Longitudinal profiling of viral infections in COPD patients and their implication to exacerbations

Viral respiratory tract infections have been associated with acute exacerbations of COPD (AECOPD). We evaluated longitudinally the incidence of viral infections and their association to AECOPD.We followed 450 patients with stable, moderate to very severe COPD, for 27 months. Detection of 18 viruses (adenovirus, influenza A-B, H1-H3, parainfluenza 1-4, RSV A-B, rhinovirus (RV)/enterovirus, coronavirus NL63, -OC43, -229E, -HKU1, bocavirus and metapneumovirus) was performed in naso- and oropharyngeal swabs collected at URTI onset (n=391), 10 days thereafter (n=356), at AECOPD (n=177) and stable periods (n=1909) using multiplex nucleic acid amplification testing (50’000 PCRs).Evidence for at least 1 respiratory virus was more common at AECOPD (39.0%, P<.001), at URTI onset (52.7%, P<.001), and at 10 days following an URTI (15.2%, P<.001), as compared to the stable period (5.4%). RV was the most frequently detected virus (35.7% of all viruses at AECOPD). However, only 11% of all RV’s detections were associated with AECOPD. Viruses more frequently related to AECOPD were metapneumovirus, influenza viruses and RSV. Patients with a positive viral PCR at URTI onset did not have a higher incidence of AECOPD, as compared to those with negative viral PCR results (14.6% vs 14.6%, P=.993). Detection of parainfluenza 3 at URTI onset was associated with a higher risk of AECOPD as compared to the other viruses (HR 6.24, 95%CI 1.85–21.0, P=.003) and this risk remained...
Source: European Respiratory Journal - Category: Respiratory Medicine Authors: Tags: Respiratory infections Source Type: research