Correlation Between Cough Characteristics and HRCT Patterns in Fibrotic Interstitial Lung Diseases and Pulmonary Sarcoidosis

Introduction: Fibrotic interstitial lung diseases and pulmonary sarcoidosis represent diffuse pulmonary disorders with different pathological and radiological patterns. High-resolution computed tomography (HRCT) plays a central role in the evaluation of these conditions, enabling detailed assessment of parenchymal abnormalities and their distribution.

Aim: To evaluate the relationship between cough characteristics and HRCT imaging patterns in patients with fibrotic interstitial lung diseases (ILDs) (UIP and NSIP) and pulmonary sarcoidosis.

Materials and Methods: This retrospective observational study included 120 patients with diffuse lung diseases diagnosed at the University Clinic for Pulmonology and Allergology in Skopje, including 70 patients with fibrotic interstitial lung diseases (UIP and NSIP) and 50 patients with pulmonary sarcoidosis. Clinical data were collected using a structured questionnaire assessing cough characteristics, dyspnea, smoking status, and the MRC dyspnea scale. HRCT scans were analyzed for the presence of reticular changes, ground-glass opacities, micronodules, consolidations, hypoattenuation, traction bronchiectasis, fibrosis, and honeycombing. Associations between clinical variables and HRCT findings were analyzed using the χ² test and Fisher’s exact test. P values between 0.05 and 0.10 were interpreted as indicating a statistical trend.

Results: Cough was present in approximately 80% of patients with fibrotic interstitial lung diseases. Productive cough was more common in UIP, whereas dry cough was more frequent in NSIP. In pulmonary sarcoidosis, dry cough predominated in the early stages, while productive or mixed cough was more common in advanced disease. Dyspnea was highly prevalent in fibrotic ILDs and increased with sarcoidosis stage. HRCT patterns characterized by perilymphatic and peribronchovascular micronodules were more frequently observed in patients without cough, whereas fibrotic abnormalities, including traction bronchiectasis and pulmonary fibrosis, were associated with more pronounced respiratory symptoms.

Conclusion: Respiratory symptoms in diffuse lung diseases show significant associations with HRCT imaging patterns. Fibrotic interstitial lung diseases are associated with more pronounced cough and dyspnea, whereas pulmonary sarcoidosis demonstrates milder symptoms in the early stages and increasing respiratory impairment in advanced stages.