Clinical and demographic characteristics of patients presenting with post-infectious bronchial hyperresponsiveness at a pulmonology clinic.

OBJECTIVE

This study aimed to characterize the clinical and demographic features of patients presenting with asthma-like symptoms following an upper respiratory tract infection (URI), despite no prior history of asthma. The goal of this study is to highlight this unrecognized clinical pattern and prevent misdiagnosis of asthma in this population.

METHODS

This cross-sectional study analyzed electronic medical records from 1,306 adult patients who presented to a pulmonology outpatient clinic with post-URI cough and associated symptoms. Extracted data included demographics, clinical manifestations, comorbidities, laboratory and spirometry results, and radiological imaging.

RESULTS

Prolonged cough was the presenting symptom in all patients, with the majority being female (62.9%) and having a mean age of 45.6 ± 12.3 years. The most common associated symptoms were sputum production (35.3%), post-nasal drip (34.6%), dyspnea (34.5%), and wheezing (34.2%). Demographically, older patients and ex-smokers had significantly longer symptom durations (≥3 weeks). Smokers had a significantly higher prevalence of wheezing and sputum production compared to non-smokers. Among patients with available spirometry (n = 594), 32.7% had reduced FEF25-75 values, suggesting small airway involvement. Older patients also showed a higher frequency of bronchovascular prominence on X-rays, which was significantly associated with dyspnea and elevated IgE levels.

CONCLUSION

This study describes the characteristics of a specific patient population presenting with temporary post infectious bronchial hyperresponsiveness. Future studies should investigate the characteristics of these patients who are responsive to short-term treatment compared to those progressing to asthma. Recognizing this pattern may help prevent asthma misdiagnosis and optimize treatment strategies.