An acute cough could be a symptom of undiagnosed asthma or COPD, according to new research, which found that both bronchodilator responsiveness and persistent airway obstruction are common in adults without established asthma or COPD who consult for acute cough. The authors note that, "as both conditions benefit from appropriate and timely interventions, clinicians should be aware and responsive to potential underdiagnosis."
Investigators included nearly 2,000 patients from 16 centers across 12 European countries who presented to their physician with acute cough but had not previously been diagnosed with asthma or COPD.
Overall, 12% of patients responded to the bronchodilator and had experienced more than one other episode of wheezing, cough, or chest tightness in the previous year. Airway obstruction was diagnosed in 10% of patients using the Global Initiative for Chronic Obstructive Lung Disease (GOLD) classification of an FEV1 to forced vital capacity ratio of less than 0.7. However, it was diagnosed in fewer patients (6%) when obstruction was defined by the lower limit of normal (LLN) based on age and gender.
"Although these findings are necessary but not sufficient to diagnose COPD and asthma, patients with these findings are at higher risk of having (yet undetected) chronic obstructive lung disease and might benefit from ongoing treatment," the authors wrote. They also noted significant discordance between the two definitions of obstruction.
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