Exploring cough hypersensitivity patterns across respiratory diseases

Cough hypersensitivity is increasingly recognized as a key mechanism underlying chronic cough across diverse etiologies. The Cough Hypersensitivity Questionnaire (CHQ) was developed to systematically assess characteristic triggers and abnormal sensory perceptions; however, its structural and clinical relevance across respiratory diseases remains unclear.

We prospectively enrolled 300 adults with chronic cough from multiple respiratory centers. Participants completed four cough-related questionnaires: the Numeric Rating Scale (NRS), Leicester Cough Questionnaire (LCQ), Cough Assessment Test (COAT), and CHQ. Spearman correlation and network analyses were used to evaluate associations between CHQ items and other cough-related measures, including subgroup analyses by disease etiology.

The CHQ demonstrated variable associations with conventional instruments and differing patterns across respiratory diseases. Triggers such as perfume and smoke correlated with LCQ hypersensitivity items, while the sensation item "urge to cough" exhibited broad correlations across physical, psychological, and social domains. Socially mediated triggers (e.g., talking) aligned with LCQ social interference items. In contrast, items such as hot air, dampness, laughter, and eating/drinking had minimal external associations. Internal CHQ correlations were sparse, and no significant associations were observed between CHQ and NRS, indicating a dissociation between hypersensitivity features and perceived severity. Disease-specific analyses suggested differing patterns, with broader associations observed in asthma and bronchiectasis compared with chronic obstructive pulmonary disease and idiopathic pulmonary fibrosis.

The CHQ captures distinct and heterogeneous dimensions of cough hypersensitivity that are not adequately reflected by conventional cough measures, suggesting its potential utility for characterizing clinically relevant multidimensional aspects of chronic cough.