Klin Padiatr 2022; 234(05): 322
DOI: 10.1055/s-0042-1754456
Abstracts
Orals
Highlights der Posterpräsentationen

Cough phenotypes in children: findings from the Swiss Paediatric Airway Cohort

MC Mallet
1   Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland
,
ESL Pedersen
1   Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland
,
R Makhoul
1   Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland
,
S Blanchon
2   Unité de pneumologie et de mucoviscidose pédiatrique, Département Femme-Mère-Enfant, CHUV et Université de Lausanne, Lausanne, Switzerland
,
K Hoyler
3   Kinderpneumologie Horgen, Private Practice for Paediatric Pneumology, Horgen, Switzerland
,
A Jochmann
4   Department of Paediatric Pulmonology, University Children’s Hospital Basel, Basel, Switzerland
,
P Latzin
5   Division of Paediatric Respiratory Medicine and Allergology, Department of Paediatrics, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
,
A Moeller
6   Department of Respiratory Medicine, University Children’s Hospital Zurich and Children’s Research Centre, University of Zurich, Zurich, Switzerland
,
N Regamey
7   Division of Paediatric Pulmonology, Children's Hospital, Cantonal Hospital Lucerne, Lucerne, Switzerland
,
O Sutter
8   Paediatric Practice, Worb, Switzerland
,
M Goutaki
1   Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland
5   Division of Paediatric Respiratory Medicine and Allergology, Department of Paediatrics, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
,
BD Spycher
1   Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland
,
CE Kuehni
1   Institute of Social and Preventive Medicine, University of Bern, Bern, Switzerland
5   Division of Paediatric Respiratory Medicine and Allergology, Department of Paediatrics, Inselspital, Bern University Hospital, University of Bern, Bern, Switzerland
› Author Affiliations
› Further Information
Also available at
 

Introduction Distinction of phenotypes among children with cough can help understand underlying causes. We used a data-driven approach to identify cough phenotypes in children and assess their clinical validity.

Methods We used data from the Swiss Paediatric Airway Cohort, a national multicentre and observational clinical cohort of children aged 0-16 years seen in paediatric respiratory outpatient clinics in Switzerland. In this study we included 531 children aged 5-16 years with cough (i.e. without cold, at night, more than others or more than 4 weeks) but no wheeze. We applied latent class analysis to identify phenotypes using cough characteristics and symptoms from parental questionnaires and selected the best fitting model and optimum number of classes using Akaike Information Criteria. We tested the validity of the phenotypes by comparing characteristics, objective tests, doctors’ diagnosis, and one-year prognosis.

Results We identified four cough phenotypes: allergic (61%), infectious (4%), mixed allergic and infectious (9%) and nonspecific (25%). Demographic characteristics were similar but children of the allergic phenotype were older. History of atopy was most frequent in the allergic phenotype. FeNO differed across groups (p<0.001) being highest in the allergic (17.9 ppb, 95% CI 15.6-19.5) and lowest in the infectious phenotype (7.0 ppb, 95% CI 5.0-17.7). Similarly, positive allergy tests were common in the allergic (70%) and rare in the nonspecific phenotype (31%). 80% of children in the allergic phenotype were diagnosed with asthma compared to 44-55% in other phenotypes. A diagnosis of chronic cough was more frequent in the mixed allergic and infectious (44%) and infectious phenotypes (39%). At one-year follow up, children of the allergic phenotype more often developed wheeze and cough persisted less often.

Conclusion The four identified phenotypes of cough without wheeze are valuable to understand underlying causes and predict short-term prognosis which is essential for clinical management.

Funding SNF320030_182628



Publication History

Article published online:
21 September 2022

© 2022. Thieme. All rights reserved.

Georg Thieme Verlag
Rüdigerstraße 14, 70469 Stuttgart, Germany