Objective To analyze the clinical features of 46 adult patients with cough variant asthma (CVA) and the factors affecting its recurrence.Methods Baseline clinical data of 46 CVA patients admitted to Zhongshan Hospital of Fudan University from March 2015 to October 2017 were collected, and the last patient was followed up in October 2022 to ensure that each patient was followed up for at least 5 years. According to the final results of 5-year follow-up, patients with annual recurrence ≥1 were included in the high frequency recurrence group. Patients with annual recurrence less than 1 were included in the low-frequency recurrence group. The clinical characteristics of the two groups of patients were summarized, and the clinical indicators of the patients were compared and analyzed. The indicators with significant differences between the two groups were Logistic regression analysis, and the clinical factors affecting the recurrence of CVA patients were analyzed and summarized. Results The 46 patients were mainly under 65 years of age, mostly female, 69.6% had abnormal BMI, 82.6% had no smoking habit, 28.3% had positive allergen test, 71.8% had preexisting factors, and 23.9% had CVA more than 1 year from the onset to the diagnosis. The initial treatment of most patients consisted of inhaled glucocorticoids (ICS) + long-acting β2 receptor agonists (LABA), and the treatment time of most patients was less than two months, 78.3% of patients had a significant response, and 67.4% of patients no longer maintained therapy after initial treatment. Unifactor analysis of clinical characteristics of the two groups of patients showed that ACT at return visit, ACQ at return visit, ACQ at return visit-ACQ at first visit (ACQ decreased), FEV1% decreased, FEV50% decreased, and there were significant differences in 5 factors (P＜0.05). Logistic multivariate regression analysis showed that, the decrease of ACQ was an independent risk factor for adult CVA prognosis (P＜0.05). Conclusion FEV1% decline, FEV50% decline and the difference of ACQ are correlated with CVA recurrence, and the decline of ACQ is a risk factor for adult CVA recurrence (P＜0.05), which is related to the prognosis of patients, while there is no statistical significance between small airway dysfunction and CVA recurrence frequency at initial treatment