RESUMO
Background Coronaviruses are viral agents that commonly infect animals, but have the ability to cause respiratory illness in humans, exemplified by the ongoing novel coronavirus outbreak (COVID-19). Due to the sparse literature on the effects of COVID-19 on the respiratory system, and the possible development of persistent asthma-like symptoms after infection, this cross-sectional analysis was performed in order to compare the clinical and investigative parameters between post-COVID patients and asthmatic patients. Methods A retrospective cross-sectional study was conducted on patients with prior history of COVID-19 infection that presented to the pulmonology or respiratory outpatient clinics with asthma-like symptoms and were subsequently compared to known asthmatic patients with absent history of prior COVID-19 infection, in order to evaluate the degree of similarity between both cohorts. In this study, asthma-like symptoms were defined as: (i) cough, (ii) wheezing, (iii) chest tightness, and (iv) shortness of breath. Moreover, comparisons of investigative parameters were also performed, including (i) fractional exhaled nitric oxide (FeNO), (ii) serum immunoglobulin E (IgE), (iii) absolute eosinophil counts, and (iv) qualitative spirometry results. All statistical analyses were conducted via chi-squared testing for categorical variables, and independent t-test for continuous variables. Results In this study, there were a total of 76 patients included that conformed to the eligibility criteria, including 39 patients with post-COVID symptoms with absent history of asthma or other respiratory illnesses, and 37 patients with known asthma with absent history of prior COVID-19 infection or other respiratory illnesses. Overall, this study revealed the similarities between both cohorts with respect to the incidence of cough, chest tightness, and shortness of breath. Moreover, there were similarities between the serum IgE and spirometry results. However, there were differences within the complaint of wheeze, FeNO values, and eosinophil counts between both cohorts. The placement of post-COVID patients on bronchodilator therapy involving inhaled corticosteroids and long-acting beta-agonists revealed improvement in all follow-up patients. Conclusion In conclusion, there was considerable similarity in the complaint of asthma-like symptoms after COVID-19 infection, associated with an improvement after the use of bronchodilator therapy, indicating the potential role of anti-asthma therapy (e.g., bronchodilator therapy) in managing post-COVID asthma-like symptoms. In order to validate our conclusion, further comprehensive studies with robust methodologies and larger sample populations are encouraged.
RESUMO
Background Cough is one of the most common presenting complaints for physicians across the world, with the potential to result in a significant influence on one's daily life. It is typically categorized into acute cough (<3 weeks), subacute cough (three to eight weeks), and chronic cough (>8 weeks). The lack of specific treatment guidelines and evidence-based recommendations for resolving cough creates reasonable controversy in the medical field. This retrospective study aims to identify the clinical features of cough and evaluate the comparative efficacy between different anti-asthmatic treatment modalities in the urban city of Dubai, United Arab Emirates. Methods A retrospective cross-sectional study was performed on patients presenting to pulmonology or respiratory outpatient clinics with complaints of cough in the absence of any known history of chronic respiratory illness (e.g., asthma). Analysis was conducted via chi-squared and analysis of variance (ANOVA) testing. Results A total of 308 patients were eligible for inclusion, with 273 patients presenting for follow-up. Overall, patients with acute, subacute, and chronic coughs had similar clinical presentations, with no statistically significant differences noted. However, patients with pets were more likely to develop an acute cough (p = 0.04). Moreover, the follow-up outcomes of acute, subacute, and chronic cough were similar, with no significant statistical difference noted. Furthermore, patients receiving dual therapy using budesonide and montelukast, and patients receiving triple therapy using budesonide, montelukast, and tiotropium/ipratropium were most likely to gain complete relief of their symptoms, although triple therapy treatment was also associated with the highest rate of null improvement (p = 0.012). Additionally, chronic cough patients were more likely to be subject to higher C-reactive protein (CRP) levels in comparison to other cohorts (p = 0.26). Conclusion The comparative superiority of dual therapy using budesonide and montelukast, and triple therapy using budesonide, montelukast, and tiotropium/ipratropium were highlighted in this study. In the sparseness of specific treatment guidelines and evidence-based recommendations for cough, the use of anti-asthmatic therapy for cough patients has shown favorable results. Moreover, the lack of clinical differences between acute, subacute, and chronic cough may result in difficulties with the treatment of cough patients. To arrive at a valid conclusion, further comprehensive studies with larger and more diversified sample populations are encouraged.