Different pattern of viral infections and clinical outcomes in patient with acute exacerbation of chronic obstructive pulmonary disease and chronic obstructive pulmonary disease with pneumonia

Abstract

Respiratory viruses are well-known causes of acute exacerbation of chronic obstructive pulmonary disease (AE-COPD) and also important pathogens for concomitant pneumonia in COPD (CP-COPD). However, the differences in a viral infection pattern and clinical impacts of respiratory viruses between the two groups have not been well investigated. The clinical and microbiological data from COPD patients admitted with AE-COPD (n = 281) or CP-COPD (n = 284) between January 2010 and December 2012 were reviewed. After excluding 88 patients (40 with AE-COPD and 48 with CP-COPD) who did not undergo a multiplex RT-PCR test for respiratory viruses, the demographic characteristics, identified viruses, and clinical outcomes of the AE-COPD and CP-COPD groups were compared. Respiratory viruses were identified in 41.9% of AE-COPD group and 33.5% of the CP-COPD groups. The most common virus was influenza virus in the AE-COPD group (33.7%) versus human coronavirus (24.1%) in the CP-COPD group. Influenza virus was significantly more common in the AE-ACOPD group than in the CP-COPD group (P < 0.01). In-hospital mortality of AE-COPD and CP-COPD were 1.2% and 12.3%, respectively (P < 0.01). Among CP-COPD patients, in-hospital mortality of patients with only viral infection group, only bacterial infection group, and viral-bacterial co-infection were 2.6%, 25.8%, and 17.5%, respectively (P = 0.01). Respiratory viruses were commonly identified in both AE-COPD and CP-COPD, influenza virus and human coronavirus were the most common viruses identified in AE-COPD and CP-COPD patients, respectively. The mortality rates of only viral infection group was significantly lower than only bacterial infection or viral-bacterial co-infection group in CP-COPD patients. J. Med. Virol. 88:2092-2099, 2016. © 2016 Wiley Periodicals, Inc.

Acute exacerbations of chronic obstructive pulmonary disease: in search of diagnostic biomarkers and treatable traits

“…75 However, another retrospective cohort analysis found a lower mortality rate in exacerbations associated with respiratory viruses compared with those testing positive for bacteria either based on culture or PCR of sputum, endotracheal aspirates or bronchoalveolar lavage. 78 Different respiratory viruses may have different effects on the immune responses and thus distinct clinical outcomes, but most studies evaluate the presence of all viruses and data are scarce on the differential clinical impact of specific virus types. Occasionally, both bacteria and viruses are identified in exacerbations and their coexistence is associated with a longer length of hospital stay and a higher symptom burden.…”

Current Status of Community-Acquired Pneumonia in Patients with Chronic Obstructive Pulmonary Disease

“…[ 13 14 ] Several studies have been undertaken to examine the impact of COPD on the clinical outcome for patients, who developed CAP, with the majority of studies showing that COPD increased mortality in patients with CAP and prolonged the hospital stay in patients who were successfully treated for CAP. [ 9 15 16 17 ] However, some other studies have shown that COPD had no relationship with patient mortality in CAP, length of stay in the hospital, as well as more frequent admission to the ICU. [ 10 13 14 18 19 20 ]…”

“…[ 63 ] The findings of another prospective study showed that in patients with AECOPD, viral pneumonia was more common and was these patients had an increased rate of coinfection with bacteria, especially with pneumococcal pneumonia. [ 16 ]…”

Structure-Based Drug Design of Potent Pyrazole Derivatives against Rhinovirus Replication

“…6,7 Since a decade, RVs are known to cause exacerbations of chronic pulmonary diseases in infants, elderly, and immunocompromised patients. 8,9 RVs have a strong impact on the morbidity and the mortality related to asthma in these populations. 10,11,12,13 Also, it has been reported that RV infections lead to worsening of chronic obstructive pulmonary disease (COPD), 14,15 and cystic fibrosis.…”