Persistent Cough as a Predictor of Poor Responsiveness in Asthma Patients.

OBJECTIVES/HYPOTHESIS: The aim of this study is to establish a correlation between persistent cough (PC) and asthma diagnosis and its severity. We hypothesize that patients with past or current diagnosis of PC may have more severe asthma diagnosis and thus poor responsiveness to treatment. STUDY DESIGN: Retrospective chart review. METHODS: A retrospective review was performed on 699 charts that had a positive immunoglobulin E (IgE) allergy blood test between 2014 and 2018, and a positive asthma diagnosis. Patient demographics and asthma severity parameters such as number of clinic and emergency department (ED) visits, asthma treatment, and number of medications were recorded, as well as PC diagnosis. Logistic regressions were used to analyze the likelihood of severe asthma diagnosis in patients with PC. RESULTS: A total of 55% of patients were treated with oral corticosteroids in the PC group, compared to 41% in those without (P < .001). The mean number of hospitalizations from the ED was higher for patients with PC 0.65 (2.47) versus 0.38 (1.18) P < .05. Patients with asthma and PC, positive to lamb's quarter 2.92 (95% confidence interval [CI] 1.63, 5.22; P < .001), showed a higher likelihood of ED visits. Positivity to cat dander 2.09 (95% CI 1.03, 4.59; P < .05), lamb's quarter 2.96 (95% CI 1.50, 5.79; P < .002), dog dander 3.37 (95% CI 1.54, 8.45; P < .004) showed a higher likelihood of hospitalizations due to asthma. CONCLUSION: Patients with PC, especially those with a positive IgE allergy class test to cat dander, dog dander, house dust, Alternaria tenuis, or lamb's quarter can have a more severe asthmatic presentation. LEVEL OF EVIDENCE: 3 Laryngoscope, 132:1719-1722, 2022.

Phenotypes of Allergic Asthma: Does In-Vitro Allergy Testing Help Predict Asthma Disease Severity?

BACKGROUND: Allergy and asthma are often diagnosed concomitantly. Patients with both diagnoses might need to have a more targeted approach to reduce the symptomatic burden and severity of disease. OBJECTIVE: This study was designed to explore the relationship between specific allergen sensitization, and asthma diagnosis and severity with the hypothesis that patients who tested positive to a higher allergy class of response and to more allergens would be more likely to have severe asthma. METHODS: A retrospective review was performed on 1419 charts that had a positive IgE allergy class blood test between 2014 and 2018. A total of 701 patients had one or more positive tests and a diagnosis of asthma. Patient demographics and pertinent variables including all clinic and ED visits, specific allergy and class of response, and information related to their asthma treatment and severity were recorded. Logistic regression was used to analyze the likelihood of asthma diagnosis, concomitant diagnosis of asthma and allergic rhinitis, and measures of asthma severity. RESULTS: Higher class of response to cat dander 1.24 (1.09, 1.41), dog dander 1.29 (1.13, 1.47), lamb's quarter 1.35 (1.06, 1.70), house dust 1.41 (1.11, 1.82), Cladosporium herbarum 1.35 (1.07, 1.67) or cockroach 1.56 (1.00, 2.44) showed increased odds of hospitalizations. There was a statistically significant difference between the average number of classes for patients with and without asthma (P < .001), and those with and without steroids (P < .001). CONCLUSIONS: This study found that positivity to cat dander, dog dander, some fungus, and house dust was associated with more severe asthma.