Background: Chronic cough (CC) at a population level is not well recognized.

Objectives: To describe characteristics, and socioeconomics of adults with possible chronic cough (PCC) in Sweden

Methods: A national cohort with individuals ?18 years from two population-based databases; The National Patient Register and the Swedish Prescribed Drug Register, linked with socioeconomic factors from Statistics Sweden. Secondly, a regional primary care cohort. PCC was defined as at least one cough diagnosis (ICD-10 DR05) and/or with ?2 redeemed prescriptions for relevant cough-medication within the inclusion period, 2016 ? 2018. All individuals on medications which may induce cough or suggest acute infection and individuals diagnosed with conditions where cough is a cardinal symptom, were excluded.

Results: From 256,046 individuals in the national cohort 62,963 filled the criteria for PCC, giving a prevalence of about 1%. Mostly women (60%); Mean age 56 years. In the regional cohort, the prevalence of PCC was 2%. About three percent of the individuals with PCC in primary care had referrals to a secondary care specialist. Cough medicines were mainly prescribed by primary care physicians (82%). A majority (63%) had evidence of PCC 10 years prior to the inclusion period. From PCC individuals, 56% had Unexplained CC vs 44% had Refractory CC. The cohort with PCC had a lower level of education and a lower income compared with Swedish general population.

Conclusion: Most PCC individuals had a long history of cough, worse socioeconomic status, indicating a substantial burden of the condition, but referrals to specialist care was very rare. Signifying the need to facilitate a standardized approach for diagnosis and treatment.