TY - JOUR T1 - Adenovirus IgG avidity - A marker of outcome in COPD-exacerbations JF - European Respiratory Journal JO - Eur Respir J VL - 40 IS - Suppl 56 SP - P3475 AU - Lucas Boeck AU - Mesut Gencay AU - Michael Tamm AU - Mirjam Christ-Crain AU - Beat Mueller AU - Michael Roth AU - Daiana Stolz Y1 - 2012/09/01 UR - http://erj.ersjournals.com/content/40/Suppl_56/P3475.abstract N2 - BACKGROUND:Adenovirus causes respiratory infections in healthy and chronically ill adult individuals. Virus replication, cell lysis and inflammation provoke pulmonary damage. Little is known about adenovirus infection, reinfection and reactivation in acute exacerbations of COPD (AECOPD).OBJECTIVES:To evaluate effects of adenovirus infection during and after AECOPD.METHODS:208 patients with severe AECOPD were tested for anti-adenovirus antibodies at exacerbation and after two weeks. Outcome parameters were measured for two years.RESULTS:Studied patients were predominantly male (54.8%), had an age of 70.3 ±9.8 years, a FEV1 of 41.2 ±17.2 % predicted and smoked 45.2 ±27.9 pack years. At the time of exacerbation 39 patients (18.6 %) had anti-adenovirus IgM and low-avidity IgG, indicating a present adenovirus infection. At exacerbation, patients with acute adenovirus infection were younger (p=0.031) and presented a lower hospitalization rate in the previous year (p=0.037). In contrast, they reported a poorer health-related quality of life at admission (p=0.003) and persistendly impaired functional status 14 days after exacerbation (p=0.044). Patients with initial low-avidity adenovirus IgG who failed to convert into high-avidity adenovirus IgG within two weeks (n=13, 7%) had more recurrent AECOPDs within six months (1.23 vs. 0.63; p=0.032) and a shorter time to re-hospitalisation for AECOPD or death within two years (p=0.018).CONCLUSION:Adenovirus related severe AECOPDs potentially have a more severe clinical course. In addition, patients who remain at low-avidity adenovirus IgG are at higher risk for subsequent AECOPDs and hospitalisation or death. ER -