Analysis of the Effect of pneumococcal vaccination in patients with COPD in combination with bronchiectasis

Abstract

Objective: To analyze the clinical efficacy of PCV13 in patients with COPD in combination with bronchiectasis for 5 years.

Materials and methods: the study included 73 patients with COPD III (28.8%) and COPD IV (71.2%) in combination with bronchiectasis: bilateral - 67.1%, cylindrical - 82.2%, lower lobe - 60.3%. All male patients, average age 72.7 years, duration of COPD - 9.04 years, BMI 20.6 kg/m². At baseline all patients had a high frequency of COPD exacerbations - 3.13 (CI 95% 2-5), frequent hospitalizations - 2.37 (CI 95% 2-5), high incidence of pneumonia (32.9%). Clinical characteristics of subjects with bronchiectasis: daily sputum production (95.6%), dyspnea (mMRC 2.77, CI 95% 2-4), severe hypoxemia (SpO2 91.7%). All patients had a high level of inflammation markers: CRP - 8.07 mg/l (CI 95% 4.94-11.2), fibrinogen - 5.11 g/l (CI 95% 3.27-6.95).

Results: 5 years after PCV13 vaccination, the number of cases of pneumonia decreased by 3 times (registeres in 8 patients), decreased the incidence of COPD exacerbations by 1.4 times (2.18, CI 95% 1.12-3.24). After vaccinations improved clinical and laboratory parameters: decreased severe of dyspnea (mMRC 2.23, CI 95% 2-3), decreased the level of CRP (6.51 mg/l, CI 95% 5.5-7.5) and fibrinogen (3.84 g/l, CI 95% 2.67-5.01).

Thus, vaccination PCV13 in subjects with COPD in combination with bronchiectasis reduces the risk of adverse events and has positive effect on clinical, laboratory parameters and remains effective for 5 years.