摘要
咳嗽是新型冠状病毒 SARS-CoV-2感染急性期的常见症状, 部分患者可发展为持续性咳嗽(亚急性咳嗽甚至慢性咳嗽), 严重影响生活质量。目前, 新型冠状病毒的奥密克戎变异株感染在中国仍然十分普遍, 中华医学会呼吸病学分会哮喘学组与国家呼吸医学中心组织相关专家制定了本共识, 共识的主要内容包括以下5个部分:流行病学与发病机制、临床表现、诊断与鉴别诊断、治疗和展望, 以期及时指导广大临床医生规范诊治新型冠状病毒感染相关咳嗽。
Cough is a common symptom in the acute phase of novel coronavirus SARS-CoV-2 infection,and some patients may develop persistent cough(subacute cough or even chronic cough),which affects the quality of life.Currently,the Omicron variant of SARS-CoV-2 infection is still widespread in China.In order to guide physicians on the diagnosis and treatment of SARS-CoV-2-associated cough,the Asthma Group of the Chinese Thoracic Society and the National Centre for Respiratory Medicine organized relevant experts to develop the Expert Consensus on the Diagnosis and Treatment of SARS-CoV-2-associated Cough.This consensus includes five parts:epidemiology and pathogenesis,clinical manifestations,diagnosis and differential diagnosis,treatment and outlook.The incidence of acute cough is 44%-72.5%,and about one third is productive cough.Current data shows that the average duration of cough is proximately 2 weeks,but in some patients,cough could last longer,even up to several months.SARS-CoV-2 infection cough is associated with airway epithelial damage,immunogenic or neurogenic inflammation,airway mucus hypersecretion,and cough hypersensitivity(peripheral or central).The diagnosis of SARS-CoV-2-associated cough in acute phase relies on epidemiological history,clinical characteristics,physical examination,and SARS-CoV-2 antigen or nucleic acid tests.It is also important to distinguish it from cough following other respiratory infections.The patients in acute and subacute phases of cough are currently treated symptomatically,by using cough suppressants and expectorants according to the types of the cough.For patients with severe cough,central or peripheral cough suppressants can be used.Combined first-generation antihistamines/decongestants(A/D preparations)are recommended.Anti-viral treatment such as Paxlovid is used in severe patients or patients who are likely to develop severe conditions.Anti-bacterial treatment is not recommended except for patients with bacterial infectious traits.Inhaled corticosteroids or corticosteroids plus long acting beta agonists or leukotriene antagonists are only used for patients with wheezing,or those who have asthma or allergy history,or who have evidence of eosinophilic inflammation or who are refractory to antitussive treatment.Patients who have chronic respiratory diseases such as COPD or asthma should maintain the regular treatments.With regard to TCM treatment,effectiveness is indicated both in the acute phase or non-acute phase based on clinical practice,and collection of more evidence on this aspect is also under way.There is limited data on SARS-CoV-2-associated cough in regard of epidemiology,pathogenesis,features of cough,treatment,and prognosis.More studies are warranted to improve our understanding and management of SARS-CoV-2-associated cough in the future.
作者
中华医学会呼吸病学分会
国家呼吸医学中心
赖克方
沈华浩
Chinese Thoracic Society;National Center for Respiratory Medicine;Lai Kefang(不详;Department of Pulmonary and Critical Care Medicine,the FirstAfiliated Hospital of Guangzhou Medical University,National Center for Respiratory Medicine,National Clinical Research Center for Respiratory Disease,State Key Laboratory of Respiratory Disease,Guangzhou Institute of Respiratory Health,Guangzhou 510120,China)
出处
《中华结核和呼吸杂志》
CAS
CSCD
北大核心
2023年第3期217-227,共11页
Chinese Journal of Tuberculosis and Respiratory Diseases
