CHEST Guidelines-Etiologies-of-Chronic-Cough-in-Pediatric-Cohorts

Etiologies-of-Chronic-Cough-in-Pediatric-Cohorts_2

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The CHEST guideline and expert panel report focuses on the etiologies of chronic cough in pediatric cohorts, particularly children aged 14 years or younger. This systematic review investigated three key questions: whether common etiologies of chronic cough differ between children and adults, whether these etiologies are age- or setting-dependent, and if obstructive sleep apnea (OSA) is a cause of chronic cough in children.<br /><br />The findings indicate moderate-quality evidence that the causes of chronic cough in children are distinct from those in adults and vary with age and clinical settings. Unlike adults, where asthma, gastroesophageal reflux disease (GERD), and upper airway cough syndrome are common, pediatric cough is often attributed to asthma-like conditions, protracted bacterial bronchitis, and cough resolution without a specific diagnosis. Additionally, regional and economic factors influence common causes; for example, tuberculosis is cited more in less affluent settings.<br /><br />Regarding the association between sleep abnormalities and chronic cough, there is limited data, primarily case reports, which found cough in children with either tonsillar hypertrophy or treated with positive airway pressure for snoring-related cough.<br /><br />Based on these conclusions, the panel recommends against assuming adult cough etiologies are common in children and advises considering the child’s age and setting when diagnosing and managing their cough. For children suspected of having OSA, they should be managed following sleep guidelines.<br /><br />The report also highlights the need for further research, advocating for multicenter cohort studies with validated cough outcomes and investigations into the relationship between OSA and cough, using rigorous research designs. This approach underscores the nuanced differences in pediatric cough management, emphasizing tailored strategies distinct from adult treatment protocols.

Keywords

chronic cough

pediatric

etiologies

obstructive sleep apnea

asthma

protracted bacterial bronchitis

tuberculosis

age-dependent

clinical settings

research