Abnormalities on chest high-resolution computed tomography in patients with cough-variant asthma

PURPOSE: There is a limited understanding of the imaging features of chest high-resolution computed tomography (HRCT) in patients with cough variant asthma (CVA). We conducted this retrospective study to explore whether patients with CVA had relevant abnormalities on chest HRCT. PATIENTS AND METHODS: We retrospectively studied 406 patients with CVA at Beijing Chao-Yang Hospital between November 1, 2021, and October 31, 2022. We collected and analyzed the baseline data, lung function, and chest HRCT abnormalities of these patients. RESULTS: The median age of patients with CVA was 43 years, and females accounted for 63.1% of the patients. The median symptom duration of CVA was 4 months. Most patients with CVA have normal lung function (47.3%) or mild obstructive lung dysfunction (45.6%). Only 18 patients (4.4%) had small airway dysfunction. The incidence of type 2 inflammation was 64.5% among 363 patients. A total of 80.0% of the patients had abnormal chest HRCT findings in the patients. The percentage of bronchiolar abnormalities was 45.8%; however, the percentage of bronchial abnormalities was 61.3%. When subgroup analyses were performed according to lung function, 73.4% of patients with normal lung function had abnormal chest HRCT findings. Among patients with mild obstructive lung dysfunction, 85.9% had abnormal chest HRCT findings. CONCLUSION: Chest HRCT abnormalities are common in patients with newly diagnosed CVA including those with normal lung function. This suggests chest CT abnormalities may precede detectable changes in pulmonary function. Furthermore, the proportion of these abnormalities increases as lung function declines. This implies that bronchial wall thickening and pulmonary emphysema may be involved in the deterioration of lung function in CVA patients.