Infection as a comorbidity of COPD

Sethi, Sanjay

doi:10.1183/09031936.00081409

Cited by 212 publications

(183 citation statements)

References 55 publications

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“…Associations between COPD and lower respiratory tract infection, cardiovascular disease, psychiatric disease, musculoskeletal disease, cancer and diabetes have been documented [7][8][9][10][11][12][13]. The magnitude of the real-world impact of COPD on each of these and their impact on COPD, however, has not been well quantified.…”

Section: Introductionmentioning

confidence: 99%

Quantifying comorbidity in individuals with COPD: a population study

et al. 2014

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Chronic obstructive pulmonary disease (COPD) has been associated with many types of comorbidity. We aimed to quantify the real world impact of COPD on lower respiratory tract infection, cardiovascular disease, diabetes, psychiatric disease, musculoskeletal disease and cancer, and their impact on COPD through health services.A population study using health administrative data from Ontario, Canada, in 2008-2012 was conducted. Absolute and adjusted relative rates of ambulatory care visits, emergency department visits and hospitalisations for the comorbidities of interest in people with and without COPD were determined and compared.Among 7 241 591 adults, 909 948 (12.6%) had COPD. Over half of all lung cancer, a third of all lower respiratory tract infection and cardiovascular disease, a quarter of all low trauma fracture, and a fifth of all psychiatric, musculoskeletal, non-lung cancer and diabetes ambulatory care visits, emergency department visits and hospitalisations in Ontario were used by people with COPD. Individuals with COPD used about five times more health services for lung cancer, and two times more health services for lower respiratory tract infections and cardiovascular disease than people without COPD.Individuals with COPD use a disproportionate amount of health services for comorbid disease, placing significant burden on the healthcare system. @ERSpublications COPD responsible for significant proportion of all hospitalisations, emergency department visits and ambulatory care

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Section: Introductionmentioning

confidence: 99%

Quantifying comorbidity in individuals with COPD: a population study

et al. 2014

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“…The majority of upper respiratory tract infections and most uncomplicated cases of acute tracheobronchitis are due to respiratory viral infections [1]. Moreover, respiratory viruses play an important role as infective triggers of acute exacerbations of chronic respiratory diseases such as asthma [2][3][4][5] and chronic obstructive pulmonary disease (COPD) [6][7][8]. Human rhinoviruses (HRVs) were by far the most frequent respiratory viruses detected in most of the studies cited.…”

mentioning

confidence: 99%

Rhinovirus vaccination: the case in favour

Rohde¹

2010

European Respiratory Journal

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“…The most common causes of exacerbations are respiratory infections, with the resulting incidence of exacerbations showing seasonal variation, increasing in the winter months when there is greater circulation of respiratory viruses [Seemungal et al 1998;Wedzicha and Donaldson, 2003;Doherty and Briggs, 2004;Papi et al 2006;Sapey and Stockley, 2006]. In the healthy lung, innate defences protect the lower respiratory tract from infection [Sethi, 2010]. However, in COPD, pathological changes in the airways provide the ideal condition for bacterial colonization.…”

Section: The Burden Of Influenza In Copdmentioning

confidence: 99%

Influenza vaccination for patients with chronic obstructive pulmonary disease: understanding immunogenicity, efficacy and effectiveness

Sanei

Wilkinson

2016

Ther Adv Respir Dis

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Influenza infection is an important cause of global mortality and morbidity with the greatest impact on older people and those with chronic disease. Patients with chronic obstructive pulmonary disease (COPD) are particularly vulnerable to influenza, with evidence for increased incidence and severity of infection. In this patient group influenza is associated with exacerbations and pneumonia which result in a significant healthcare burden and premature mortality. Influenza vaccination and in particular the use of the seasonal trivalent influenza vaccine (TIV) is recommended for patients with COPD. The evidence base for its effects in this population is, however, limited. Available data suggest that immunogenicity is variable in COPD but the underlying mechanisms are not completely understood. The contribution of age, disease severity, comorbidity and treatments to vaccine responses has only been investigated in a limited manner. Existing data suggest that key immune mechanisms governing T-and B-cell responses are adversely affected by these factors. The efficacy of TIV has been studied in a number of small clinical trials which form the basis of a Cochrane review. Here evidence for effect is conflicting depending on individual trial design and inclusions. Overall, TIV offers protection against influenza infection in the trial setting but further studies are required to stratify patients and enable prediction of inadequate responses. Larger-scale clinical studies have largely been observational and have often been conducted in consort with pneumonia vaccination. Overall the mortality benefit of TIV in COPD is suggested by a number studies but the impact on exacerbation prevention is less clear. Influenza vaccination currently plays an important role in disease prevention in COPD. However, we postulate that a more in-depth understanding of mechanisms of response in the context of a highly heterogeneous disease will lead to a more informed approach to vaccination and greater benefit for the individual patient.

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Infection as a comorbidity of COPD

Cited by 212 publications

References 55 publications

Quantifying comorbidity in individuals with COPD: a population study

Quantifying comorbidity in individuals with COPD: a population study

Rhinovirus vaccination: the case in favour

Influenza vaccination for patients with chronic obstructive pulmonary disease: understanding immunogenicity, efficacy and effectiveness

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