Characteristics Of Ear Cough Reflex In Chronic Cough Patients,Its Impact On The Prognosis One Year Later And The Quality Of Life

BackgroundEpidemiological surveys show that the prevalence of chronic cough is as high as 10%globally.The etiology and pathogenesis of chronic cough are complex,and the treatment cycle is long.Frequent coughing can affect the physical and mental health and quality of life of patients.At present,there are few reports about the impact of the ear cough reflex(ANR)on chronic cough at home and abroad.What is the relationship between ANR and the clinical characteristics of chronic cough,exhaled nitric oxide(FeNO),whether ANR is related to the prognosis of chronic cough one year later,and whether ANR is related to the quality of life under normal control of novel coronavirus infection(COVID-19)remains to be futher clarified.ObjectiveTo investigate the influencing factors of ANR in chronic cough patients and its impact on the prognosis of chronic cough one year later,and to analyze the difference in the quality of life of chronic cough patients with ANR positive or not before and after the prevention and control of COVID-19.MethodsDiagnosed as a chronic cough patient from January 2018 to March 2019,included in the outpatient department of Southern Hospital.Use cotton swabs to stimulate both external auditory meatus and evaluate ear cough reflex.Compare the differences in ANR between the chronic cough group and the healthy control group,and analyze the relationship between ANR and FeNO,as well as cough status after one year of follow-up.Taking the closure of Wuhan on December 23,2019 as the time point,the patients with chronic cough were divided into two groups before and after the normal prevention and control of COVID-19 epidemic,and their leicester couch quality of life questionaire(LCQ)scores,age,gender,cough duration,ear cough reflex and FeNO test results were recorded,and the differences of the above indicators between the two groups were compared.Results200 chronic cough patients and 172 healthy controls were included.The positive rates of ANR in the chronic cough group and the control group were 15.50%and 8.14%,respectively.The chronic cough group was significantly higher than the control group(P=0.030).The positive rate of ANR in the chronic cough group showed no statistically significant differences in gender,smoking history,allergy history,and etiology.There was no statistically significant difference in FeNO levels and cough duration between ANR positive and negative patients in the chronic cough group.After one year of follow-up in the chronic cough group,there was no statistically significant difference in the proportion of cough recovery,improvement,or no improvement between ANR positive and negative patients.101 patients with chronic cough before the prevention and control of COVID-19 and 115 patients after the prevention and control of COVID-19 were included.None of the patients was infected with COVID-19.There was no statistical difference between the baseline data of the two groups.After the prevention and control of COVID-19,the total score of LCQ,the score of physiological field and the score of social field were significantly higher than those before the prevention and control of COVID-19(P=0.003,P=0.000,P=0.009).There was no statistical difference in the score of psychological field and FeNO value.The positive rate of ear cough reflex after COVID-19 prevention and control(15.65%)was higher than that before COVID-19 normal prevention and control(6.93%)(P=0.036).There was no significant difference in the LCQ scores of ANR positive chronic cough patients before and after COVID-19 prevention and control.ConclusionThe positive rate of ANR in patients with chronic cough was 15.5%.The positive rate of ANR could not judge the prognosis of cough in one year.The quality of life of ANR positive patients under the control of COVID-19 did not improve.Its clinical significance needs further study.