Clinical characteristics and disease burden of severe asthma in China: a cross-sectional analysis from the National Alliance network of Severe Asthma (NASA) registry

Severe asthma is associated with persistent symptoms, frequent exacerbations, and substantial healthcare utilization. However, real-world data describing the clinical characteristics and disease burden of severe asthma in China remain limited. The National Alliance network of Severe Asthma (NASA) is a prospective, nationwide, non-interventional registry across 52 tertiary hospitals in China. We performed a cross-sectional analysis of baseline data including demographic characteristics, symptom patterns, asthma control, exacerbation history, lung function, and type 2 (T2) inflammatory biomarkers. Cough burden was evaluated by the cough severity visual analog scale (VAS), Cough Evaluation Test (CET), and Leicester Cough Questionnaire (LCQ). A total of 614 adult patients with severe asthma were included, with a median age of 54.50 years, a median disease duration of 8.37 years, and 49.5% women. Among different symptom dimensions, wheezing and cough were consistently the two most common symptoms, and cough was reported as a predominant symptom in 62.2% of patients. The proportions meeting the severe cough criterion were 16.4% (VAS), 19.2% (CET), and 30.4% (LCQ), respectively; 33.3% met the composite definition of severe cough burden. At least two exacerbations in the previous 12 months were reported by 49.7% of patients. Lung function was markedly impaired, with a median FEV₁ % predicted of 57.9%. Among patients with available biomarker data, blood eosinophils > 0.15 × 10⁹/L were observed in 60.4% and FeNO ≥ 25 ppb in 73.7%. In this cohort, patients with severe asthma in China showed a substantial disease burden, including prominent cough symptoms, frequent exacerbations, and impaired lung function. These findings highlight the need for comprehensive symptom assessment, particularly of cough, in severe asthma. Chinese Clinical Trial Registry, ChiCTR2500111740, registered on 2025–11-05. Retrospectively registered.