1.46 - 33.14）与COVID-19感染后咳嗽显著相关。
一小部分患者在COVID-19康复后出现感染后咳嗽，尽管肺功能受损和肺部CT影像异常的比例较高，但很少有患者发展为慢性咳嗽。当前吸烟和住院期间的消化系统症状是COVID-19感染后咳嗽的危险因素。
