[Retrospective analysis of 55 cases of spring thunderstorm asthma in Chongqing City]

To retrospectively analyze the clinical characteristics and allergen profiles of Spring Thunderstorm Asthma in Chongqing City, and to provide insights for prevention and management of thunderstorm asthma in this region. Medical records of asthma patients who visited the Department of Allergy, Department of Emergency and Department of Respiratory of Chongqing General Hospital within 72 hours after the thunderstorm on April 1, 2024 were retrospectively analyzed. Data on demographics, clinical symptoms/signs, history of allergic diseases, family history, and laboratory findings (including pulmonary function, fractional exhaled nitric oxide [FeNO], and allergen testing) were collected and analyzed. A cross-sectional study was performed to analyze the clinical characteristics of patients with thunderstorm asthma. The results showed that daily average temperature and precipitation were positively associated with asthma hospital patients visits(daily average temperature: r=0.291, P<0.05; precipitation: r=0.268, P<0.05). A total of 55 patients [(21 males (38.18%), 34 females (61.82%)] presented with thunderstorm-triggered asthma exacerbations, including 3 children (5.45%) and 52 adults (94.55%). Clinical manifestations included cough (47 cases, 85.45%), wheezing (29 cases, 52.73%), dyspnea (9 cases, 16.36%), chest tightness (7 cases, 12.73%), and tachypnea (6 cases, 10.91%). Wheezes were auscultated in 14 cases (25.45%). Comorbidities: 19 patients (34.55%) had prior asthma diagnoses, 38 (69.09%) had allergic rhinitis, 8 (14.55%) had allergic conjunctivitis, 4 (7.27%) had urticaria, and 1 (1.82%) had atopic dermatitis. A family history of allergies was reported in 10 patients (18.2%). Pulmonary function tests (17 patients): normal ventilation (7 cases, 41.18%), mild (7 cases, 41.18%), moderate (2 cases, 11.76%), and severe obstructive dysfunction (1 case, 5.88%). FeNO levels (6 patients) were 150.5 (98.5-206.5) ppb. Serum total IgE (23 patients) was 363.35 (103.09-597.2) kU/L. Allergen skin prick testing (24 patients) showed sensitivities to spring III pollen (91.67%, 22 cases), Humulus scandens (70.83%, 17 cases), Juniperus chinensis (58.33%, 14 cases), Dermatophagoides pteronyssinus (50.00%, 12 cases), Dermatophagoides farinae (50.00%, 12 cases), and Ulmus pumila (50.00%, 12 cases). In the non-thunderstorm asthma (non-TA) group, clinical manifestations included cough in 29 cases (60.42%), wheezing in 12 (25.00%), and no cases of dyspnea (0%), chest tightness (0%), or shortness of breath (0%). The predominant symptoms were sneezing (41 cases, 85.42%), rhinorrhea (40 cases, 83.33%), and ocular pruritus (33 cases, 68.75%). Statistically significant differences were observed between the non-TA and TA groups in cough (χ²=8.307, P<0.05), wheezing (χ²=8.224, P<0.05), dyspnea (χ²=12.030, P<0.05), chest tightness (χ²=9.228, P<0.05), and shortness of breath (χ²=7.852, P<0.05). Wheezes were audible on lung auscultation in only 2 non-TA patients (4.17%), which also differed significantly from the TA group (χ²=8.853, P<0.05). In the non-TA group 18 cases (37.50%) were diagnosed with mild asthma, with no cases of moderate-to-severe asthma, showing significant differences compared to the TA group in both mild (χ²=30.006, P<0.05) and moderate-to-severe asthma diagnoses (χ²=7.852, P<0.05). Additionally, significant differences in sensitization rates were found between the non-TA and TA groups for specific allergens: Spring III pollen (χ²=4.659, P<0.05), Humulus pollen (χ²=6.250, P<0.05), Juniperus pollen (χ²=4.114, P<0.05), and Ulmus pollen (χ²=6.415, P<0.05). In conclusion, cough was the predominant symptom of thunderstorm asthma in Chongqing City. Most patients had no prior asthma diagnosis but exhibited comorbid allergic rhinitis, highlighting the importance of pulmonary function tests and FeNO for identifying occult asthma. Spring pollen allergens (e.g., Broussonetia papyrifera, Ginkgo biloba) were major triggers, suggesting heightened caution for sensitized individuals during spring thunderstorms.